WorldWideScience

Sample records for advanced wound management

  1. [Wound management].

    Science.gov (United States)

    Gresser, J; Bitz, K; Hegglin, J

    1992-07-01

    The following article is a check-list for wound care giving some practical hints. Special interest has been given to the themes of local anesthesia and prevention of infections. The indications and limits of the ambulant wound care are also discussed. Finally, a short explanation is given for the treatment of wounds situated at delicate regions of the body. PMID:1440441

  2. Management of gunshot wounds

    Energy Technology Data Exchange (ETDEWEB)

    Ordog, G.; Drew, R.

    1987-01-01

    Management of Gunshot Wounds provides a review of wound ballistics and a systemic review of gunshot wound management of all major body areas and systems. This volume includes information on pre-hospital care, nursing care, and care of infants, children, and the elderly patient with gunshot wounds. This volume also features information on: lead toxicity; complications of gunshot wounds; socioeconomic aspects of gunshot wounds; the forensic and pathological aspects of gunshot wounds; future directions in the care of gunshot wounds.

  3. Effectively managing wound exudate.

    Science.gov (United States)

    Chamanga, Edwin

    2015-09-01

    The management of wound exudate remains a clinical challenge despite technological advances in products with better exudate-handling capacities. This clinical challenge is occasionally encountered when thick exudate (viscous exudate) is present, and when most modern dressings do not possess the capabilities to manage the viscosity while enabling exudate absorption. Maceration to the peri-wound area poses another challenge, irrespective of the number of topical barrier application products on the market and the innovation of dressing products that lock exudate away or those that encourage vertical wicking. In addition to all the above, in clinical practice, the assessment and documentation of wound exudate remains sporadic, leading to the challenges of effective wound exudate dressing selection and cost-effective dressings. PMID:26322408

  4. Wound healing and treating wounds: Chronic wound care and management.

    Science.gov (United States)

    Powers, Jennifer G; Higham, Catherine; Broussard, Karen; Phillips, Tania J

    2016-04-01

    In the United States, chronic ulcers--including decubitus, vascular, inflammatory, and rheumatologic subtypes--affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers. PMID:26979353

  5. Novel advancements in wound healing

    Directory of Open Access Journals (Sweden)

    reza Ghaderi

    2014-05-01

    Full Text Available Maintaining skin integrity is vital in humans and animals to protect the organisms against dehydration, bleeding, and ingress of microorganisms. In order to do this, in Man and other evolved animals a sophisticated mechanism of wound healing occurs. At first the gap is quickly filled with a thin layer of fibrinous exudate, re-epithelialized, and rapidly replaced by new matrix. It is obvious that the speed of wound healing depends upon many factors such as the size of the wound, blood supply to the area, presence or absence of foreign bodies and microorganisms, age, health and nutritional status of the patient of the patient. Acute and chronic wounds care has extremely changed in recent years. Recenly, some traditional medications honey and other herbal medications( and new procedures are available that can be used to accelerate the healing of skin wounds.In the present article the most novel advances made in wound care and management in recent years were reviewed.

  6. Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective

    OpenAIRE

    Jeffery, Lt Col S. L. A.

    2009-01-01

    Objective: The purpose of this article is to describe the treatment of injuries resulting from land mine explosions using a holistic approach that includes gauze-based negative pressure wound therapy (NPWT) and encompasses wound bed preparation, exudate management, and infection control. Method: In the treatment of 3 traumatic injuries, each requiring limb amputation, we describe the application of NPWT using the Chariker-Jeter system, which uses a single layer of saline-moistened antimicrobi...

  7. Telemedicine for wound management

    Directory of Open Access Journals (Sweden)

    Ravi K Chittoria

    2012-01-01

    Full Text Available The 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.

  8. Managing painful chronic wounds: the Wound Pain Management Model

    DEFF Research Database (Denmark)

    Price, Patricia; Fogh, Karsten; Glynn, Chris;

    2007-01-01

    the wound should be handled as one of the main priorities in chronic wound management together with addressing the cause. Management of pain in chronic wounds depends on proper assessment, reporting and documenting patient experiences of pain. Assessment should be based on six critical dimensions of...... document persistent wound pain and not to develop a treatment and monitoring strategy to improve the lives of persons with chronic wounds. Unless wound pain is optimally managed, patient suffering and costs to health care systems will increase. Udgivelsesdato: 2007-Apr...

  9. Chronic wound management and research

    OpenAIRE

    Romanelli M

    2014-01-01

    Marco Romanelli Wound Healing Research Unit, Division of Dermatology, University of Pisa, Pisa, ItalyI would like to share with you a new open access peer-reviewed journal – Chronic Wound Care Management and Research, published by Dove Medical Press. Chronic Wound Care Management and Research is an international, peer-reviewed, open-access online journal publishing original research, case reports, reviews, editorials, and commentaries on the management of chronic wounds and...

  10. Recent advances in topical wound care

    OpenAIRE

    Sarabahi, Sujata

    2012-01-01

    There are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound,...

  11. Current concepts in wound management and wound healing products.

    Science.gov (United States)

    Davidson, Jacqueline R

    2015-05-01

    Current concepts in wound management are summarized. The emphasis is on selection of the contact layer of the bandage to promote a moist wound environment. Selection of an appropriate contact layer is based on the stage of wound healing and the amount of wound exudate. The contact layer can be used to promote autolytic debridement and enhance wound healing. PMID:25744144

  12. The management of perineal wounds

    Directory of Open Access Journals (Sweden)

    Ramesh k Sharma

    2012-01-01

    Full Text Available Management of perineal wounds can be very frustrating as these invariably get contaminated from the ano-genital tracts. Moreover, the apparent skin defect may be associated with a significant three dimensional dead space in the pelvic region. Such wounds are likely to become chronic and recalcitrant if appropriate wound management is not instituted in a timely manner. These wounds usually result after tumor excision, following trauma or as a result of infective pathologies like hideradenitis suppurativa or following thermal burns. Many options are available for management of perineal wounds and these have been discussed with illustrative case examples. A review of literature has been done for listing commonly instituted options for management of the wounds in perineum.

  13. Biophysical Technologies for Management of Wound Bioburden.

    Science.gov (United States)

    Korzendorfer, Holly; Hettrick, Heather

    2014-12-01

    Significance: Chronic wounds commonly have high levels of bioburden and antibiotic-resistant pathogens. This review article focuses on findings from current literature related to four biophysical technologies (ultrasound, electrical stimulation, phototherapy, and negative pressure wound therapy) believed to be beneficial for managing wound bioburden and support healing. Recent Advances and Critical Issues: Recent advances for each modality are provided as a basic synopsis of the technology followed by brief overviews of the most recent literature addressing its effectiveness for managing wound bioburden, and critical issues for each modality are provided as conclusions. Future Directions: This review highlights the need for further clinically relevant studies examining bacterial levels in addition to healing progression for each technology. PMID:25493207

  14. Advanced Therapeutic Dressings for Effective Wound Healing--A Review.

    Science.gov (United States)

    Boateng, Joshua; Catanzano, Ovidio

    2015-11-01

    Advanced therapeutic dressings that take active part in wound healing to achieve rapid and complete healing of chronic wounds is of current research interest. There is a desire for novel strategies to achieve expeditious wound healing because of the enormous financial burden worldwide. This paper reviews the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behind this demand. The paper reviews information mainly from peer-reviewed literature and other publicly available sources such as the US FDA. A major focus is the treatment of chronic wounds including amputations, diabetic and leg ulcers, pressure sores, and surgical and traumatic wounds (e.g., accidents and burns) where patient immunity is low and the risk of infections and complications are high. The main dressings include medicated moist dressings, tissue-engineered substitutes, biomaterials-based biological dressings, biological and naturally derived dressings, medicated sutures, and various combinations of the above classes. Finally, the review briefly discusses possible prospects of advanced wound healing including some of the emerging physical approaches such as hyperbaric oxygen, negative pressure wound therapy and laser wound healing, in routine clinical care. PMID:26308473

  15. Wound pruritus: pathophysiology and management

    Directory of Open Access Journals (Sweden)

    Paul JC

    2015-08-01

    Full Text Available Julia C PaulSchool of Nursing, Oakland University, Rochester, MI, USAPurpose: The objective of this article is to review literature on wound pruritus, with a focus on summarizing pathophysiology and management.Method: Literature related to the physiology of itch was reviewed. PubMed, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL, and Embase were searched for all research studies written in English which include “wound” (injury/burn and “pruritus” (itch in the title or abstract. Articles were accepted if they involved wounds or acute burns. Literature related to options for management of wound pruritus was reviewed.Results: While all types of wounds can be the source of associated pruritus, most studies have been done concerning pruritus associated with burns. There are treatment options for pruritus which can be considered for management of wound pruritus. Conclusion: Further research is indicated to gain insights into the problem of wound pruritus. As more is learned about the physiology of wound pruritus, more effective management strategies can be developed and employed.Keywords: wound, chronic itch, C-fibers, spinothalamic tract, positron emission tomography, pruritogens

  16. Principles of Wound Management and Wound Healing in Exotic Pets.

    Science.gov (United States)

    Mickelson, Megan A; Mans, Christoph; Colopy, Sara A

    2016-01-01

    The care of wounds in exotic animal species can be a challenging endeavor. Special considerations must be made in regard to the animal's temperament and behavior, unique anatomy and small size, and tendency toward secondary stress-related health problems. It is important to assess the entire patient with adequate systemic evaluation and consideration of proper nutrition and husbandry, which could ultimately affect wound healing. This article summarizes the general phases of wound healing, factors that affect healing, and principles of wound management. Emphasis is placed on novel methods of treating wounds and species differences in wound management and healing. PMID:26611923

  17. Recent advances in topical wound care

    Directory of Open Access Journals (Sweden)

    Sujata Sarabahi

    2012-01-01

    Full Text Available There are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound, and help to minimize pain and infection. The present dictum is to promote the concept of moist wound healing. This is in sharp contrast to the earlier practice of exposure method of wound management wherein the wound was allowed to dry. It can be quite a challenge for any physician to choose an appropriate dressing material when faced with a wound. Since wound care is undergoing a constant change and new products are being introduced into the market frequently, one needs to keep abreast of their effect on wound healing. This article emphasizes on the importance of assessment of the wound bed, the amount of drainage, depth of damage, presence of infection and location of wound. These characteristics will help any clinician decide on which product to use and where,in order to get optimal wound healing. However, there are no ′magical dressings′. Dressings are one important aspect that promotes wound healing apart from treating the underlying cause and other supportive measures like nutrition and systemic antibiotics need to be given equal attention.

  18. Management of radiation wounds

    OpenAIRE

    Subramania Iyer; Deepak Balasubramanian

    2012-01-01

    Radiotherapy forms an integral part in cancer treatment today. It is used alone or in combination with surgery and chemotherapy. Although radiotherapy is useful to effect tumour death, it also exerts a deleterious effect on surrounding normal tissues. These effects are either acute or can manifest months or years after the treatment. The chronic wounds are a result of impaired wound healing. This impairment results in fibrosis, nonhealing ulcers, lymphoedema and radionecrosis amongst others. ...

  19. Significant Differences in Nurses’ Knowledge of Basic Wound Management

    DEFF Research Database (Denmark)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B;

    2014-01-01

    of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found...... that the length of experience (adjusted for workplace and education) did not have any impact on nurses' knowledge. Nurses' knowledge of clinical investigations was consistently lower than their knowledge of therapy and clinical symptoms. This study provides benchmarking information about the current status......Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level...

  20. Management of radiation wounds

    Directory of Open Access Journals (Sweden)

    Subramania Iyer

    2012-01-01

    Full Text Available Radiotherapy forms an integral part in cancer treatment today. It is used alone or in combination with surgery and chemotherapy. Although radiotherapy is useful to effect tumour death, it also exerts a deleterious effect on surrounding normal tissues. These effects are either acute or can manifest months or years after the treatment. The chronic wounds are a result of impaired wound healing. This impairment results in fibrosis, nonhealing ulcers, lymphoedema and radionecrosis amongst others. This article will discuss the pathophysiology in brief, along with the manifestations of radiation-induced injury and the treatment available currently

  1. Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kaitani T

    2015-02-01

    Full Text Available Toshiko Kaitani,1 Gojiro Nakagami,2 Junko Sugama,3 Masahiro Tachi,4 Yutaka Matsuyama,5 Yoshiki Miyachi,6 Takashi Nagase,2 Yukie Takemura,7 Hiromi Sanada2 1School of Nursing, Sapporo City University, Hokkaido, Japan; 2Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; 4Department of Plastic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan; 5Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 6Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; 7Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan Aims and objectives: We investigated the effectiveness and safety of an advanced pressure ulcer (PU management protocol comprising 1 ultrasonography to assess the deep tissue, 2 use of a non-contact thermometer to detect critical colonization, 3 conservative sharp debridement, 4 dressing selection, 5 negative pressure wound therapy, and 6 vibration therapy in comparison with those of a conventional approach. Each protocol was followed by trained wound, ostomy, and continence nurses (WOCNs. Background: At present, there is no systematic PU management protocol for nurses that includes appropriate assessment and intervention techniques for deep tissue injury and critical colonization. In Japan, there is no such protocol that the nurses can follow without a physician’s orders. Design and methods: This was a prospective non-randomized controlled trial. Over a 3-week period, we evaluated the effectiveness of an advanced protocol by comparing the PU severity and healing on the basis of the DESIGN-R scale and presence of patients' discomfort. We recruited ten WOCNs to follow

  2. Current management of wound healing

    DEFF Research Database (Denmark)

    Gottrup, F; Karlsmark, T

    2009-01-01

    While the understanding of wound pathophysiology has progressed considerably over the past decades the improvements in clinical treatment has occurred to a minor degree. During the last years, however, new trends and initiatives have been launched, and we will continue to attain new information in...... the next decade. It is the hope that increasing parts of the new knowledge from basic wound healing research will be implemented in daily clinical practice. The development of new treatment products will also continue, and especially new technologies with combined types of dressing materials or...... dressing containing active substances will be accentuated. Further developments in the management structure and education will also continue and consensus of treatment guidelines, recommendations and organization models will hopefully be achieved....

  3. Medical management of radioactively contaminated wounds

    International Nuclear Information System (INIS)

    In addition to the usual measures involved in the medical management of wounds, the presence of radioactivity requires further considerations. In brief, these involve the decontamination of the surface area surrounding the wound, evaluation of the radioactivity contained in the wound, excision of the contaminated tissue, treatment with a regimen utilizing the intravenous administration of a suitable chelating agent, followed by urinary or faecel assay for a period of time. (author)

  4. Local wound care and topical management of hidradenitis suppurativa.

    Science.gov (United States)

    Alavi, Afsaneh; Kirsner, Robert S

    2015-11-01

    Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating disease predominantly involving apocrine gland-bearing skin. The folliculoinfundibular dysfunction and an aberrant cutaneous immune response to commensal bacteria are recognized as potential contributors. Topical antibiotics, such as clindamycin, and keratolytic agents have been used in the management of early stages of HS. Proper wound care is a key part of management, particularly in patients with advanced HS. The evidence for the optimal topical therapy or optimal local wound care is limited. As such, a multidisciplinary approach is necessary to address all aspects of HS, including topical therapy, systemic therapy, and proper wound care. The focus of this paper is to review the evidence for the topical management and local wound care strategies in patients with HS. PMID:26470618

  5. Cutaneous wound healing: Current concepts and advances in wound care

    OpenAIRE

    Kenneth C Klein; Somes Chandra Guha

    2014-01-01

    A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care. [1] It is a snapshot of a patient′s total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors. [2...

  6. Larva therapy in wound management.

    OpenAIRE

    Courtenay, M; Church, J C; Ryan, T J

    2000-01-01

    The use of maggots for wound debridement has a long history and has lately gained ground in several countries. We collected prospective data to examine the current use of larva therapy (LT) in the UK. Quantitative information was collected on 70 patients treated in nine hospitals. LT is used primarily to treat leg ulcers and generally involves three applications of larvae at two to three day intervals. This method is judged effective in wound debridement and promotes the growth of granulation...

  7. Use of advanced technologies across the wound care spectrum: prologue.

    Science.gov (United States)

    Kirsner, Robert S; Romanelli, Marco

    2016-09-01

    The growing trends of ageing populations and increasing prevalence of diabetes have given rise to an expanding number of problematic acute and chronic wounds. Over the past two decades, the use of negative pressure wound therapy (NPWT) with and without instillation of topical wound solutions has expanded to include treatment of a large variety of wounds. Additionally, the use of NPWT specifically designed for use over closed surgical incisions has been associated with favourable results. The recent introduction of an automated epidermal harvesting system, which neither creates a donor site wound nor requires the use of a surgeon, operating room or anaesthesia, has facilitated the use of epidermal grafting. This supplement highlights some of the advanced wound approaches that have been developed to address challenging wounds and the growing burden of wound care affecting both the patient and the health care system. PMID:27547957

  8. DIABETIC WOUND HEALING MANAGEMENT- A PEER REVIEW

    OpenAIRE

    Harshavardhan Pathapati; T.E. Gopala Krishna Murthy; B. Ramanaiah; Davu Srinivas

    2014-01-01

    Objectives: Diabetes is a metabolic disorder mainly impairs the body glucose utilization capacity due to this perforcely repressing the immuno-dysfunction (decreases chemotaxis, phagocytosis and intracellular killing actions) and collagen synthesis which are essential in wound debridement management of diabetic patients. Delayed wound healing is considered as one of the most repulsive disabling and costly complication of diabetes. People with diabetes have extenuated circulation, poor resista...

  9. Cutaneous wound healing: Current concepts and advances in wound care

    Directory of Open Access Journals (Sweden)

    Kenneth C Klein

    2014-01-01

    Full Text Available A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care. [1] It is a snapshot of a patient′s total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors. [2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT, as used at our institution (CAMC, and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society may vary widely from country to country and payment system. [3] In the USA, CMS (Centers for Medicare and Medicaid Services approved indications for HBOT vary from that of the UHMS for logistical reasons. [1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise.

  10. Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

    OpenAIRE

    Kaitani T; Nakagami G; Sugama J; Tachi M; Matsuyama Y; Miyachi Y; Nagase T; Takemura Y; Sanada H

    2015-01-01

    Toshiko Kaitani,1 Gojiro Nakagami,2 Junko Sugama,3 Masahiro Tachi,4 Yutaka Matsuyama,5 Yoshiki Miyachi,6 Takashi Nagase,2 Yukie Takemura,7 Hiromi Sanada2 1School of Nursing, Sapporo City University, Hokkaido, Japan; 2Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; 3Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; 4Department of Plastic ...

  11. A comprehensive review of advanced biopolymeric wound healing systems.

    Science.gov (United States)

    Mayet, Naeema; Choonara, Yahya E; Kumar, Pradeep; Tomar, Lomas K; Tyagi, Charu; Du Toit, Lisa C; Pillay, Viness

    2014-08-01

    Wound healing is a complex and dynamic process that involves the mediation of many initiators effective during the healing process such as cytokines, macrophages and fibroblasts. In addition, the defence mechanism of the body undergoes a step-by-step but continuous process known as the wound healing cascade to ensure optimal healing. Thus, when designing a wound healing system or dressing, it is pivotal that key factors such as optimal gaseous exchange, a moist wound environment, prevention of microbial activity and absorption of exudates are considered. A variety of wound dressings are available, however, not all meet the specific requirements of an ideal wound healing system to consider every aspect within the wound healing cascade. Recent research has focussed on the development of smart polymeric materials. Combining biopolymers that are crucial for wound healing may provide opportunities to synthesise matrices that are inductive to cells and that stimulate and trigger target cell responses crucial to the wound healing process. This review therefore outlines the processes involved in skin regeneration, optimal management and care required for wound treatment. It also assimilates, explores and discusses wound healing drug-delivery systems and nanotechnologies utilised for enhanced wound healing applications. PMID:24985412

  12. Applications of modern sensors and wireless technology in effective wound management.

    Science.gov (United States)

    Mehmood, Nasir; Hariz, Alex; Fitridge, Robert; Voelcker, Nicolas H

    2014-05-01

    The management of chronic wounds has emerged as a major health care challenge during the 21st century consuming, significant portions of health care budgets. Chronic wounds such as diabetic foot ulcers, leg ulcers, and pressure sores have a significant negative impact on the quality of life of affected individuals. Covering wounds with suitable dressings facilitates the healing process and is common practice in wound management plans. However, standard dressings do not provide insights into the status of the wound underneath. Parameters such as moisture, pressure, temperature and pH inside the dressings are indicative of the healing rate, infection, and wound healing phase. But owing to the lack of information available from within the dressings, these are often changed to inspect the wound, disturbing the normal healing process of wounds in addition to causing pain to the patient. Sensors embedded in the dressing would provide clinicians and nurses with important information that would aid in wound care decision making, improve patient comfort, and reduce the frequency of dressing changes. The potential benefits of this enabling technology would be seen in terms of a reduction in hospitalization time and health care cost. Modern sensing technology along with wireless radio frequency communication technology is poised to make significant advances in wound management. This review discusses issues related to the design and implementation of sensor technology and telemetry systems both incorporated in wound dressings to devise an automated wound monitoring technology, and also surveys the literature available on current sensor and wireless telemetry systems. PMID:24142514

  13. [Nursing management of wound care pain].

    Science.gov (United States)

    Chin, Yen-Fan

    2007-06-01

    Wound care is an important step in promoting wound healing, but it may cause wound care pain. This article aims to explore factors influencing wound care pain and the effectiveness of various interventions to alleviate it. Five major factors that influence wound care pain include inappropriate dressing change techniques, inflammation response, emotion, cognition, and social-cultural factors. Nurses should apply appropriate dressings and dressing change techniques to relieve wound care pain. Music therapy and aromatherapy can alleviate wound pain after dressing change. But distraction techniques should be used in conjunction with consideration of the needs of the individual subject. PMID:17554674

  14. Wound management for the 21st century: combining effectiveness and efficiency.

    Science.gov (United States)

    Lindholm, Christina; Searle, Richard

    2016-07-01

    Treatment of wounds of different aetiologies constitutes a major part of the total health care budget. It is estimated that 1·5-2 million people in Europe suffer from acute or chronic wounds. These wounds are managed both in hospitals and in community care. The patients suffering from these wounds report physical, mental and social consequences of their wounds and the care of them. It is often believed that the use of wound dressings per se is the major cost driver in wound management, whereas in fact, nursing time and hospital costs are together responsible for around 80-85% of the total cost. Healing time, frequency of dressing change and complications are three important cost drivers. However, with the use of modern, advanced technology for more rapid wound healing, all these cost drivers can be substantially reduced. A basic understanding of the terminology and principles of Health Economics in relation to wound management might therefore be of interest. PMID:27460943

  15. Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment: A Protocol With 3 Case Examples.

    Science.gov (United States)

    Benskin, Linda L

    2016-06-01

    Patients with acute wounds often delay seeking medical assistance until an incapacitating infection has developed. When such patients come for help at a remote Christian clinic in northern Ghana, West Africa, the goals of care are to resolve and prevent a return of infection, decrease pain, enable an immediate return to normal activities, and facilitate healing. Because the local protocol of care, Edinburgh University Solution of Lime (EUSOL)-soaked gauze, did not meet these goals, the author tried using a variety of donated wound dressing regimens. Ultimately, polymeric membrane dressings (PMDs) were observed to meet patient care needs while also reducing clinic staff time and resources, and a PMD protocol of care was developed. Three (3) representative patients who presented with acute wounds and infection are described: a 20-year-old man with a hand abscess, a 16-year-old boy with a malleolus wound, and an approximately 20-year-old woman with an injection abscess, all otherwise relatively healthy, albeit undernourished. All 3 patients re- ceived oral antibiotics, their wounds were initially cleansed and debrided, and an appropriate configuration of either regular or silver-containing PMDs was applied to all exposed wound surfaces. Dressing changes were scheduled based upon the personalized plan of care. In all 3 patients, the pain-relieving properties of PMDs allowed resumption of activi- ties within 1 day of initiating treatment, the dressings' continuous wound cleansing system kept the wounds clean and free of infection despite the challenging environment, and the wounds healed steadily. Managing infected acute wounds with PMDs through complete wound closure was time efficient for clinic staff and met all 4 major patient goals of care. Randomized, controlled studies to compare wound and quality of life outcomes in patients whose infected wounds are managed with PMDs compared with those whose wounds are managed with other advanced dressings are warranted. PMID

  16. Advanced skin, scar and wound care centre for children: A new era of care

    Science.gov (United States)

    Burd, Andrew; Huang, Lin

    2012-01-01

    Advanced wound care centres are now a well established response to the growing epidemic of chronic wounds in the adult population. Is the concept transferable to children? Whilst there is not the same prevalence of chronic wounds in children there are conditions affecting the integumentary system that do have a profound effect on the quality of life of both children and their families. We have identified conditions involving the skin, scars and wounds which contribute to a critical number of potential patients that can justify the setting up of an advanced skin, scar and wound care centre for children. The management of conditions such as giant naevi, extensive scarring and epidermolysis bullosa challenge medical professionals and lead to new and novel treatments to be developed. The variation between and within such conditions calls for a customizing of individual patient care that involves a close relationship between research scientists and clinicians. This is translational medicine of its best and we predict that this is the future of wound care particularly and specifically in children. PMID:23162215

  17. Advanced skin, scar and wound care centre for children: A new era of care

    Directory of Open Access Journals (Sweden)

    Andrew Burd

    2012-01-01

    Full Text Available Advanced wound care centres are now a well established response to the growing epidemic of chronic wounds in the adult population. Is the concept transferable to children? Whilst there is not the same prevalence of chronic wounds in children there are conditions affecting the integumentary system that do have a profound effect on the quality of life of both children and their families. We have identified conditions involving the skin, scars and wounds which contribute to a critical number of potential patients that can justify the setting up of an advanced skin, scar and wound care centre for children. The management of conditions such as giant naevi, extensive scarring and epidermolysis bullosa challenge medical professionals and lead to new and novel treatments to be developed. The variation between and within such conditions calls for a customizing of individual patient care that involves a close relationship between research scientists and clinicians. This is translational medicine of its best and we predict that this is the future of wound care particularly and specifically in children.

  18. Management of postoperative instrumented spinal wound infection

    Institute of Scientific and Technical Information of China (English)

    FANG Xiu-tong; Kirkham B.Wood

    2013-01-01

    Background Wound infection following spinal instrumented surgery is a frequent complication.The optimal treatment of acute deep wound infection following spinal instrumentation fusion remains controversial because of variability in cohort identification,definition of an infection,and the instrument used to measure outcomes.This retrospective study evaluated the clinical curative effect for postoperative spinal infection after instrumented spine fusion with extensive debridement,or implant removal.Methods From January 2004 to October 2009,851 patients were identified who underwent surgical treatment of spinal diseases.The medical records of patients who developed infections were reviewed in detail.Results Of 851 patients,41 (4.9%) developed an infection.Thirty-three were acute,and eight were delayed.Acute infected cases were managed with antibiotic therapy,and aggressive debridement of the wound and soft tissues leaving all instrumentation in situ in all but one patient.The most common symptoms of acute infection included:posterior incisional drainage (26 of 33 patients),back pain (22 of 33 patients) and fever (13 of 33 patients).Among patients with delayed onset infection,five of eight patients had local pain,four of eight patients had incision drainage,and one patient had a prolonged period of intermittent fever.The most frequent causative organism for postoperative spinal infection following spine surgery is Staphylococcus aureus.Pseudarthrosis was noted in long-term follow-up in four of 41 patients.Conclusions We recommend irrigation and debridement,no instrumentation removal,and,if necessary,repeat debridement followed by delayed primary closure for the treatment of acute deep infection with instrumentation.

  19. Understanding effective management of postoperative wounds

    OpenAIRE

    Ousey, Karen; Roberts, Peter

    2013-01-01

    Acute surgical wounds generally heal with no problems. However, some wounds blister around the periwound area and surgical site infection postoperatively, partly due to inappropriate choice of wound dressing. These complications can cause pain, discomfort, persistent wound leakage, and possible risk of surgical site infection (Jester et al, 2000; Bhattacharyya et al, 2005; Cosker et al, 2005). Postoperative blistering and infection have been identified as the main problems in hip and knee rep...

  20. EDUCATIONAL PERSPECTIVES ON SIMULATED LEARNING IN WOUND MANAGEMENT

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    2014-01-01

    them the opportunity to practice skills and gives a realistic insight in the com-plexity of managing the chronic wound. Conclusions: Simulated learning is a useful pedagogical strategy in wound management. It is effective in relation to practical skills training and ability to reflect. It is yet......Aim: The aim was to explore whether simulated learning is useful in relation to wound management among undergraduate student nurses. Methods: A key element in simulated learning is to create an authentic environment. The pur-pose of establishing collaboration with a private company was to keep...... authenticity of the simulated learning. The objectives of the course are that students can identify different kinds of chronic wounds and risk factors contributing to decreased wound healing. This demands knowledge related to skin and wound types. We used five medium fidelity mannequins equipped with...

  1. The importance of tetanus risk assessment during wound management

    Directory of Open Access Journals (Sweden)

    Sarah Collins

    2015-01-01

    Full Text Available Public Health England undertakes surveillance of vaccine preventable diseases including enhanced surveillance of clinically suspected tetanus. In the United Kingdom, tetanus has become increasingly rare due to the success of the national routine immunization program. Consequently, few practitioners have experience of diagnosing and managing patients with clinical tetanus. We report two cases of tetanus where comparatively minor wounds proved fatal. These cases highlight the importance of the accurate identification and management of tetanus prone wounds and the fatal consequences from untreated injuries in susceptible individuals. We conclude that appropriate risk assessment for tetanus prophylaxis forms an essential part of wound management.

  2. The importance of tetanus risk assessment during wound management.

    Science.gov (United States)

    Collins, Sarah; White, Joanne; Ramsay, Mary; Amirthalingam, Gayatri

    2015-01-01

    Public Health England undertakes surveillance of vaccine preventable diseases including enhanced surveillance of clinically suspected tetanus. In the United Kingdom, tetanus has become increasingly rare due to the success of the national routine immunization program. Consequently, few practitioners have experience of diagnosing and managing patients with clinical tetanus. We report two cases of tetanus where comparatively minor wounds proved fatal. These cases highlight the importance of the accurate identification and management of tetanus prone wounds and the fatal consequences from untreated injuries in susceptible individuals. We conclude that appropriate risk assessment for tetanus prophylaxis forms an essential part of wound management. PMID:26793439

  3. News in wound healing and management

    DEFF Research Database (Denmark)

    Gottrup, Finn; Jørgensen, Bo; Karlsmark, Tonny

    2009-01-01

    . In the treatment of wounds, the new trend in the wound device marked is to produce dressings containing compounds or drugs. This could be local antiseptics (silver, other antiseptics, honey) and pain relieving drugs such as ibuprofen and morphine. New treatments such as anti-tumor necrosis factor...

  4. SELF WOUND MANAGEMENT PRACTICES BEFORE ATTENDING ANTIRABIES VACCINE CLINIC

    Directory of Open Access Journals (Sweden)

    Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda

    2015-07-01

    Full Text Available Introduction: In INDIA almost 20000 people die (40% of world death each year from rabies. Most of these deaths could be prevented by post exposure prophylaxis with wound washing, rabies immunoglobulin & vaccination. Local wound management alone can reduce viral load by up to 80%. Objective: To study self-wound management practices in animal exposure patients before attending a tertiary level ARV clinic. Methodology: Data regarding wound management was collected by individual interview of patients attending the ARV clinic during OCT 2011 to MAR 2012. The data collected in the form of a questionnaire. Analysis of data was done in the Department Of Community Medicine, V.S.S. Medical College, Burla. Results: Total 493 cases of animal exposure were attended during the study period. Most common biting animal was dog (94.5%. 31% of cases were under the age of 10 years & 23% belongs to the age of 10-19 years. Male to female ratio was 3:1. Most of the cases (91% were of category III exposure. Immediate management of wound was practiced by 63-77% of cases before visiting ARV clinic; only 2% wash the wound with running water & soap for 15 minutes. 39% of cases applied Dettol/savlon at the wound side & other 38% applied turmeric, red chilli, kerosene, Band-Aid & ghee locally. Most cases (61% reported to ARV clinic within 24hours.

  5. [Hydroactive stage-adapted wound management].

    Science.gov (United States)

    Karl, T

    2012-09-01

    The treatment of subacute and chronic wounds is not only a major medical challenge but because of demographic developments and the concurrent increase in predisposing diseases, such as diabetes mellitus and arterial occlusive disease is also a relevant socioeconomic challenge. The principle of modern, moist wound care can now be regarded as established. In daily practice there are nevertheless significant treatment problems which are, among other things due to the vast variety of products available. As evidence-based guidelines for the treatment of chronic wounds were until recently lacking and many question were left unanswered, standards of care represent an appropriate means of orientation. In addition to improved quality of care in this way costs can also be reduced. Furthermore, criteria can be illustrated by which the selection of appropriate wound dressings can be facilitated and established. PMID:22935896

  6. Advances in Wound Healing: A Review of Current Wound Healing Products

    OpenAIRE

    Murphy, Patrick S.; Gregory R.D. Evans

    2012-01-01

    Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest appl...

  7. Advances in research on mechanisms of the effect of negative pressure wound treatment in wound healing

    OpenAIRE

    Li, Lei(Beijing Institute of Petrochemical Technology, Beijing, 102617, People's Republic of China); Kai-yang LV; Wu, Guo-Sheng; Zhu, Shi-hui

    2014-01-01

    Negative pressure wound treatment (NPWT) refers to apply a highly porous material between the wound and a semipermeable membrane, and it is then connected to a suction apparatus, leading to a minimal deformation of wound, resulting in promoting cell proliferation and wound repair. These devices may significantly expedite wound healing, facilitate the formation of granulation tissue, and reduce the complexity of subsequent reconstructive operations. In recent years, along with wide clinical us...

  8. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical efficacy of Negative Pressure Wound Therapy (NPWT) using Vacuum Assisted Closure (VAC) compared with Advanced Moist Wound Therapy (AMWT) to treat Diabetic Foot Ulcer (DFU). Study Design: Randomized control trial. Place and Duration of Study: Surgical Department, Combined Military Hospital (CMH) / Military Hospital (MH), Rawalpindi, from November 2010 to June 2012. Methodology: The study consisted of 278 patients, with 139 patients each in Group A and B, who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio (UTHCSA) image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks. Results: Mean age of presentation in group Awas 55.88 10.97 years while in group B, it was 56.83 ± 11.3 (p=0.48). Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B, respectively (p=0.74). Majority of patients had Wagner's grade 2 ulcer (82% in group A and 87.8% in group B, p= 0.18). Initial wound size in group A was 15.07 ± 2.92 cm2and in group B 15.09 ± 2.81 cm2(p = 0.95). Wound size measured after 2 weeks, treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 (p < 0.001). Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A(p < 0.001). Conclusion: NPWT using VAC was more efficacious than AMWT in the management of diabetic foot ulcers. (author)

  9. Advances in research on mechanisms of the effect of negative pressure wound treatment in wound healing

    Directory of Open Access Journals (Sweden)

    Lei LI

    2014-10-01

    Full Text Available Negative pressure wound treatment (NPWT refers to apply a highly porous material between the wound and a semipermeable membrane, and it is then connected to a suction apparatus, leading to a minimal deformation of wound, resulting in promoting cell proliferation and wound repair. These devices may significantly expedite wound healing, facilitate the formation of granulation tissue, and reduce the complexity of subsequent reconstructive operations. In recent years, along with wide clinical use, the therapeutic effect of NPWT has been recognized, but the mechanism of its clinical effect still needs further research. DOI: 10.11855/j.issn.0577-7402.2014.08.15

  10. Acute wound management: revisiting the approach to assessment, irrigation, and closure considerations

    OpenAIRE

    Nicks, Bret A.; Ayello, Elizabeth A.; Woo, Kevin; Nitzki-George, Diane; Sibbald, R. Gary

    2010-01-01

    Background As millions of emergency department (ED) visits each year include wound care, emergency care providers must remain experts in acute wound management. The variety of acute wounds presenting to the ED challenge the physician to select the most appropriate management to facilitate healing. A complete wound history along with anatomic and specific medical considerations for each patient provides the basis of decision making for wound management. It is essential to apply an evidence‐bas...

  11. An audit to determine the clinical effectiveness of a pathway for managing wound infection

    OpenAIRE

    Grothier, Lorraine; Stephenson, John

    2015-01-01

    Prevention of wound infection is a key objective in the planning of care for patients with wounds. The potential for wound infection, particularly in chronic wounds that are heavily contaminated with bacteria, can be high (Bowler et al, 2001). Wound infection can negatively affect the patient experience, causing pain, delayed healing and poor clinical outcomes (Butcher, 2011). This article outlines the introduction of a clinical pathway for identifying and managing wound infection in a commun...

  12. Managing Advanced Parkinson Disease

    Science.gov (United States)

    ... well.” 11 Managing Advanced Parkinson Disease DENTAL CARE Oral hygiene should remain an important part of the daily routine in order to prevent serious dental problems and the development of other illnesses. The ...

  13. Wound Care.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve. PMID:26022525

  14. Prehospital advanced trauma life support for critical penetrating wounds to the thorax and abdomen.

    Science.gov (United States)

    Pons, P T; Honigman, B; Moore, E E; Rosen, P; Antuna, B; Dernocoeur, J

    1985-09-01

    The role of advanced trauma life support (ATLS) in the prehospital care of the critically injured is highly controversial. This study analyzes the efficacy of ATLS in the management of critical penetrating wounds of the thorax and abdomen. In the 2 1/2-year period ending July 1984, 203 consecutive patients underwent emergency laparotomy or thoracotomy for gunshot and stab wounds. All patients were treated in the field by advanced paramedics (EMT-P). For gunshot wounds the mean time (+/- S.E.M.) responding to the scene was 4.5 (+/- 0.29) minutes, on the scene 10.1 (+/- 0.41) minutes, and returning to the hospital 6.4 (+/- 0.32) minutes. For stab wounds the mean time responding to the scene was 4.8 (+/- 0.21) minutes, on the scene 9.5 (+/- 0.37) minutes, and returning to the hospital 5.7 (+ 0.30) minutes. The number of intravenous lines started averaged 1.8 per patient. Eighty-one patients had PASG applied and 28 patients underwent endotracheal intubation (21 orally, seven nasally). Thirty-three patients had no obtainable blood pressure, of whom six survived (18%). One hundred sixty (94%) of the remaining 170 patients who had any initial blood pressure survived. One hundred nine (55%) patients had an increase in BP greater than or equal to 10 mm Hg (average, 35.6 mm Hg), 64 (32%) had no significant change, and 25 (13%) had a fall greater than or equal to 10 mm Hg (average, 24.2 mm Hg) from the field to the emergency department. Twenty (80%) of the 25 patients with a fall in blood pressure survived.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4032506

  15. Negative pressure wound therapy: clinical utility

    OpenAIRE

    Sandoz H

    2015-01-01

    Heidi Sandoz Accelerate CIC, Mile End Hospital, London, UK Abstract: Negative pressure wound therapy (NPWT), also known as topical negative pressure therapy, has been increasingly used in health care for the management of a wide variety of wounds over the last 2–3 decades. It is an advanced therapy that can be helpful to accelerate wound healing in both acute and chronic wounds by delivering negative pressure (suction) to the wound bed. More recent advancements in the application of NP...

  16. Negative pressure wound therapy: clinical utility

    OpenAIRE

    Sandoz H

    2015-01-01

    Heidi Sandoz Accelerate CIC, Mile End Hospital, London, UK Abstract: Negative pressure wound therapy (NPWT), also known as topical negative pressure therapy, has been increasingly used in health care for the management of a wide variety of wounds over the last 2–3 decades. It is an advanced therapy that can be helpful to accelerate wound healing in both acute and chronic wounds by delivering negative pressure (suction) to the wound bed. More recent advancements in the application o...

  17. Advanced Distribution Management System

    Science.gov (United States)

    Avazov, Artur R.; Sobinova, Liubov A.

    2016-02-01

    This article describes the advisability of using advanced distribution management systems in the electricity distribution networks area and considers premises of implementing ADMS within the Smart Grid era. Also, it gives the big picture of ADMS and discusses the ADMS advantages and functionalities.

  18. Difficult wounds: radiation wounds

    International Nuclear Information System (INIS)

    In an era of modern radiotherapy, problems associated with the indiscriminate treatment of benign disease have largely disappeared. Skin sparing effects of super voltage radiation equipment make the problems previously seen with orthovoltage equipment less frequent. Vigilance on the part of the workers in the field, in general, protects from the disasters that befell Thomas Edison's laboratory assistant. Despite these modern advances, the reconstructive surgeon often faces problems of managing acute local radiation injury from accident following planned therapeutic radiation or the ulcerations and breakdowns seen months or years after radiation therapy. The single most serious hazard to surgery in radiated tissue is the lodgment of bacteria in this tissue rendered avascular by the radiation and secondary necrosis from the infection itself. The principles of management are no different from those used for other chronic granulating wounds: local wound care, appropriate topical antibacterial therapy, systemic antibiotics during the perioperative period and, most importantly, adequate soft tissue coverage

  19. The importance of tetanus risk assessment during wound management

    OpenAIRE

    Sarah Collins; Joanne White; Mary Ramsay; Gayatri Amirthalingam

    2014-01-01

    Public Health England undertakes surveillance of vaccine preventable diseases including enhanced surveillance of clinically suspected tetanus. In the United Kingdom, tetanus has become increasingly rare due to the success of the national routine immunization program. Consequently, few practitioners have experience of diagnosing and managing patients with clinical tetanus. We report two cases of tetanus where comparatively minor wounds proved fatal. These cases highlight the importance of the ...

  20. Field surgery on a future conventional battlefield: strategy and wound management.

    OpenAIRE

    Ryan, J M; Cooper, G. J.; Haywood, I. R.; Milner, S. M.

    1991-01-01

    Most papers appearing in the surgical literature dealing with wound ballistics concern themselves with wound management in the civilian setting. The pathophysiology of modern war wounds is contrasted with ballistic wounds commonly encountered in peacetime, but it should be noted that even in peacetime the modern terrorist may have access to sophisticated military weaponry, and that patients injured by them may fall within the catchment area of any civilian hospital. Management problems associ...

  1. In Vitro Models in Biocompatibility Assessment for Biomedical-Grade Chitosan Derivatives in Wound Management

    OpenAIRE

    Lim Chin Keong; Ahmad Sukari Halim

    2009-01-01

    One of the ultimate goals of wound healing research is to find effective healing techniques that utilize the regeneration of similar tissues. This involves the modification of various wound dressing biomaterials for proper wound management. The biopolymer chitosan (b-1,4-D-glucosamine) has natural biocompatibility and biodegradability that render it suitable for wound management. By definition, a biocompatible biomaterial does not have toxic or injurious effects on biological systems. Chemica...

  2. Recent advances on the development of wound dressings for diabetic foot ulcer treatment--a review.

    Science.gov (United States)

    Moura, Liane I F; Dias, Ana M A; Carvalho, Eugénia; de Sousa, Hermínio C

    2013-07-01

    Diabetic foot ulcers (DFUs) are a chronic, non-healing complication of diabetes that lead to high hospital costs and, in extreme cases, to amputation. Diabetic neuropathy, peripheral vascular disease, abnormal cellular and cytokine/chemokine activity are among the main factors that hinder diabetic wound repair. DFUs represent a current and important challenge in the development of novel and efficient wound dressings. In general, an ideal wound dressing should provide a moist wound environment, offer protection from secondary infections, remove wound exudate and promote tissue regeneration. However, no existing dressing fulfills all the requirements associated with DFU treatment and the choice of the correct dressing depends on the wound type and stage, injury extension, patient condition and the tissues involved. Currently, there are different types of commercially available wound dressings that can be used for DFU treatment which differ on their application modes, materials, shape and on the methods employed for production. Dressing materials can include natural, modified and synthetic polymers, as well as their mixtures or combinations, processed in the form of films, foams, hydrocolloids and hydrogels. Moreover, wound dressings may be employed as medicated systems, through the delivery of healing enhancers and therapeutic substances (drugs, growth factors, peptides, stem cells and/or other bioactive substances). This work reviews the state of the art and the most recent advances in the development of wound dressings for DFU treatment. Special emphasis is given to systems employing new polymeric biomaterials, and to the latest and innovative therapeutic strategies and delivery approaches. PMID:23542233

  3. Advanced thermal management materials

    CERN Document Server

    Jiang, Guosheng; Kuang, Ken

    2012-01-01

    ""Advanced Thermal Management Materials"" provides a comprehensive and hands-on treatise on the importance of thermal packaging in high performance systems. These systems, ranging from active electronically-scanned radar arrays to web servers, require components that can dissipate heat efficiently. This requires materials capable of dissipating heat and maintaining compatibility with the packaging and dye. Its coverage includes all aspects of thermal management materials, both traditional and non-traditional, with an emphasis on metal based materials. An in-depth discussion of properties and m

  4. COLLAGEN DRESSING VERSUS HEPARIN DRESSING IN BURN WOUND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Rakesh

    2013-11-01

    Full Text Available One of the greatest discoveries of mankind is the double edge sword “fi re”. This has been both a boon and a bane to mankind, on one side it helps in the survival and on the other it causes suffering to those who succumb to its injuries. Burn injuries are known for their complexity and their treatment requires a complete under standing of patho - physiology and interaction of the major organ systems. In India burn injuries account for most of the hospital admissions. Various treatment options are available for burn wound management. Heparin and collagen are the two dressings have been found to useful in burn wound management, hence we decided to study their comparison in burn wound management. AIMS: In view of the above said we considered to study the effectiveness of collagen dressing in treating burns with that of heparin dressin g. METHODS AND MATERIAL: A prospective study was done at between June 2010 to September 2012 in which 100 patients who presented with second degree burns were chosen by random sampling technique, and were grouped into 2 groups consisting of 50 patients eac h after excluding patients who did not meet the inclusion criteria and those who met the exclusion criteria . STATISTICAL ANALYSIS: Chi square test, Fishers exact test used to assess the statistically significant values. Values of p<0.05 or less were consid ered to be statistically significant. RESULTS: In our study it was observed that duration taken for wound healing is lesser in the collagen group than heparin group, 17.36 days in case of collagen dressing and 21.26 days in case of conventional dressings. It was also observed that duration of hospital stay was less that is 10.02 days in those treated with collagen dressing as compared to 15.32 days in heparin group. It was also observed that there was less pain and better patient compliance with collagen dr essing. CONCLUSION: Collagen sheet is very useful in second - degree burns when compared to heparin. It

  5. Wound healing and hyper-hydration - a counter intuitive model

    OpenAIRE

    Ousey, Karen; Cutting, Keith

    2016-01-01

    Winters seminal work in the 1960s relating to providing an optimal level of moisture to aid wound healing (granulation and re-epithelialisation) has been the single most effective advance in wound care over many decades. As such the development of advanced wound dressings that manage the fluidic wound environment have provided significant benefits in terms of healing to both patient and clinician. Although moist wound healing provides the guiding management principle confusion may arise betwe...

  6. Maggot Debridement Therapy: Advancing to the Past in Wound Care.

    Science.gov (United States)

    Klaus, Kelsey; Steinwedel, Cynthia

    2015-01-01

    Maggot debridement therapy (MDT) is experiencing resurgence as an effective alternative to conventional mechanical debridement in nonhealing wounds, especially those with antibiotic-resistant organisms. MDT has antibiotic, antifungal, and anti-inflammatory properties. Military use is on the rise. PMID:26863704

  7. Managing Acute Wounds with Negative Pressure System in a Developing Country

    OpenAIRE

    Akpaloo, J.; Yorke, J.; Agbenorku, P.; Yenli, E. M. T.

    2013-01-01

    Introduction. The negative pressure system has been found to be a valuable addition to the various procedures of wound management and has been widely accepted to be safe and effective in promoting wound healing. Aim. The study seeks to find out the outcome of the use of the VAC device in the treatment of patients with acute wounds. Materials and Methods. Between January 2009 and December 2011, a consecutive nonrandomized study was conducted among 48 patients who presented with acute wounds at...

  8. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    Science.gov (United States)

    Skerritt, Louise; Moore, Zena

    2014-06-01

    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care. PMID:24912830

  9. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    LENUS (Irish Health Repository)

    Skerritt, Louise

    2014-06-01

    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care.

  10. Nutrition in Wound Care Management: A Comprehensive Overview.

    Science.gov (United States)

    Quain, Angela M; Khardori, Nancy M

    2015-12-01

    Wound care is a multidisciplinary specialty requiring many physiologic and immunologic processes as well as physical, social, and societal factors to achieve successful wound closure. Most wounds are treated with combinations of antimicrobials, protective barriers, and topical growth agents, including skin and biologic grafts.The role of nutrition in wound healing may be overlooked in the wound care patient. Like the specialty, it is often multifaceted, with many nutritional components playing a variety of roles in the wound healing process. Suboptimal nutrition can alter immune function, collagen synthesis, and wound tensile strength, all of which are essential in the wound healing process. It is also important to remember that not all wounds are equal: a burn is different from a diabetic foot ulcer, which is different from a pressure ulcer. Nonetheless, nutrition is a common denominator for all wound patients, and what is studied in 1 wound population is often relevant in another. Due to the complexities of monitoring and measuring both wound healing and dietary intake, randomized, controlled trials of wound care patients are difficult to conduct, and much of the data concerning nutrition in wound care relies on combined supplements. In summary, it appears that some nutrients are necessary only if deficient, whereas others may become conditionally essential and serve a therapeutic role. All of the nutrients discussed should be viewed as a component of a broader, complete diet. This article is a summary of wound healing and the roles of a variety of macronutrients and micronutrients in the process. PMID:27447105

  11. Management of negative pressure wound therapy in the treatment of diabetic foot ulcers

    Science.gov (United States)

    Meloni, Marco; Izzo, Valentina; Vainieri, Erika; Giurato, Laura; Ruotolo, Valeria; Uccioli, Luigi

    2015-01-01

    Diabetic foot (DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers (DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy (NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs. PMID:25992316

  12. Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds

    Directory of Open Access Journals (Sweden)

    Fahmida Alam

    2014-01-01

    Full Text Available Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey’s antibacterial activity on diabetic wound-related microorganisms and honey’s clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims.

  13. Advanced glaucoma: Management pearls

    Directory of Open Access Journals (Sweden)

    Girum W Gessesse

    2013-01-01

    Full Text Available A significant proportion of glaucoma patients present late, particularly in the developing world, and unfortunately, in an advanced stage of the disease. They are at imminent danger of losing remaining vision, and may also be afflicted with various socioeconomic and health challenges. The encounter with such a patient is typically characterized by anxiety/fear and sometimes hopelessness from the patient′s perspective. The physician may also feel that they are in a difficult position managing the patient′s disease. When dealing with such cases, we suggest a holistic, individualized approach taking into account the ′biopsychosociospiritual′ (BPSS profile of each patient. The BPSS model takes into account relevant ocular as well as systemic biology (factors such as the mechanism of glaucoma, level of intraocular pressure [IOP], rate of progression, life expectancy, general health, psychological considerations (e.g., fear, depression, socio-economic factors and spiritual/cultural values and beliefs before being able to decide with the patient and their care partner(s what treatment goals should be and how they can best be approached. Treatment for advanced glaucoma can be highly effective, and patients and their care partners should be informed that aggressive IOP lowering to the low teens or even single digits offers the best chance of protecting remaining vision. This can be achieved safely and effectively in most cases with trabeculectomy (including an antimetabolite, and in some cases with medical and/or laser therapy. Vision rehabilitation and psychosocial support should also be considered in order to optimize remaining vision, replace fear with hope as appropriate, and thus improve the overall quality of life.

  14. Wound management and the use of mouth rinse in mandibular third molar surgery.

    Science.gov (United States)

    Vlcek, Daniel; Razavi, Amir; Kuttenberger, Johannes J

    2015-01-01

    The aim of this survey was to assess the knowledge and practice of Swiss dentists regarding wound management and the use of mouth rinse in surgical removal of mandibular third molars (MTM). A postal survey was conducted among all 3,288 dentists who are members of the Swiss Dental Society (SSO) representing the majority of dentists in Switzerland. The questionnaire consisted of 13 questions with mostly multiple-choice answers. Demographic profile, surgical experience, the use of antibiotics, and wound management, i.e. wound closure and the use of mouth rinse were assessed. The response rate was 55%. Semi-closed (59.1%), closed (19%) and open wound management (11.7%) were applied most often. Semi-closed wound management was preferred in the German-speaking region (67%) and closed wound management was preferred in the French-speaking region (55%). For semi-closed wound healing, drains impregnated with terra-cortril (42%) and iodoform-Vaseline (40%) were used. For closed wound management, most dentists reported leaving the wound to heal with the blood clot only (60.5%). Most dentists (74.5%) prescribed chlorhexidine 0.2% (CHX) mouth rinse when performing MTM surgery and a combination of immediate preoperative and postoperative use was preferred. Semi-closed wound management with drain and CHX mouth rinse is frequently used in Switzerland in the perioperative management in MTM surgery. It is a well-documented procedure leading to favourable outcomes without using any systemic antibiotics. However, wound management techniques differ between the three linguistic regions. PMID:26472719

  15. Preparing Student Nurses for the Future of Wound Management: Telemedicine in a Simulated Learning Enviroment

    DEFF Research Database (Denmark)

    Christiansen, Sytter; Rethmeier, Anita

    2015-01-01

    Background: The Danish Society for Wound Healing advocates for the use of telemedicine in chronic wound management. It is crucial that student nurses are prepared for the technological demands of the future so that they will be competent to manage chronic wounds. Aim: The aim of this project was to...... integrate the concept of telemedicine for wound care into a simulation-based class for undergraduate student nurses and to evaluate their experiences with this integrated learning method. Methods: Five medium-fidelity mannequins were used in a simulated learning environment consisting of a simulated...... laboratory and a simulated wound clinic. A primitive electronic platform was used to allow the students to experience the benefits and challenges of telemedicine in wound care. At the end of the course, the students were asked to evaluate the course based on their experiences with telemedicine and simulation...

  16. Negative pressure wound therapy for management of the surgical incision in orthopaedic surgery

    OpenAIRE

    Karlakki, S.; Brem, M.; Giannini, S.; Khanduja, V.; Stannard, J; R. Martin

    2013-01-01

    Objectives The period of post-operative treatment before surgical wounds are completely closed remains a key window, during which one can apply new technologies that can minimise complications. One such technology is the use of negative pressure wound therapy to manage and accelerate healing of the closed incisional wound (incisional NPWT). Methods We undertook a literature review of this emerging indication to identify evidence within orthopaedic surgery and other surgical disciplines. Liter...

  17. Enzymatic wound debridement; role of papaya in the management of post cesarean gaped wounds

    International Nuclear Information System (INIS)

    Background: Enzymatic wound debridement is an emerging concept in facilitating the wound healing process. Papaya has de-sloughing, antibacterial and wound healing properties. It has been used in African countries since centuries for different medicinal pur-poses. Apart from anecdotal reports and few studies on chronic ulcers and burns, no planned studies are available to support its action in postoperative wound infection.Objectives: To compare efficacy and safety of papaya dressing with conventional wound dressing with povidone iodine in post cesarean section gaped wounds. Setting: Gynecology Unit 3, Sir Ganga Ram Hospital Lahore - Pakistan, over a period of six months(June 2012 to Nov 2012). Study Design: Randomized, quasi experimental stu-dy. Materials and Methods: The study sample included 60 patients with post cesarean section gaped wounds. The sample was divided into two groups; thirty patients as Group A or the study group received Papaya dressing and rest of thirty patients as Group B or the control group received Povidone iodine dressing. Wounds were thoroughly washed with saline and then mashed unripe papaya was spread over the whole area of wound in the study group and povidone iodine in the control group. Wounds were covered with sterile bandage for at least 48 hours in study group and 24 hours in the control group. The process was repeated till a clean base of wound with healthy granulation tis-sue was achieved suitable for secondary suture. The efficacy parameters studied were the duration of time needed to develop healthy granulation tissue and total duration of hospital stay which were compared bet-ween the two groups. Safety factors studied were the adverse effects of medications used in the study. Results: Out of 1200 cesarean sections done during study period, sixty (5%) were gaped in the post-operative period. Out of 60, 55 (90%) were emergency and only 5 (10%) were elective cesarean sections. All the sixty patients with postoperative gaped

  18. Sternal Wound Infection after Cardiac Surgery: Management and Outcome.

    Directory of Open Access Journals (Sweden)

    Marie Dubert

    Full Text Available Sternal Wound Infection (SWI is a severe complication after cardiac surgery. Debridement associated with primary closure using Redon drains (RD is an effective treatment, but data on RD management and antibiotic treatment are scarce.We performed a single-center analysis of consecutive patients who were re-operated for SWI between 01/2009 and 12/2012. All patients underwent a closed drainage with RD (CDRD. Patients with endocarditis or those who died within the first 45 days were excluded from management analysis. RD fluid was cultured twice weekly. Variables recorded were clinical and biological data at SWI diagnosis, severity of SWI based on criteria for mediastinitis as defined by the Centers for Disease Control (CDC, antibiotic therapy, RD management and patient's outcome.160 patients developed SWI, 102 (64% fulfilled CDC criteria (CDC+ and 58 (36% did not (CDC- SWI. Initial antibiotic treatment and surgical management were similar in CDC+ and CDC- SWI. Patients with CDC+ SWI had a longer duration of antibiotic therapy and a mortality rate of 17% as compared to 3% in patients with CDC- SWI (p = 0.025. Rates of superinfection (10% and 9% and need for second reoperation (12% and 17% were similar. Failure (death or need for another reoperation was associated with female gender, higher EuroScore for prediction of operative mortality, and stay in the ICU.In patients with SWI, initial one-stage surgical debridement with CDRD is associated with favorable outcomes. CDC+ and CDC- SWI received essentially the same management, but CDC+ SWI has a more severe outcome.

  19. Outcomes in controlled and comparative studies on non-healing wounds: recommendations to improve the quality of evidence in wound management

    DEFF Research Database (Denmark)

    Gottrup, F; Apelqvist, J; Price, P

    2010-01-01

    While there is a consensus that clinical practice should be evidence based, this can be difficult to achieve due to confusion about the value of the various approaches to wound management. To address this, the European Wound Management Association (EWMA) set up a Patient Outcome Group whose remit...

  20. NEGATIVE PRESSURE WOUND THERAPY (NPWT FOR THE MANAGEMENT OF DIABETIC FOOT WOUND

    Directory of Open Access Journals (Sweden)

    Wesiana Heris Santy

    2015-11-01

    Full Text Available Complications often experienced by people with diabetes are complications in the feet ( 15 % called diabetic foot ( Akhtyo , 2009 . Where the injury to the leg if not treated properly will lead to infections and ultimately need to be amputated .The purpose of writing articles is to review and discuss the evidence-based literature bersadarkanpraktice of Negative Pressure Wound Therapy Effectiveness ( NPWT on the healing of diabetic foot ulcers.One technology that is used to prevent and avoid lower limb amputation is the technique of negative pressure or Negative Pressure Wound Therapy ( NPWT . This negative pressure technique has grown rapidly and now has been widely used in many countries , especially in Western European countries ( Germany and the United States . Negative pressure technique has the advantage that it is relatively cheaper cost than the use of hyperbaric oxygen . Results obtained by several studies that the use of NPWT may improve wound healing process through efforts to create a moist wound environment and decrease edema that becomes optimal wound healing , throw that out of the wound exudate so that the protease enzyme in the exudate also go wasted , this enzyme is known to interfere wound healing process . The other benefit is that it can stimulate cell growth by increasing angiogenesis physically , so that the growth of new cells will be maximal Abstrak : Komplikasi sering dialami pengidap diabetes adalah komplikasi pada kaki (15% disebut kaki diabetes (Akhtyo, 2009.Dimana luka pada kaki jika tidak ditangani dengan baik akan menyebabkan terjadinya infeksi dan akhirnya perlu di amputasi. Tujuan penulisan artikel adalah mengkaji dan membahas literature bersadarkan evidence based praktice  tentang Efektifitas Negative Pressure Wound Therapy (NPWT pada penyembuhan ulkus kaki Diabetik. Salah satu teknologi yang digunakan untuk mencegah dan menghindari amputasi ekstremitas bawah adalah  teknik tekanan negatif atau Negative

  1. Burn wound healing and treatment: review and advancements

    OpenAIRE

    Rowan, Matthew P.; Cancio, Leopoldo C; Elster, Eric A.; Burmeister, David M.; Rose, Lloyd F.; Natesan, Shanmugasundaram; Chan, Rodney K.; Christy, Robert J.; Chung, Kevin K.

    2015-01-01

    Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted in more effective patient stabilization and decreased mortality, especially among young patients and those with burns of intermediate extent. However, for the intensivist, chall...

  2. [Precise management of extraordinary agent wound by establishment of a multidisciplinary cooperation mechanism].

    Science.gov (United States)

    Liu, Yi

    2016-06-01

    With the development of social economy, people's lifestyle has changed accompanied with the problem of population aging. The spectrum of disease also varied accordingly, thus led to complicated and varied wound aetiology, along with the formation of innumerably changed acute and chronic wounds. Therefore, it is hard to meet the requirement of multidisciplinary knowledge and technique in the diagnosis and treatment of some extraordinary agent wound with a single discipline. The extraordinary agent wound is caused by some uncommon or rare etiological factors, the specialty of which lays on the unique mechanism of wound formation, and a lot of disciplines were involved in the diagnosis and management of the wound. A unification of multiple disciplines is needed to integrate the relevant theory and technique to care the wound by giving consideration of the symptom and the aetiology. The primary diseases which induced the uncommon agent wound should be targeted and treated effectively; meanwhile, a comprehensive treatment combined with multiple new wound management techniques should be carried out to realize the objective of precise treatment. PMID:27321484

  3. Burn wound: Pathophysiology and its management by herbal plants

    Directory of Open Access Journals (Sweden)

    Dhirender Kaushik

    2013-01-01

    Full Text Available In human body, wound healing is a normal biological phenomenon. Burns may be acute or chronic depending upon the source and its time of exposure. Burn wounds may be superficial, partial or full thickness wounds. When skin comes in contact with higher temperature, protein denaturation takes place due to which the plasma membrane integrity is lost. When skin is burned, a number of inflammatory mediators and releasing agents such as histamine, nitric oxide, oxygen free radicals, eicosanoid products, tumor necrosis factors, and interleukins etc., are released at the site. For wound healing mechanism, the keratinocytes has to move from uninjured site to the burned area. For deeper burns this process takes a long time. By some unknown mechanisms, burn wounds may convert from one form to another form. So burn wound depth must be accurately measured before starting the treatment to prevent the complications. Burns can be induced in experimental animals by using different models. Many treatments such as herbal drugs, topical agents, gene therapy, volume therapy, and rehabilitation can be employed. This review article mainly deals with the theoretical and practical aspects of burn wound healing. Some burn wound healing plants with their chemical constituents, plant part used, uses and animal models are described here.

  4. Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review

    OpenAIRE

    Stanirowski, Paweł Jan; Wnuk, Anna; Cendrowski, Krzysztof; Sawicki, Włodzimierz

    2015-01-01

    Purpose The last two decades witnessed the development of numerous innovative regimens for the management of patients with abnormally healing and infected wounds. Growth factors, negative pressure wound therapy (NPWT) and antiseptic dressings containing silver are examples of methods with best documented efficacy, being widely used in the treatment of acute and chronic post-traumatic wounds, burns and ulcers of various etiology. As far as obstetrics and gynecology are concerned, prevention an...

  5. Terapija s kontroliranim negativnim tlakom: Negative wound pressure therapy:

    OpenAIRE

    Ciringer, Miha; Smrke, Dragica; TRILLER, CIRIL

    2011-01-01

    Wound management represents a great burden for the patients' quality of life and also for the healthcare expenditures. The understanding of the complex cellular and molecular mechanisms involved in the healing process enabled the recent development in the field of wound dressing. One of the recent advances in the field is the negative wound pressure therapy. This modern wound dressing consists of a special foam or gauze that fills the entire wound volume and a microprocessor guided pump that ...

  6. NEGATIVE PRESSURE WOUND THERAPY (NPWT) FOR THE MANAGEMENT OF DIABETIC FOOT WOUND

    OpenAIRE

    Wesiana Heris Santy

    2015-01-01

    Complications often experienced by people with diabetes are complications in the feet ( 15 % ) called diabetic foot ( Akhtyo , 2009) . Where the injury to the leg if not treated properly will lead to infections and ultimately need to be amputated .The purpose of writing articles is to review and discuss the evidence-based literature bersadarkanpraktice of Negative Pressure Wound Therapy Effectiveness ( NPWT ) ) on the healing of diabetic foot ulcers.One technology that is used to prevent and ...

  7. Chronic wound bed preparation using a cleansing solution.

    Science.gov (United States)

    Chamanga, Edwin Tapiwa; Hughes, Maria; Hilston, Keith; Sparke, Ann; Jandrisits, Johanna M

    Chronic wound management remains challenging in clinical practice, especially in the presence of bacterial bioburden and slough. To resolve these clinical challenges, it is essential clinicians implement the TIME framework (tissue, inflammation/infection, moisture, edge of wound) as a model of effective wound bed preparation. As a result of advances in technology and wound care therapies, on the market today are products that can help reduce the wound bed clinical challenges recommended by the TIME framework. This article looks at a wound cleansing solution that reduces the wound bed bioburden by breaking down biofilms and debriding slough. PMID:26110987

  8. Medical management of radio-contaminated wounded by the French military health service

    International Nuclear Information System (INIS)

    The French armed forces health service has set up in France specialized installation only designed and used to take care of radio contaminated patients. These installations can be used for the military and for the civilians, e.g. in case of an accident in a civilian nuclear installation or in case of terrorist attack with a few injured. The main principles of the medical management of a radio contaminated wounded are: - Trauma care is the first priority, - External decontamination has to be treated as fast and reasonably as possible, - Medical treatment for internal contamination is more efficiency that is given earlier (stable iodine, DTPA). Three type of installations have been developed to take charge of contaminated patient or with a suspicion of contamination: - The hasty decontamination post, to take into account the involved victims physically fit, - The advance post for radio-contaminated wounded (P.A.B.R.C.), for the relative emergency whom evacuation can be delayed after medical examination, - The center for the treatment of radio-contaminated wounded(C.T.B.R.C.), in an hospital area, for the absolute emergencies (needing some resuscitation and emergency surgery for saving life, like stopping an hemorrhage). Each military hospital in France has is own C.T.B.R.C. These structures are dedicated to the decontamination, that means that all type of decontamination would be conducted here: skin decontamination, internal decontamination by specific de-contaminant if needed, and decontamination of a contaminated wound by surgical means. This type of surgery might be associated with a precise detection. At his arrival, in a first time, the victim is examined by an emergency physician who is in charge of the structure. Secondly, he makes a triage concerning the medical emergency to identify the type of emergency, life threatening emergency or not. - If the patient is a critical case then the medical treatment takes precedence over contamination - If the patient is

  9. Gauze-based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum.

    Science.gov (United States)

    Fraccalvieri, Marco; Fierro, Maria Teresa; Salomone, Marco; Fava, Paolo; Zingarelli, Enrico M; Cavaliere, Giovanni; Bernengo, Maria G; Bruschi, Stefano

    2014-04-01

    Pyoderma gangrenosum (PG) is an uncommon ulcerative, non-infective chronic inflammatory skin disorder of unknown aetiology. Systemic therapies are necessary to control the associated medical diseases, and, due to the inflammatory nature of PG, topical or systemic immunosuppressant agents are effective, but wound healing is usually slow. Negative wound pressure therapy (NPWT) has become an important tool for the management of complex skin ulcers, and usage in PG has been recently described in the literature: we present four cases of classic PG in which NPWT in association with systemic therapy achieved wound healing and a drastic pain reduction. PMID:22891652

  10. Aseptic procedure in the ambulant wound management – legal and practical issues

    OpenAIRE

    Schwarzkopf, Andreas

    2007-01-01

    A greater part of the care of chronic wounds takes place in private homes in Germany. Not in every case it is possible to perform hygiene control of the environment. Personal hygiene ideas of patients may differ in a wide range. Teamwork together with surgeons is not always easy for wound managers. Aseptic care of wounds is possible under nearly every condition, if well elaborated processes are engaged. Hygiene in home care is defined by laws to protect nursing persons (BiostoffV, TRBA 250) a...

  11. Outcomes in controlled and comparative studies on non-healing wounds: recommendations to improve the quality of evidence in wound management

    DEFF Research Database (Denmark)

    Gottrup, F; Apelqvist, J; Price, P

    2010-01-01

    While there is a consensus that clinical practice should be evidence based, this can be difficult to achieve due to confusion about the value of the various approaches to wound management. To address this, the European Wound Management Association (EWMA) set up a Patient Outcome Group whose remit...... was to produce recommendations on clinical data collection in wound care. This document, produced by the group and disseminated by JWC, identifies criteria for producing rigorous outcomes in both randomised controlled trials and clinical studies, and describes how to ensure studies are consistent and...

  12. Surgical wound management with adhesive polyurethane membrane: a preferred method for routine usage

    OpenAIRE

    Tinckler, L.

    1984-01-01

    The author gives an account of his experience of the use in some 1600 patients of adhesive polyurethane membrane, marketed as Op-site, both for skin closure and wound dressing, in combination, as a routine method of surgical wound management in a wide variety of surgical operations. The technique of utilising this method is described in detail, as also are the advantages for patients, nursing and medical staff.

  13. Compression, collagen and bacteria-binding: different approaches for wound management.

    Science.gov (United States)

    Fronzo, C

    2016-06-01

    In May 2016, BSN medical hosted three clinical symposia at the EWMA conference in Bremen, Germany. These introduced the challenges of managing wounds in patients with CVD, the potential of collagen-based products to stimulate wound healing, and the combination of bacteria-binding dressings with NPWT. Camila Fronzo, JWC chief sub editor, was there to summarise the main points of each session. PMID:27286669

  14. Management of stab wounds to the anterior abdominal wall

    Directory of Open Access Journals (Sweden)

    João Baptista Rezende-Neto

    2014-01-01

    Full Text Available The meeting of the Publication "Evidence Based Telemedicine - Trauma and Emergency Surgery" (TBE-CiTE, through literature review, selected three recent articles on the treatment of victims stab wounds to the abdominal wall. The first study looked at the role of computed tomography (CT in the treatment of patients with stab wounds to the abdominal wall. The second examined the use of laparoscopy over serial physical examinations to evaluate patients in need of laparotomy. The third did a review of surgical exploration of the abdominal wound, use of diagnostic peritoneal lavage and CT for the early identification of significant lesions and the best time for intervention. There was consensus to laparotomy in the presence of hemodynamic instability or signs of peritonitis, or evisceration. The wound should be explored under local anesthesia and if there is no injury to the aponeurosis the patient can be discharged. In the presence of penetration into the abdominal cavity, serial abdominal examinations are safe without CT. Laparoscopy is well indicated when there is doubt about any intracavitary lesion, in centers experienced in this method.

  15. Wearable light management system for light stimulated healing of large area chronic wounds (Conference Presentation)

    Science.gov (United States)

    Kallweit, David; Mayer, Jan; Fricke, Sören; Schnieper, Marc; Ferrini, Rolando

    2016-03-01

    Chronic wounds represent a significant burden to patients, health care professionals, and health care systems, affecting over 40 million patients and creating costs of approximately 40 billion € annually. We will present a medical device for photo-stimulated wound care based on a wearable large area flexible and disposable light management system consisting of a waveguide with incorporated micro- and nanometer scale optical structures for efficient light in-coupling, waveguiding and homogeneous illumination of large area wounds. The working principle of this innovative device is based on the therapeutic effects of visible light to facilitate the self-healing process of chronic wounds. On the one hand, light exposure in the red (656nm) induces growth of keratinocytes and fibroblasts in deeper layers of the skin. On the other hand, blue light (453nm) is known to have antibacterial effects predominately at the surface layers of the skin. In order to be compliant with medical requirements the system will consist of two elements: a disposable wound dressing with embedded flexible optical waveguides for the light management and illumination of the wound area, and a non-disposable compact module containing the light sources, a controller, a rechargeable battery, and a data transmission unit. In particular, we will report on the developed light management system. Finally, as a proof-of-concept, a demonstrator will be presented and its performances will be reported to demonstrate the potential of this innovative device.

  16. Recent advances on the association of apoptosis in chronic non healing diabetic wound

    OpenAIRE

    Arya, Awadhesh K; Tripathi, Richik; Kumar, Santosh; Tripathi, Kamlakar

    2014-01-01

    Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement...

  17. Management of wound infection after lumbar arthrodesis maintaining the instrumentation

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2015-06-01

    Full Text Available OBJECTIVE: To determinate whether a surgical protocol with immediate extensive debridement, closed irrigation system and antibiotic therapy would be effective to achieve healing of deep wound infection without removing the instrumentation.METHODS: Prospective cohort study with 19 patients presenting degenerative spinal stenosis or degenerative spondylolisthesis, who developed infection after posterior lumbar arthrodesis. The diagnosis was confirmed by a microbial culture from subfascial lumbar fluid and/or blood. Patients were treated with a protocol of wound exploration, extensive flushing and debridement, placement of a closed irrigation system that was maintained for five days and intravenous antibiotics. The instrumentation system was not removed.RESULTS: Mean age was 59.31 (±13.17 years old and most patients were female (94.7%; 18/19. The mean period for the identification of the infection was 2 weeks and 57.9% underwent a single wound exploration. White blood count, erythrocyte sedimentation rate and C-reactive protein showed a significant decrease post-treatment when compared to pre-treatment values. A significant reduction of erythrocyte sedimentation rate and C-reactive protein was also observed at the final evaluation. No laboratory test was useful to predict the need for more than one debridement.CONCLUSION: Patients with wound infection after instrumentation can be treated without removal of the instrumentation through wound exploration, extensive flushing, debridement of necrotic tissue, closed irrigation system during 5 days and proper antibiotic therapy. The blood tests were not useful to predict surgical re-interventions.

  18. Improved wound management at lower cost: a sensible goal for Australia.

    Science.gov (United States)

    Norman, Rosana E; Gibb, Michelle; Dyer, Anthony; Prentice, Jennifer; Yelland, Stephen; Cheng, Qinglu; Lazzarini, Peter A; Carville, Keryln; Innes-Walker, Karen; Finlayson, Kathleen; Edwards, Helen; Burn, Edward; Graves, Nicholas

    2016-06-01

    Chronic wounds cost the Australian health system at least US$2·85 billion per year. Wound care services in Australia involve a complex mix of treatment options, health care sectors and funding mechanisms. It is clear that implementation of evidence-based wound care coincides with large health improvements and cost savings, yet the majority of Australians with chronic wounds do not receive evidence-based treatment. High initial treatment costs, inadequate reimbursement, poor financial incentives to invest in optimal care and limitations in clinical skills are major barriers to the adoption of evidence-based wound care. Enhanced education and appropriate financial incentives in primary care will improve uptake of evidence-based practice. Secondary-level wound specialty clinics to fill referral gaps in the community, boosted by appropriate credentialing, will improve access to specialist care. In order to secure funding for better services in a competitive environment, evidence of cost-effectiveness is required. Future effort to generate evidence on the cost-effectiveness of wound management interventions should provide evidence that decision makers find easy to interpret. If this happens, and it will require a large effort of health services research, it could be used to inform future policy and decision-making activities, reduce health care costs and improve patient outcomes. PMID:26634882

  19. [Current management of stab wounds to the colon].

    Science.gov (United States)

    Peycru, T; Avaro, J P; Biance, N; Tardat, E; Balandraud, P

    2006-06-01

    Stab wounds to the colon are a frequent surgical emergency. Local wound exploration under local anaesthesia is not required systematically. We recommend surveillance based on clinical observation and laboratory testing to detect peritoneal signs. If progression of symptoms is suspected, diagnostic peritoneal lavage (DPL) should be performed. Immediate surgical exploration is indicated in two cases, i.e., generalized peritonitis and haemodynamic instability due to internal bleeding. The preferred repair technique is direct suture or resection followed by a handsewn or mechanical anastomosis. The morbidity, cost and social consequences of colostomy must be taken into account. It should be considered as a salvage procedure for patients in critical condition or extensive colonic injury. PMID:16924827

  20. Advances in Management of Retinoblastoma

    Institute of Scientific and Technical Information of China (English)

    Kensei; Minoda

    1992-01-01

    Retinobiastoma is a highly malignant intraocular tumor of children that requires accurate diagnosis to prompt treatment. This article reviewed clinical, pathological and follow-up data on 1 147 cases of retinobiastoma registered in Japan from 1975 to 1982. It is obvious that the prognosis of children with retinobiastoma has improved remarkably in recent years. The current advances in the management of the retinobiastoma were discussed.

  1. Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments

    OpenAIRE

    Hasan, Muhammed Y.; Teo, Rachel; Nather, Aziz

    2015-01-01

    Negative-pressure wound therapy (NPWT) plays an important role in the treatment of complex wounds. Its effect on limb salvage in the management of the diabetic foot is well described in the literature. However, a successful outcome in this subgroup of diabetic patients requires a multidisciplinary approach with careful patient selection, appropriate surgical debridement, targeted antibiotic therapy, and optimization of healing markers. Evolving NPWT technology including instillation therapy, ...

  2. Advances in water resources management

    CERN Document Server

    Yang, Chih; Wang, Mu-Hao

    2016-01-01

    This volume provides in-depth coverage of such topics as multi-reservoir system operation theory and practice, management of aquifer systems connected to streams using semi-analytical models, one-dimensional model of water quality and aquatic ecosystem-ecotoxicology in river systems, environmental and health impacts of hydraulic fracturing and shale gas, bioaugmentation for water resources protection, wastewater renovation by flotation for water pollution control, determination of receiving water’s reaeration coefficient in the presence of salinity for water quality management, sensitivity analysis for stream water quality management, river ice process, and computer-aided mathematical modeling of water properties. This critical volume will serve as a valuable reference work for advanced undergraduate and graduate students, designers of water resources systems, and scientists and researchers. The goals of the Handbook of Environmental Engineering series are: (1) to cover entire environmental fields, includin...

  3. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    Directory of Open Access Journals (Sweden)

    Rogers AD

    2016-06-01

    Full Text Available Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literature rather than robust randomized controlled trials. Burn units are well placed to address this considerable need, as a result of their infrastructure, their multispecialty staffing, and their need to evolve in light of the declining incidence of major burn injury in developed countries. The aim of this review is to evaluate some of the ideological and practical challenges facing wound practitioners and burn surgeons while managing chronic and complex wounds. It also includes an approach to wound assessment and how to conceptualize and implement dressing strategies and new and existing multimodal therapies. Keywords: negative pressure wound therapy, instillation, antiseptic solutions, dressings, multidisciplinary wound care, stem cells, surgery, autograft, allograft, reconstructive ladder

  4. Wound care with traditional, complementary and alternative medicine

    OpenAIRE

    Ananda A Dorai

    2012-01-01

    Wound care is constantly evolving with the advances in medicine. Search for the ideal dressing material still continues as wound care professionals are faced with several challenges. Due to the emergence of multi-resistant organisms and a decrease in newer antibiotics, wound care professionals have revisited the ancient healing methods by using traditional and alternative medicine in wound management. People's perception towards traditional medicine has also changed and is very encouraging. T...

  5. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment.

    Science.gov (United States)

    Topaz, Moris

    2012-05-01

    Regulated negative pressure-assisted wound therapy (RNPT) should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound's environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT) is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review. PMID:23162229

  6. In Vitro Models in BiocompatibilityAssessment for Biomedical-Grade Chitosan Derivatives in Wound Management

    Directory of Open Access Journals (Sweden)

    Lim Chin Keong

    2009-03-01

    Full Text Available One of the ultimate goals of wound healing research is to find effective healing techniques that utilize the regeneration of similar tissues. This involves the modification of various wound dressing biomaterials for proper wound management. The biopolymer chitosan (b-1,4-D-glucosamine has natural biocompatibility and biodegradability that render it suitable for wound management. By definition, a biocompatible biomaterial does not have toxic or injurious effects on biological systems. Chemical and physical modifications of chitosan influence its biocompatibility and biodegradability to an uncertain degree. Hence, the modified biomedical-grade of chitosan derivatives should be pre-examined in vitro in order to produce high-quality, biocompatible dressings. In vitro toxicity examinations are more favorable than those performed in vivo, as the results are more reproducible and predictive. In this paper, basic in vitro tools were used to evaluate cellular and molecular responses with regard to the biocompatibility of biomedical-grade chitosan. Three paramount experimental parameters of biocompatibility in vitro namely cytocompatibility, genotoxicity and skin pro-inflammatory cytokine expression, were generally reviewed for biomedical-grade chitosan as wound dressing.

  7. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment

    Directory of Open Access Journals (Sweden)

    Moris Topaz

    2012-01-01

    Full Text Available Regulated negative pressure-assisted wound therapy (RNPT should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound′s environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

  8. Recent advances on the association of apoptosis in chronic non healing diabetic wound

    Institute of Scientific and Technical Information of China (English)

    Awadhesh; K; Arya; Richik; Tripathi; Santosh; Kumar; Kamlakar; Tripathi

    2014-01-01

    Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement of immune cells and several other cell types. There are many evidences supporting the hypothesis that apoptosis of immune cells is involved in the wound healing process by ending inflammatory condition. It is also involved in the resolution of various phases of tissue repair. During final steps of wound healing most of the endothelial cells, macrophagesand myofibroblasts undergo apoptosis or exit from the wound, leaving a mass that contains few cells and consists mostly of collagen and other extracellular matrix proteins to provide strength to the healing tissue. This review discusses the various phases of wound healing both in the chronic and acute wounds especially during diabetes mellitus and thus support the hypothesis that the oxidative stress, apoptosis, connexins and other molecules involved in the regulation of chronic wound healing in diabetes mellitus and gives proper understanding of the mechanisms controlling apoptosis and tissue repair during diabetes and may eventually develop therapeutic modalities to fasten the healing process in diabetic patients.

  9. Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments

    Science.gov (United States)

    Hasan, Muhammed Y.; Teo, Rachel; Nather, Aziz

    2015-01-01

    Negative-pressure wound therapy (NPWT) plays an important role in the treatment of complex wounds. Its effect on limb salvage in the management of the diabetic foot is well described in the literature. However, a successful outcome in this subgroup of diabetic patients requires a multidisciplinary approach with careful patient selection, appropriate surgical debridement, targeted antibiotic therapy, and optimization of healing markers. Evolving NPWT technology including instillation therapy, nanocrystalline adjuncts, and portable systems can further improve results if used with correct indications. This review article summarizes current knowledge about the role of NPWT in the management of the diabetic foot and its mode of action, clinical applications, and recent developments. PMID:26140663

  10. Growth modulation of fibroblasts by chitosan-polyvinyl pyrrolidone hydrogel: Implications for wound management?

    Indian Academy of Sciences (India)

    Makarand Risbud; Anandwardhan Hardikar; Ramesh Bhonde

    2000-03-01

    Wounds in adults and fetuses differ in their healing ability with respect to scar formation. In adults, wounds lacking the epidermis exhibit excess collagen production and scar formation. Fibroblasts synthesize and deposit a collagen rich extracellular matrix. The early migration and proliferation of fibroblasts in the wound area is implicated in wound scarring. We have synthesized a hydrogel from chitosan-polyvinyl pyrrolidone (PVP) and examined its effect on fibroblast growth modulation in vitro. The hydrogel was found to be hydrophilic as seen from its octane contact angle (141·2 ± 0·37°). The hydrogel was non-toxic and biocompatible with fibroblasts and epithelial cells as confirmed by the 3(4,5-dimethylthiazolyl-2)-2,5-diphenyl tetrazolium bromide (MTT) assay. It showed dual properties by supporting growth of epithelial cells (SiHa) and selectively inhibiting fibroblast (NIH3T3) growth. Growth inhibition of fibroblasts resulted from their inability to attach on to the hydrogel. These findings are supported by image analysis, which revealed a significant difference ( < 0·05) between the number of fibroblasts attached to the hydrogel in tissue culture as compared to tissue culture treated polystyrene (TCPS) controls. However, no significant difference was observed ( > 0·05) in the number of epithelial (SiHa) cells attached on to the hydrogel as compared to the TCPS control. Although in vivo experiments are awaited, these findings point to the possible use of chitosan-PVP hydrogels in wound-management.

  11. Wound care with traditional, complementary and alternative medicine

    Directory of Open Access Journals (Sweden)

    Ananda A Dorai

    2012-01-01

    Full Text Available Wound care is constantly evolving with the advances in medicine. Search for the ideal dressing material still continues as wound care professionals are faced with several challenges. Due to the emergence of multi-resistant organisms and a decrease in newer antibiotics, wound care professionals have revisited the ancient healing methods by using traditional and alternative medicine in wound management. People′s perception towards traditional medicine has also changed and is very encouraging. The concept of moist wound healing has been well accepted and traditional medicine has also incorporated this method to fasten the healing process. Several studies using herbal and traditional medicine from different continents have been documented in wound care management. Honey has been used extensively in wound care practice with excellent results. Recent scientific evidences and clinical trials conducted using traditional and alternative medicine in wound therapy holds good promise in the future.

  12. Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Diaa Othman

    2012-01-01

    Full Text Available This is a paper reviewing the National Health Service (NHS agenda in relation to the use of Negative Pressure Wound Therapy (NPWT in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients’ satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients’ satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

  13. Comparisons in the Medical Management of Three Cases of Plutonium-Contaminated Wounds

    International Nuclear Information System (INIS)

    Three cases are described having small wounds on the fingers contaminated by plutonium. In each patient routine decontamination procedures were carried out which were sufficiently rigorous to ensure that all contamination was removed from the intact skin leaving only that remaining in the depths of the wound. The medical management of these patients followed much the same sort of pattern in each case, i.e. excision of the wound was undertaken and this was either preceded or followed by the intravenous administration of DTPA. However, the times at which these various procedures were carried out varied in relation to each other and to the time of injury, and, therefore, one of the purposes of this paper is to discuss the effect of this time variation on the ultimate wound and total body content of plutonium. In one of the patients an attempt has been made to define the relative effectiveness of small and large quantities of DTPA on urinary plutonium excretion, this being achieved by the alternative administration of the DTPA in doses of 1 g and 0.1 g. (author)

  14. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    LENUS (Irish Health Repository)

    2012-02-01

    Aim. To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. Background. A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. Design. The study used a survey method. Methods. A four-round eDelphi technique was used to collect responses from an international population of health professionals across 24 countries. Results. Responses were obtained from 360 professionals representing many health care settings. The top education priorities related to the standardisation of all foundation education programmes in wound care, the inclusion of wound care in all professional undergraduate and postgraduate education programmes, selecting dressings and the prevention of pressure ulcers. The top research priorities related to the dressing selection, pressure ulcer prevention and wound infection. Conclusion. Professionals from different backgrounds and countries who are engaged in wound management share a common set of priorities for research and education. Most notably, the priorities identified relate to long-established clinical challenges in wound care and underpin the principles of good patient care practices. The priorities are closely allied to an ageing population and identify many challenges ahead for practitioners engaged in wound management services. Relevance to clinical practice. The provision of wound care is a major investment of health service resources and remains a clinical challenge today. Research is essential to building evidence-based practice and fundamental to development of quality in standards of practice; education is central to achieving competence to deliver effective care. The

  15. An update on the evaluation and management of plantar puncture wounds and Pseudomonas osteomyelitis.

    Science.gov (United States)

    Inaba, A S; Zukin, D D; Perro, M

    1992-02-01

    The management of children who present to the ED with plantar puncture wounds is dependent upon the nature of the injury, the examination of the puncture site, and the potential risk of a retained foreign body. Not all patients will require wound enlargement and a search for a retained foreign body. Close follow-up of all children who are being treated as outpatients is of vital importance in detecting an early development of an infectious complication. Pseudomonas osteomyelitis should be suspected in all patients who present with foot pain, swelling, and a decreased ability to bear weight after sustaining a nail puncture through a sneaker. The current consensus favors open surgical débridement followed by a course of intravenous antibiotics. The exact duration of the postoperative antibiotic course is still being debated. PMID:1603689

  16. Microsoft System Center Configuration Manager advanced deployment

    CERN Document Server

    Coupland, Martyn

    2014-01-01

    If you are an experienced Configuration Manager administrator looking to advance your career or get more from your current environment, then this book is ideal for you. Prior experience of deploying and managing a Configuration Manager site would be helpful in following the examples throughout this book.

  17. Bone marrow derived cell-seeded extracellular matrix: A novel biomaterial in the field of wound management

    Directory of Open Access Journals (Sweden)

    V. Remya

    2014-11-01

    Full Text Available Aim: Extensive or irreversible damage to the skin often requires additional skin substitutes for reconstruction. Biomaterials have become critical components in the development of effective new medical therapies for wound care. Materials and Methods: In the present study, a cell matrix construct (bone marrow-derived cells (BMdc seeded extracellular matrix [ECM] was used as a biological substitute for the repair of full-thickness skin wound. ECM was developed by decellularizing fish swim bladder (FSB. Goat bone marrow-derived cells (G-BMdc were seeded over this decellularized matrix. Efficacy of this cell matrix construct in wound repair was tested by implanting it over 20 mm2 × 20 mm2 size fullthickness skin wound created over the dorsum of rat. The study was conducted in 16 clinically healthy adult rats of either sex. The animals were randomly divided into 2 equal groups of 8 animals each. In Group I, animal’s wounds were repaired with a cellular FSB matrix. In Group II, wounds were repaired with G-BMdc seeded a cellular FSB matrix. Immune response and efficacy of healing were analyzed. Results: Quality of healing and immuno tolerance to the biological substitute was significantly better in Group II than Group I. Conclusion: Seeding with BMdc increases the wound healing potency and modulates the immune response to a significantly negligible level. The BMdc seeded acellular FSB matrix was found to be a novel biomaterial for wound management.

  18. Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments

    Directory of Open Access Journals (Sweden)

    Muhammed Y. Hasan

    2015-07-01

    Full Text Available Negative-pressure wound therapy (NPWT plays an important role in the treatment of complex wounds. Its effect on limb salvage in the management of the diabetic foot is well described in the literature. However, a successful outcome in this subgroup of diabetic patients requires a multidisciplinary approach with careful patient selection, appropriate surgical debridement, targeted antibiotic therapy, and optimization of healing markers. Evolving NPWT technology including instillation therapy, nanocrystalline adjuncts, and portable systems can further improve results if used with correct indications. This review article summarizes current knowledge about the role of NPWT in the management of the diabetic foot and its mode of action, clinical applications, and recent developments.

  19. Complementary therapy in chronic wound management: a holistic caring case study and praxis model.

    Science.gov (United States)

    Popoola, Mercy Mammah

    2003-01-01

    Holistic caring consists of providing care to each aspect of a patient's life through the use of therapeutic caring and complementary or alternative healing modalities. Since nursing consists of caring for the whole person and not just the disease process, consideration of a patient's physical, emotional, social, economic, spiritual, and cultural needs is necessary in dealing with any chronic health problem such as chronic wounds. In this model case studies presentation, the purpose of this article is to discuss the importance of the holistic caring approach and the use of complementary and alternative medicine or therapeutic modalities in chronic wound management. The use or role of theory in practice will also be discussed to emphasize the holistic caring praxis model used in the holistic assessment and holistic plan of care for the cases presented. This article also presents a framework that will help wound care and holistic nurses move from simply the positivist-modernist philosophy to begin to embrace the postmodernist philosophy. PMID:12784899

  20. Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis

    Directory of Open Access Journals (Sweden)

    Karaaslan F

    2014-12-01

    Full Text Available Fatih Karaaslan,1 Şevki Erdem,2 Musa Ugur Mermerkaya11Department of Orthopaedics and Traumatology, Bozok University Medical School, Yozgat, Turkey; 2Department of Orthopaedics and Traumatology, Haydarpasa Numune Training Hospital, Istanbul, TurkeyObjective: To evaluate the results of negative-pressure wound therapy (NPWT in the treatment of surgical spinal site infections.Materials and methods: The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar interbody fusion plus posterior instrumentation was studied retrospectively. From February 2011 to January 2012, six patients (females out of 317 (209 females; 108 males were readmitted to our clinic with surgical site infections on postoperative day 14 (range 9–19 and were treated with debridement, NPWT, and antibiotics. We evaluated the clinical and laboratory data, including the ability to retain the spinal hardware and recurrent infections.Results: The incidence of deep postoperative surgical site infection was six (1.89% patients (females out of 317 patients (209 females; 108 males at 1 year. All patients completed their wound NPWT regimen successfully. An average of 5.1 (range 3–8 irrigation and debridement sessions was performed before definitive wound closure. The mean follow-up period was 13 (range 12–16 months. No patient had a persistent infection requiring partial or total hardware removal. The hospital stay infection parameters normalized within an average of 4.6 weeks.Conclusion: The study illustrates the usefulness of NPWT as an effective adjuvant treatment option for managing complicated deep spinal surgical wound infections.Keywords: surgical infection, NPWT, VAC, TLIF

  1. Use of antibiotics in the management of postirradiation wound infection and sepsis

    International Nuclear Information System (INIS)

    Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra-abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. 111 references

  2. Westinghouse advanced fuel management system

    International Nuclear Information System (INIS)

    The Westinghouse Incore Fuel Management analysis methodology has been qualified and implemented for a broad range of fuel management strategies and operating conditions. Monitoring of the performance and additions to the qualification database provide a continuous process for methodology upgrades. Additions to the experience database include performance for other NSSS and fuel assembly designs, including large guide thimble and off-center assembly core configuration, Mixed-Oxide reload design, and Gadolinia burnable absorber. Several other functional interfaces are required for the design, safety evaluation, licensing, operation support and core monitoring of PWR cores. In-core fuel management methods need to provide the data required for these interfaces in a consistent manner (format and accuracy) so as to avoid unnecessary conservatisms that penalize operational margins. This paper reviews recent results in the Westinghouse Incore Fuel Management methodology. (author). 3 refs, 5 figs, 2 tabs

  3. Performance Enhancements for Advanced Database Management Systems

    OpenAIRE

    Helmer, Sven

    2000-01-01

    New applications have emerged, demanding database management systems with enhanced functionality. However, high performance is a necessary precondition for the acceptance of such systems by end users. In this context we developed, implemented, and tested algorithms and index structures for improving the performance of advanced database management systems. We focused on index structures and join algorithms for set-valued attributes.

  4. Management of Advanced Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Patrick Sheahan

    2014-04-01

    Full Text Available Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.

  5. Negative pressure wound therapy: clinical utility

    Directory of Open Access Journals (Sweden)

    Sandoz H

    2015-04-01

    Full Text Available Heidi Sandoz Accelerate CIC, Mile End Hospital, London, UK Abstract: Negative pressure wound therapy (NPWT, also known as topical negative pressure therapy, has been increasingly used in health care for the management of a wide variety of wounds over the last 2–3 decades. It is an advanced therapy that can be helpful to accelerate wound healing in both acute and chronic wounds by delivering negative pressure (suction to the wound bed. More recent advancements in the application of NPWT have provided clinicians with wider choices of utilization. There are now devices available that can deliver irrigation to the wound bed, be used for closed surgical incisions, or are disposable and highly portable. Systematic reviews considering NPWT have been published previously. These usually focus on one wound group or device and fail to offer practical clinical guidance due to the scrutiny offered to the evidence via a systematic review process. Here, an overview of the history of NPWT, the varieties of device available, their wide clinical application, and the evidence to support its use are explored in a pragmatic way. Keywords: negative pressure, wound, incision, healing, pain 

  6. Advanced technologies in trauma critical care management.

    Science.gov (United States)

    Cannon, Jeremy W; Chung, Kevin K; King, David R

    2012-08-01

    Care of critically injured patients has evolved over the 50 years since Shoemaker established one of the first trauma units at Cook County Hospital in 1962. Modern trauma intensive care units offer a high nurse-to-patient ratio, physicians and midlevel providers who manage the patients, and technologically advanced monitors and therapeutic devices designed to optimize the care of patients. This article describes advances that have transformed trauma critical care, including bedside ultrasonography, novel patient monitoring techniques, extracorporeal support, and negative pressure dressings. It also discusses how to evaluate the safety and efficacy of future advances in trauma critical care. PMID:22850154

  7. Advanced Radio Resource Management for IMT

    DEFF Research Database (Denmark)

    Monserrat, Jose M.; Sroka, Pawel; Auer, Gunther; Mihovska, Albena D.; Rossi, Roberto; SAUL, Andreas; SCHOENEN, Rainer

    The race towards IMT-Advanced was recently started by ITU-R who distributed a Circular Letter asking for the submission of new technology proposals. The European Celtic project WINNER+ is bridging together experts from industry, academia and government all around Europe to devise this next fourth...... generation mobile, 4G. This paper presents the first set of innovative concepts for advanced Radio Resource Management that has been identified by the Innovation Group of WINNER+ for potential inclusion in IMT-Advanced. These concepts consist of promising innovative techniques that are ready to be included...

  8. Management of patients with advanced prostate cancer

    DEFF Research Database (Denmark)

    Gillessen, S; Omlin, A; Attard, G;

    2015-01-01

    The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration......-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion, and not...

  9. Strategic management of advanced manufacturing technology

    OpenAIRE

    Pandža, Krsto; Polajnar, Andrej; Buchmeister, Borut

    2012-01-01

    The aim of this paper is threefold. First, it discusses the role of advanced manufacturing technology (AMT) within a strategic management context of a manufacturing organisation. Resource-based view is presented as a useful theoretical school for understanding strategic management of AMT. Second, a brief case from a manufacturing organisation is provided to illustrate the debate. In the reported case study, the relevant mechanisms for understanding capability accumulation process and the role...

  10. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series.

    Science.gov (United States)

    Mustafi, N; Engels, P

    2016-04-01

    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery. PMID:27064368

  11. Advances in Business and Management Forecasting

    CERN Document Server

    Lawrence, Kenneth D

    2011-01-01

    The topics within Advances in Business and Management Forecasting will normally include sales and marketing, forecasting, new product forecasting, judgmentally-based forecasting, the application of surveys to forecasting, forecasting for strategic business decisions, improvements in forecasting accuracy, and sales response models.

  12. Advances in Management of Acute Pancreatitis.

    Science.gov (United States)

    Janisch, Nigeen H; Gardner, Timothy B

    2016-03-01

    This article reviews advances in the management of acute pancreatitis. Medical treatment has been primarily supportive for this diagnosis, and despite extensive research efforts, there are no pharmacologic therapies that improve prognosis. The current mainstay of management, notwithstanding the ongoing debate regarding the volume, fluid type, and rate of administration, is aggressive intravenous fluid resuscitation. Although antibiotics were used consistently for prophylaxis in severe acute pancreatitis to prevent infection, they are no longer used unless infection is documented. Enteral nutrition, especially in patients with severe acute pancreatitis, is considered a cornerstone in management of this disease. PMID:26895677

  13. Licensed bases management for advanced nuclear plants

    International Nuclear Information System (INIS)

    Prospective Advanced Nuclear Plant (ANP) owners must have high confidence that the integrity of the licensed bases (LB) of a plant will be effectively maintained over its life cycle. Currently, licensing engineers use text retrieval systems, database managers, and checklists to access, update, and maintain vast and disparate licensing information libraries. This paper describes the demonstration of a ''twin-engine'' approach that integrates a program from the emerging class of concept searching tools with a modern Product Data Management System (PDMS) to enhance the management of LB information for an example ANP design. (author)

  14. Novel application of vacuum sealing drainage with continuous irrigation of potassium permanganate for managing infective wounds of gas gangrene.

    Science.gov (United States)

    Hu, Ning; Wu, Xing-Huo; Liu, Rong; Yang, Shu-Hua; Huang, Wei; Jiang, Dian-Ming; Wu, Qiang; Xia, Tian; Shao, Zeng-Wu; Ye, Zhe-Wei

    2015-08-01

    Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputation. The aim of the present study was to use vacuum sealing drainage (VSD) with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical efficacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Amputations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol (PVA) foam dressing and polyurethane (PU) film, with continuous irrigation of 1:5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe septic shock. Emergent resuscitation was performed and the patient returned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenvironment and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection. PMID:26223928

  15. Katupila (Securinega leucopyrus) as a potential option for diabetic wound management

    OpenAIRE

    Ahamed Shahan Ajmeer; Tukaram Sambhaji Dudhamal; Sanjay Kumar Gupta; Vyasdeva Mahanta

    2014-01-01

    In acute and chronic wounds, Katupila (Securinega leucopyrus) (Willd.) Muell is a commonly used folklore remedy in Sri Lanka and Saurashtra region of India. We report a case of Madhumehajanya Dushta Vrana (chronic diabetic wound) that was treated with local application of S. leucopyrus in paste form once daily. Wound healed within a month with normal pigmentation and minimal scar. This case also demonstrated possible antimicrobial potential in the treatment of Dushta Vrana.

  16. Katupila Securinega leucopyrus as a potential option for diabetic wound management

    Directory of Open Access Journals (Sweden)

    Ahamed Shahan Ajmeer

    2014-01-01

    Full Text Available In acute and chronic wounds, Katupila (Securinega leucopyrus (Willd. Muell is a commonly used folklore remedy in Sri Lanka and Saurashtra region of India. We report a case of Madhumehajanya Dushta Vrana (chronic diabetic wound that was treated with local application of S. leucopyrus in paste form once daily. Wound healed within a month with normal pigmentation and minimal scar. This case also demonstrated possible antimicrobial potential in the treatment of Dushta Vrana.

  17. Water Management Applications of Advanced Precipitation Products

    Science.gov (United States)

    Johnson, L. E.; Braswell, G.; Delaney, C.

    2012-12-01

    Advanced precipitation sensors and numerical models track storms as they occur and forecast the likelihood of heavy rain for time frames ranging from 1 to 8 hours, 1 day, and extended outlooks out to 3 to 7 days. Forecast skill decreases at the extended time frames but the outlooks have been shown to provide "situational awareness" which aids in preparation for flood mitigation and water supply operations. In California the California-Nevada River Forecast Centers and local Weather Forecast Offices provide precipitation products that are widely used to support water management and flood response activities of various kinds. The Hydrometeorology Testbed (HMT) program is being conducted to help advance the science of precipitation tracking and forecasting in support of the NWS. HMT high-resolution products have found applications for other non-federal water management activities as well. This presentation will describe water management applications of HMT advanced precipitation products, and characterization of benefits expected to accrue. Two case examples will be highlighted, 1) reservoir operations for flood control and water supply, and 2) urban stormwater management. Application of advanced precipitation products in support of reservoir operations is a focus of the Sonoma County Water Agency. Examples include: a) interfacing the high-resolution QPE products with a distributed hydrologic model for the Russian-Napa watersheds, b) providing early warning of in-coming storms for flood preparedness and water supply storage operations. For the stormwater case, San Francisco wastewater engineers are developing a plan to deploy high resolution gap-filling radars looking off shore to obtain longer lead times on approaching storms. A 4 to 8 hour lead time would provide opportunity to optimize stormwater capture and treatment operations, and minimize combined sewer overflows into the Bay.ussian River distributed hydrologic model.

  18. Advances in mechanisms of negative pressure wound therapy%负压创面疗法作用机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    刘道宏; 唐佩福; 张立海

    2014-01-01

    负压创面疗法处理临床上各种创面均具有显著效果。对其作用机制的研究有助于指导正确应用及进一步改进。本文综述了近些年负压创面疗法作用机制研究的最新进展。被广泛接受的机制包括收缩创面、稳定局部环境、减轻水肿和清除渗出物、增加血流灌注和促进肉芽组织形成等,而细菌清除和抗菌作用方面的机制尚存争议。%Negative-pressure wound therapy (NPWT) exerts a significant effect on different wounds. Studies on its mechanisms contribute to its correct application and further improvement. Following is a review of the update advances in its mechanisms. NPWT can reduce the wound surface area, stabilize the wound environment, alleviate wound edema, remove wound exudates, increase blood flow, and promote granulation tissue formation, which are the widely accepted mechanisms of NPWT. However, it is still controversial on its antimicrobial efficacy and bacterial clearance.

  19. Information management systems improve advanced plant design

    Energy Technology Data Exchange (ETDEWEB)

    Turk, R.S.; Serafin, S.A.; Leckey, J.B. [ABB-Combustion Engineering, Inc., Windsor, CT (United States); Morgan, J.S. [Duke Engineering & Services, Charlotte, NC (United States)

    1994-12-31

    Computer-aided engineering tools are proving invaluable in both the design and operation of nuclear power plants. ABB Combustion Engineering`s Advanced Light Water Reactor (ALWR) features a computerized Information Management System (IMS) as an integral part of the design. The System 80+ IMS represents the most powerful information management tool for Nuclear Power Plants commercially available today. Developed by Duke Power Company specifically for use by nuclear power plant owner operators, the IMS consists of appropriate hardware and software to manage and control information flow for all plant related work or tasks in a systematic, consistent, coordinated and informative manner. A significant feature of this IMS is that it is primarily based on plant data. The principal design tool, PASCE (Plant Application and Systems from Combustion Engineering), is comprised of intelligent databases that describe the design and from which accurate plant drawings are created. Additionally the IMS includes, at its hub, a relational database management system and an associated document management system. During the design phase, the IMS captures all design information in a database as it is generated. Interrelated data are automatically checked for consistency. Engineers and managers from various disciplines are automatically and simultaneously notified of pending changes. The 3-D model automatically checks for interferences and can be used to simulate the removal and replacement of equipment. Thus any potential difficulties can be corrected in the design phase. Document and data search times are greatly reduced by the querying capabilities of the system.

  20. Management of locally advanced prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Heather Payne

    2009-01-01

    The management of all stages of prostate cancer is an increasingly complex process and involves a variety of available treatments and many disciplines.Despite prostate-specific antigen (PSA) testing,the presentation of prostate cancer at a locally advanced stage is common in the UK,accounting for one-third of all new cases.There is no universally accepted definition of locally advanced prostate cancer;the term is loosely used to encompass a spectrum of disease profiles that show high-risk features.Men with high-risk prostate cancer generally have a significant risk of disease progression and cancer-related death if left untreated.High-risk patients,including those with locally advanced disease,present two specific challenges.There is a need for local control as well as a need to treat any microscopic metastases likely to be present but undetectable until disease progression.The optimal treatment approach will therefore often necessitate multiple modalities.The exact combinations,timing and intensity of treatment continue to be strongly debated.Management decisions should be made after all treatments have been discussed by a multidisciplinary team (including urologists,oncologists,radiologists,pathologists and nurse specialists) and after the balance of benefits and side effects of each therapy modality has been considered by the patient with regard to his own individual circumstances.This article reviews the current therapy options.

  1. Postoperative abdominal wound infection – epidemiology, risk factors, identification, and management

    Directory of Open Access Journals (Sweden)

    Azoury SC

    2015-09-01

    Full Text Available Saïd C Azoury,1 Norma Elizabeth Farrow,2 Qing L Hu,2 Kevin C Soares,1 Caitlin W Hicks,1 Faris Azar,1 Nelson Rodriguez-Unda,3 Katherine E Poruk,1 Peter Cornell,1 Karen K Burce,1 Carisa M Cooney,3 Hien T Nguyen,1 Frederic E Eckhauser1 1Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; 2School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 3Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA Abstract: Surgical site infections (SSIs complicate the postoperative course of a significant proportion of general abdominal surgical patients and are associated with excessive health care costs. SSIs increase postoperative morbidity and mortality, and may require hospital admission, intravenous antibiotics, and even surgical reintervention. Risks associated with SSIs are related to both host and perioperative factors. However, a vast majority of these infections are preventable. More recently, quality initiative programs such as American College of Surgeons National Surgical Quality Improvement Program are expanding their roles to help better monitor adherence to improvement measures. Indeed, standardizing preoperative antibiotic prophylaxis timing is perhaps the most persuasive example and this has been integral to reducing postoperative SSI rates. Herein, the authors provide an update on the epidemiology, risk factors, identification, and management of wound infections following abdominal surgery. Keywords: surgical site infection, diagnosis, treatment, prevention

  2. Advanced Risk Management and Monitoring System, ARMMS

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kil Yoo; Han, Sang Hoon; Lim, Ho Gon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-10-15

    Many risk informed regulation and applications (RIR and A) are approved and used for the nuclear power plants(NPPs), and more RIR and A will be actively applied in Korea. Also, since Korean NPPs are recently exported to other country such as UAE, RIR and A would be applied to the exported NPPs. Thus, a tool which will help the user apply RIR and A is required. KAERI is being developing a tool, called ARMMS (Advanced Risk Management and Monitoring System), for this purpose. The design plan of ARMMS was introduced in the Ref, and in this paper, the actual implementation of ARMMS is introduced, and the performance monitoring module is introduced

  3. Management of negative pressure wound therapy in the treatment of diabetic foot ulcers

    OpenAIRE

    Meloni, Marco; Izzo, Valentina; Vainieri, Erika; Giurato, Laura; Ruotolo, Valeria; Uccioli, Luigi

    2015-01-01

    Diabetic foot (DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers (DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these,...

  4. Management of advanced medullary thyroid cancer.

    Science.gov (United States)

    Hadoux, Julien; Pacini, Furio; Tuttle, R Michael; Schlumberger, Martin

    2016-01-01

    Medullary thyroid cancer arises from calcitonin-producing C-cells and accounts for 3-5% of all thyroid cancers. The discovery of a locally advanced medullary thyroid cancer that is not amenable to surgery or of distant metastases needs careful work-up, including measurement of serum calcitonin and carcinoembryonic antigen (and their doubling times), in addition to comprehensive imaging to determine the extent of the disease, its aggressiveness, and the need for any treatment. In the past, cytotoxic chemotherapy was used for treatment but produced little benefit. For the past 10 years, tyrosine kinase inhibitors targeting vascular endothelial growth factor receptors and RET (rearranged during transfection) have been used when a systemic therapy is indicated for large tumour burden and documented disease progression. Vandetanib and cabozantinib have shown benefits on progression-free survival compared with placebo in this setting, but their toxic effect profiles need thorough clinical management in specialised centres. This Review describes the management and treatment of patients with advanced medullary thyroid cancer with emphasis on current targeted therapies and perspectives to improve patient care. Most treatment responses are transient, emphasising that mechanisms of resistance need to be better understood and that the efficacy of treatment approaches should be improved with combination therapies or other drugs that might be more potent or target other pathways, including immunotherapy. PMID:26608066

  5. Management of necrotic neck wounds with a sandwich pectoralis myocutaneous flap

    International Nuclear Information System (INIS)

    A modified pectoralis major myocutaneous flap was used to stabilize necrotic neck wounds rapidly in irradiated patients. The flap was a sandwich flap that included an overlying parasternal pectoral skin paddle for pharyngeal reconstruction, the pectoralis muscle for carotid protection, and a meshed skin graft applied to the undersurface of the muscle to replace cervical skin. This flap has been used to reconstruct seven patients with severe wound necrosis from pharyngeal fistula and infection. All patients had carotid exposure in the infected wound. Reconstruction in all patients accomplished restoration of pharyngeal continuity, carotid protection, and cervical skin replacement. Some patients required more than one procedure for closure. There were no carotid blowouts in any of the patients. This technique enables the head and neck surgeon to stabilize these contaminated wounds rapidly and to reconstruct complex defects of the pharynx and cervical skin

  6. Measurement of localized tissue water – clinical application of bioimpedance spectroscopy in wound management

    International Nuclear Information System (INIS)

    Wound healing is a complex process which can be impeded by the presence of accumulated cell fluid or oedema. A simple and convenient method for the assessment of wound oedema would aid improvement in patient care. In this proof of concept study we investigated whether bioelectrical impedance spectroscopy has the potential to provide such a tool. A number of important observations were made. Firstly, the method was highly reproducible and data can be obtained from electrodes located at different positions around the region of interest; important given the highly variable topography of surface wounds, e.g. burns. Secondly, the method was highly sensitive with the potential to detect changes of as little as 20 μl in extracellular fluid. Thirdly the relative changes in R0, R∞ and Ri following sub-cutaneous injections of saline were consistent with redistribution of water from the extracellular to intracellular space and /or removal from the local area as may occur during wound healing.

  7. Measurement of localized tissue water - clinical application of bioimpedance spectroscopy in wound management

    Science.gov (United States)

    Ward, L. C.; Sharpe, K.; Edgar, D.; Finlay, V.; Wood, F.

    2013-04-01

    Wound healing is a complex process which can be impeded by the presence of accumulated cell fluid or oedema. A simple and convenient method for the assessment of wound oedema would aid improvement in patient care. In this proof of concept study we investigated whether bioelectrical impedance spectroscopy has the potential to provide such a tool. A number of important observations were made. Firstly, the method was highly reproducible and data can be obtained from electrodes located at different positions around the region of interest; important given the highly variable topography of surface wounds, e.g. burns. Secondly, the method was highly sensitive with the potential to detect changes of as little as 20 μl in extracellular fluid. Thirdly the relative changes in R0, R∞ and Ri following sub-cutaneous injections of saline were consistent with redistribution of water from the extracellular to intracellular space and /or removal from the local area as may occur during wound healing.

  8. Biomedical-Grade Chitosan in Wound Management and Its Biocompatibility In Vitro

    OpenAIRE

    Halim, Ahmad Sukari; Lim, Chin Keong

    2010-01-01

    Chitosan and chitosan-based derivatives have various medical applications. It is wellknown that chitosan possesses medicinal properties that accelerate wound healing and tissue regeneration. Chitosan is a natural product. It is biocompatible and biodegradable, enabling it to be used for wound dressing material. However, the practical use of chitosan is restricted to the unmodified forms, as these are water-insoluble and have high viscosity and the tendency to coagulate with proteins at high p...

  9. SKIN CARE AND WOUND MANAGEMENT IN PATIENTS WITH INHERITED BULLOUS EPIDERMOLYSIS

    OpenAIRE

    Murat-Sušić, Slobodna; Husar, Karmela; Marinović, Branka; Skerlev, Mihael; Štulhofer Buzina, Daška; Kljenak, Antun; Martinac, Ivana

    2014-01-01

    Inherited epidermolysis bullosa is a group of diseases characterized by skin/mucous membrane fragility and development of blisters and erosions after insignificant mechanical trauma. It is a multisystemic disease with complications occurring on numerous organs other than the skin. As there is no cure for these diseases, treatment consists of early recognition and therapy of complications, quality wound care and skin protection. Optimal wound treatment depends primarily on the type of the dise...

  10. Microvascular free flaps in the management of war wounds with tissue defects

    OpenAIRE

    Kozarski Jefta; Panajotović Ljubomir; Novaković Marijan

    2003-01-01

    Background. War wounds caused by modern infantry weapons or explosive devices are very often associated with the defects of soft and bone tissue. According to their structure, tissue defects can be simple or complex. In accordance with war surgical doctrine, at the Clinic for Plastic Surgery and Burns of the Military Medical Academy, free flaps were used in the treatment of 108 patients with large tissue defects. With the aim of closing war wounds, covering deep structures, or making the prec...

  11. Management of Madhumehajanya Vrana (diabetic wound) with Katupila (Securinega leucopyrus [Willd] Muell.) Kalka

    Science.gov (United States)

    Ajmeer, Ahamed Shahan; Dudhamal, Tukaram S.; Gupta, Sanjay Kumar

    2015-01-01

    Introduction: Prevalence of diabetes and its complications have been a burden to the society from the ancient times, in the present and also will be in the future unless proper measures are taken to prevent its manifestation. There have been an increasing number of death associated-amputation cases which are mainly caused by nonhealing wounds. These facts urge researchers to develop new, more effective wound treatments for diabetic patients. Aim: To evaluate and compare the effect of Katupila Kalka (Securinega leucopyrus [Willd.] Muell. leaf paste) and Tila Taila (Sesamum indicum oil) in Madhumehajanya Vrana (diabetic wounds/ulcers) with Betadine ointment. Materials and Methods: A total of 23 patients of Madhumehajanya Vrana were chosen and randomly divided into two groups (Group A and B). Patients of Group A were treated with local application of Katupila Kalka with Tila Taila, whereas, in Group B, Betadine ointment was applied on the affected parts, once a day in the morning for 30 days. The relief in signs and symptoms were assessed on scoring pattern. Results: In Group A, diabetic wounds treated with Katupila paste got healed within 28 days with minimal scar formation without any complications, whereas in Group B, wound was healed completely only in two patients within 28 days. In both the groups, no patients reported any adverse drug reaction during the entire course of treatment as well as in follow-up period. Conclusion: Study concluded that the drug Katupila Kalka possesses Vrana Ropana (wound healing) activity with fine scaring.

  12. Clinical recommendations and practical guide for negative pressure wound therapy with instillation.

    Science.gov (United States)

    Gupta, Subhas; Gabriel, Allen; Lantis, John; Téot, Luc

    2016-04-01

    Effective wound management involves a comprehensive assessment of the patient and the wound to determine an optimal wound treatment plan. It is critical to identify and address factors that may impair wound healing, prior to selecting the most appropriate therapy for each patient. Negative pressure wound therapy (NPWT) is a well-established advanced therapy that has been successful in adjunctive management of acute and chronic wounds. In recent years, the introduction of topical wound solution delivery in combination with NPWT has provided further benefits to wound healing. A commercially available system now offers automated, volumetric control of instilled topical wound solutions with a dwell time in combination with NPWT (NPWTi-d; V.A.C. VeraFlo Therapy, KCI, an Acelity company, San Antonio, TX). This NPWTi-d system differs from other instillation systems in that a timed, predetermined volume of topical wound solution is intermittently delivered (versus continuously fed) and allowed to dwell in the wound bed (without NPWT), for a user-selected period of time before NPWT is resumed. This added accuracy and process simplification of solution delivery in tandem with NPWT have prompted use of NPWTi-d as first-line therapy in a wider subset of complex wounds. However, considerably more research is required to validate efficacy of NPWTi-d in various wound types. The purpose of this review is to provide a relevant overview of wound healing, describe current literature supporting the adjunctive use of NPWTi-d, propose a clinical approach for appropriate application of NPWTi-d and conclude with case studies demonstrating successful use of NPWTi-d. Based on this review, we conclude that either a large case series examining effects of NPWTi-d on different wound types or possibly a large prospective registry evaluating NPWTi-d with real-world topical wound solutions versus immediate debridement and closure would be valuable to the medical community in evaluating the

  13. Cell Therapy for Wound Healing

    OpenAIRE

    You, Hi-Jin; Han, Seung-Kyu

    2014-01-01

    In covering wounds, efforts should include utilization of the safest and least invasive methods with goals of achieving optimal functional and cosmetic outcome. The recent development of advanced wound healing technology has triggered the use of cells to improve wound healing conditions. The purpose of this review is to provide information on clinically available cell-based treatment options for healing of acute and chronic wounds. Compared with a variety of conventional methods, such as skin...

  14. Microvascular free flaps in the management of war wounds with tissue defects

    Directory of Open Access Journals (Sweden)

    Kozarski Jefta

    2003-01-01

    Full Text Available Background. War wounds caused by modern infantry weapons or explosive devices are very often associated with the defects of soft and bone tissue. According to their structure, tissue defects can be simple or complex. In accordance with war surgical doctrine, at the Clinic for Plastic Surgery and Burns of the Military Medical Academy, free flaps were used in the treatment of 108 patients with large tissue defects. With the aim of closing war wounds, covering deep structures, or making the preconditions for reconstruction of deep structures, free flaps were applied in primary, delayed, or secondary term. The main criteria for using free flaps were general condition of the wounded, extent, location, and structure of tissue defects. The aim was also to point out the advantages and disadvantages of the application of free flaps in the treatment of war wounds. Methods. One hundred and eleven microvascular free flaps were applied, both simple and complex, for closing the war wounds with extensive tissue defects. The main criteria for the application of free flaps were: general condition of the wounded, size, localization, and structure of tissue defects. For the extensive defects of the tissue, as well as for severely contaminated wounds latissimus dorsi free flaps were used. For tissue defects of distal parts of the lower extremities, scapular free flaps were preferred. While using free tissue transfer for recompensation of bone defects, free vascularized fibular grafts were applied, and in skin and bone defects complex free osteoseptocutaneous fibular, free osteoseptocutaneous radial forearm, and free skin-bone scapular flaps were used. Results. After free flap transfer 16 (14,4% revisions were performed, and after 8 unsuccessful revisions another free flaps were utilized in 3 (37,5% patients, and cross leg flaps in 5 (62,5% patients. Conclusion. The treatment of war wounds with large tissue defects by the application of free microvascular flaps

  15. Successful Management of a Cesarean Scar Defect with Dehiscence of the Uterine Incision by Using Wound Lavage

    Directory of Open Access Journals (Sweden)

    Akinori Ida

    2014-01-01

    Full Text Available Cesarean scar defects (CSDs that can be visualized using transvaginal ultrasonography (TVUS may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4 had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second cesarean section, she demonstrated prolonged menstruation and the presence of a menstrual fistula due to dehiscence of the cesarean section incision from the myometrium to the serosa. We treated the defect by lavaging with a physiological saline solution. After lavaging the wound 3 times, spontaneous healing of the dehiscent muscle layer was successfully achieved. The treatment was complication-free and the healing of the muscle layer has been maintained for more than 8 months.

  16. Development of advanced spent fuel management process

    International Nuclear Information System (INIS)

    This study is to develop an advanced spent fuel management process for countries which have not yet decided a back-end nuclear fuel cycle policy. The aims of this process development based on the pyroreduction technology of PWR spent fuels with molten lithium, are to reduce the storage volume by a quarter and to reduce the storage cooling load in half by the preferential removal of highly radioactive decay-heat elements such as Cs-137 and Sr-90 only. From the experimental results which confirm the feasibility of metallization technology, it is concluded that there are no problems in aspects of reaction kinetics and equilibrium. However, the operating performance test of each equipment on an engineering scale still remain and will be conducted in 1999. (author). 21 refs., 45 tabs., 119 figs

  17. ATF [Advanced Toroidal Facility] data management

    International Nuclear Information System (INIS)

    Data management for the Advanced Toroidal Facility (ATF), a stellarator located at Oak Ridge National Laboratory (ORNL), is provided by DMG, a locally developed, VAX-based software system. DMG is a data storage and retrieval software system that provides the user interface to ATF raw and analyzed data. Data are described in terms of data models and data types and are organized as signals into files, which are internally documented. The system was designed with user accessibility, software maintainability, and extensibility as primary goals. Extensibility features include compatibility with ATF as it moves from pulsed to steady-state operation and capability for use of the DMG system with experiments other than ATF. DMG is implemented as a run-time library of routines available as a shareable image. General-purpose and specialized data acquisition and analysis applications have been developed using the DMG system. This paper describes the DMG system and the interfaces to it. 4 refs., 2 figs

  18. Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)

    OpenAIRE

    Achten, Juul; Parsons, Nick R; Bruce, Julie; Petrou, Stavros; Tutton, Elizabeth; Willett, Keith; Lamb, Sarah E; Costa, Matthew L

    2015-01-01

    Introduction Patients who sustain open lower limb fractures have reported infection risks as high as 27%. The type of dressing applied after initial debridement could potentially affect this risk. In this trial, standard dressings will be compared with a new emerging treatment, negative pressure wound therapy, for patients with open lower limb fractures. Methods and analysis All adult patients presenting with an open lower limb fracture, with a Gustilo and Anderson (G&A) grade 2/3, will be co...

  19. Management of intestinal obstruction in advanced malignancy

    Directory of Open Access Journals (Sweden)

    Henry John Murray Ferguson

    2015-09-01

    Full Text Available Patients with incurable, advanced abdominal or pelvic malignancy often present to acute surgical departments with symptoms and signs of intestinal obstruction. It is rare for bowel strangulation to occur in these presentations, and spontaneous resolution often occurs, so the luxury of time should be afforded while decisions are made regarding surgery. Cross-sectional imaging is valuable in determining the underlying mechanism and pathology. The majority of these patients will not be suitable for an operation, and will be best managed in conjunction with a palliative medicine team. Surgeons require a good working knowledge of the mechanisms of action of anti-emetics, anti-secretories and analgesics to tailor early management to individual patients, while decisions regarding potential surgery are made. Deciding if and when to perform operative intervention in this group is complex, and fraught with both technical and emotional challenges. Surgery in this group is highly morbid, with no current evidence available concerning quality of life following surgery. The limited evidence concerning operative strategy suggests that resection and primary anastomosis results in improved survival, over bypass or stoma formation. Realistic prognostication and involvement of the patient, care-givers and the multidisciplinary team in treatment decisions is mandatory if optimum outcomes are to be achieved.

  20. Wound healing and hyper-hydration: a counterintuitive model.

    Science.gov (United States)

    Rippon, M G; Ousey, K; Cutting, K F

    2016-02-01

    Winter's seminal work in the 1960s relating to providing an optimal level of moisture to aid wound healing (granulation and re-epithelialisation) has been the single most effective advance in wound care over many decades. As such the development of advanced wound dressings that manage the fluidic wound environment have provided significant benefits in terms of healing to both patient and clinician. Although moist wound healing provides the guiding management principle, confusion may arise between what is deemed to be an adequate level of tissue hydration and the risk of developing maceration. In addition, the counter-intuitive model 'hyper-hydration' of tissue appears to frustrate the moist wound healing approach and advocate a course of intervention whereby tissue is hydrated beyond what is a normally acceptable therapeutic level. This paper discusses tissue hydration, the cause and effect of maceration and distinguishes these from hyper-hydration of tissue. The rationale is to provide the clinician with a knowledge base that allows optimisation of treatment and outcomes and explains the reasoning behind wound healing using hyper-hydration. Declaration of interest: K. Cutting is a Clinical Research Consultant to the medical device and biotechnology industry. M. Rippon is Visiting Clinical Research Fellow, University of Huddersfield and K. Ousey provides consultancy for a range of companies through the University of Huddersfield including consultancy services for Paul Hartmann Ltd on HydroTherapy products. PMID:26878298

  1. Recent Advances in Postoperative Pain Management

    OpenAIRE

    Vadivelu, Nalini; Mitra, Sukanya; Narayan, Deepak

    2010-01-01

    Good pain control after surgery is important to prevent negative outcomes such as tachycardia, hypertension, myocardial ischemia, decrease in alveolar ventilation, and poor wound healing. Exacerbations of acute pain can lead to neural sensitization and release of mediators both peripherally and centrally. Clinical wind up occurs from the processes of N-Methyl D-Aspartate (NMDA) activation, wind up central sensitization, long-term potentiation of pain (LTP), and transcription-dependent sensiti...

  2. Does topical wound oxygen (TWO2) offer an improved outcome over conventional compression dressings (CCD) in the management of refractory venous ulcers (RVU)? A parallel observational comparative study.

    LENUS (Irish Health Repository)

    Tawfick, W

    2009-07-01

    Topical wound oxygen (TWO(2)) may help wound healing in the management of refractory venous ulcers (RVU). The aim of this study was to measure the effect of TWO(2) on wound healing using the primary end-point of the proportion of ulcers healed at 12 weeks. Secondary end-points were time to full healing, percentage of reduction in ulcer size, pain reduction, recurrence rates and Quality-Adjusted Time Spent Without Symptoms of disease and Toxicity of Treatment (Q-TWiST).

  3. Advanced Security Management in Metro Ethernet Networks

    Directory of Open Access Journals (Sweden)

    Ammar Rayes

    2010-01-01

    Full Text Available With the rapid increase in bandwidth and the introduction of advanced IP services including voice, high-speed internet access, and video/IPTV, consumers are more vulnerable to malicious users than ever. In recent years, providing safe and sound networks and services have been the zenith priority for service providers and network carriers alike. Users are hesitant to subscribe to new services unless service providers guarantee secure connections. More importantly, government agencies of many countries have introduced legislations requiring service providers to keep track andrecords of owners of IP and MAC addresses at all time.In this paper, we first present an overview of Metro Ethernet (or Ethernet-To-The-Home/Business (ETTx and compare with various IP broadband access technologies including DSL, wireless and cable. We then outline major security concerns for Metro Ethernet networks including network and subscriber/end user security.Next we introduce state-of-the-art algorithms to prevent attackers from stealing any IP or MAC addresses. Our proposal is to use network management in conjunction with hardware features for security management to provide a secure and spoofing-free ETTx network. The key idea behind our proposal is to utilize network management to enforce strict (port, MAC, IP binding in the access network to provide subscriber security.The paper then proposes an adaptive policy-based security controller to quickly identify suspected malicious users, temporarily isolate them without disconnecting them from the network or validating their contracts, and then carry the required analysis. The proposed controller identifies malicious users without compromising between accurate but lengthy traffic analysis and premature decision. It also provides the ability to make granular corrective actions that are adaptive to any defined network condition.

  4. [Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

    Science.gov (United States)

    Ohura, Takehiko; Sanada, Hiromi; Mino, Yoshio

    2004-01-01

    In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor. Thus, cost-effectiveness in pressure ulcer care has not yet been fully established. To provide true cost effectiveness data, a comparative prospective study was initiated in patients with stage II and III pressure ulcers. Considering the potential impact of the pressure reduction mattress on clinical outcome, in particular, the same type of pressure reduction mattresses are utilized in all the cases in the study. The cost analysis method used was Activity-Based Costing, which measures material and labor cost aspects on a daily basis. A reduction in the Pressure Sore Status Tool (PSST) score was used to measure clinical effectiveness. Patients were divided into three groups based on the treatment method and on the use of a consistent algorithm of wound care: 1. MC/A group, modern dressings with a treatment algorithm (control cohort). 2. TC/A group, traditional care (ointment and gauze) with a treatment algorithm. 3. TC/NA group, traditional care (ointment and gauze) without a treatment algorithm. The results revealed that MC/A is more cost-effective than both TC/A and TC/NA. This suggests that appropriate utilization of modern dressing materials and a pressure ulcer care algorithm would contribute to reducing health care costs, improved clinical results, and, ultimately, greater cost-effectiveness. PMID:14999922

  5. Burn wound: How it differs from other wounds?

    Directory of Open Access Journals (Sweden)

    V K Tiwari

    2012-01-01

    Full Text Available Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.

  6. Advanced Management Communication: An Elective Course in Corporate Communication.

    Science.gov (United States)

    Argenti, Paul A.

    1986-01-01

    Proposes a college-level elective course in advanced management communication that would teach future managers how to communicate with shareholders, the media, financial analysts, and the labor force. (SRT)

  7. Patient perception of wound photography.

    Science.gov (United States)

    Wang, Sheila C; Anderson, John Ae; Jones, Duncan Vb; Evans, Robyn

    2016-06-01

    The objectives of this study were to provide an assessment of photographic documentation of the wound from the patients' perspective and to evaluate whether this could improve patients' understanding of and involvement in their wound care. Our results revealed that most patients visiting the wound care clinic have difficult-to-see wounds (86%). Only 20% of patients monitor their wounds and instead rely on clinic or nurse visits to track the healing progress. There was a significant association between patients' ability to see their wound and their subsequent memory of the wound's appearance. This was especially true for patients who had recently begun visiting the wound care clinic. This relationship was not present in patients who had visited the clinic for 3  or more years. Patients reported that the inability to see their wounds resulted in feeling a loss of autonomy. The majority of patients reported that photographing their wounds would help them to track the wound progress (81%) and would afford them more involvement in their own care (58%). This study provides a current representation of wound photography from the patients' perspective and reveals that it can motivate patients to become more involved in the management of their wounds - particularly for patients with difficult-to-see wounds. PMID:24872018

  8. A critical review of modern and emerging absorbent dressings used to treat exuding wounds.

    Science.gov (United States)

    Sweeney, India R; Miraftab, Mohsen; Collyer, Graham

    2012-12-01

    Wound management has progressed significantly over the last five decades. This emanates from a greater understanding of wound healing, technological progression and improved clinical and scientific research. There are currently a plethora of absorbent dressings on the wound care market which claim to have the ability to manage exudates whilst encouraging healing. However, it is becoming clear, from analysing randomised controlled trials, that some of these absorbent dressings are not meeting their expectations when applied in a clinical setting. Many clinicians now feel that there should be more focus, not only on a dressing's ability to manage exudate efficiently, but on a dressing's ability to proactively encourage healing and thus exudate reduction will ensue. This paper proposes to critically review modern and emerging absorbent wound care dressings used to manage exuding wounds and discuses some advances in this area. PMID:22248337

  9. Advances in Understanding and Managing Chronic Urticaria

    Science.gov (United States)

    Moolani, Yasmin; Lynde, Charles; Sussman, Gordon

    2016-01-01

    There have been recent advances in the classification and management of chronic urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic inducible urticaria (CINDU) has replaced physical urticaria and includes other forms of inducible urticaria, such as cholinergic and aquagenic urticaria. Furthermore, novel research has resulted in a new understanding with guidelines being revised in the past year by both the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA 2LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There are some differences in the recommendations, which will be discussed, but the core updates are common to both groups. The basic treatment for chronic urticaria involves second-generation non-sedating non-impairing H 1 antihistamines as first-line treatment. This is followed by up to a 4-fold increase in the licensed dose of these H 1 antihistamines. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor. Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab for CSU. There are also some small studies showing efficacy of omalizumab in CINDU. While there were previously many treatment options which were lacking in strong evidence, we are moving into an era where the treatment algorithm for chronic urticaria is simplified and contains more evidence-based, effective, and less toxic treatment options. PMID:26949520

  10. Advances in Understanding and Managing Chronic Urticaria.

    Science.gov (United States)

    Moolani, Yasmin; Lynde, Charles; Sussman, Gordon

    2016-01-01

    There have been recent advances in the classification and management of chronic urticaria. The new term chronic spontaneous urticaria (CSU) has replaced chronic idiopathic urticaria and chronic autoimmune urticaria. In addition, chronic inducible urticaria (CINDU) has replaced physical urticaria and includes other forms of inducible urticaria, such as cholinergic and aquagenic urticaria. Furthermore, novel research has resulted in a new understanding with guidelines being revised in the past year by both the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA (2)LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO). There are some differences in the recommendations, which will be discussed, but the core updates are common to both groups. The basic treatment for chronic urticaria involves second-generation non-sedating non-impairing H 1 antihistamines as first-line treatment. This is followed by up to a 4-fold increase in the licensed dose of these H 1 antihistamines. The major therapeutic advance in recent years has been in third-line treatment with omalizumab, a humanized monoclonal anti-immunoglobulin E (anti-IgE) antibody that prevents binding of IgE to the high-affinity IgE receptor. Several multicenter randomized controlled trials have shown safety and efficacy of omalizumab for CSU. There are also some small studies showing efficacy of omalizumab in CINDU. While there were previously many treatment options which were lacking in strong evidence, we are moving into an era where the treatment algorithm for chronic urticaria is simplified and contains more evidence-based, effective, and less toxic treatment options. PMID:26949520

  11. Development of Advanced Spent Fuel Management Process

    International Nuclear Information System (INIS)

    As a part of research efforts to develop an advanced spent fuel management process, this project focused on the electrochemical reduction technology which can replace the original Li reduction technology of ANL, and we have successfully built a 20 kgHM/batch scale demonstration system. The performance tests of the system in the ACPF hot cell showed more than a 99% reduction yield of SIMFUEL, a current density of 100 mA/cm2 and a current efficiency of 80%. For an optimization of the process, the prevention of a voltage drop in an integrated cathode, a minimization of the anodic effect and an improvement of the hot cell operability by a modulation and simplization of the unit apparatuses were achieved. Basic research using a bench-scale system was also carried out by focusing on a measurement of the electrochemical reduction rate of the surrogates, an elucidation of the reaction mechanism, collecting data on the partition coefficients of the major nuclides, quantitative measurement of mass transfer rates and diffusion coefficients of oxygen and metal ions in molten salts. When compared to the PYROX process of INL, the electrochemical reduction system developed in this project has comparative advantages in its application of a flexible reaction mechanism, relatively short reaction times and increased process yields

  12. Natural language processing and advanced information management

    Science.gov (United States)

    Hoard, James E.

    1989-01-01

    Integrating diverse information sources and application software in a principled and general manner will require a very capable advanced information management (AIM) system. In particular, such a system will need a comprehensive addressing scheme to locate the material in its docuverse. It will also need a natural language processing (NLP) system of great sophistication. It seems that the NLP system must serve three functions. First, it provides an natural language interface (NLI) for the users. Second, it serves as the core component that understands and makes use of the real-world interpretations (RWIs) contained in the docuverse. Third, it enables the reasoning specialists (RSs) to arrive at conclusions that can be transformed into procedures that will satisfy the users' requests. The best candidate for an intelligent agent that can satisfactorily make use of RSs and transform documents (TDs) appears to be an object oriented data base (OODB). OODBs have, apparently, an inherent capacity to use the large numbers of RSs and TDs that will be required by an AIM system and an inherent capacity to use them in an effective way.

  13. Development of Advanced Spent Fuel Management Process

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Chung Seok; Choi, I. K.; Kwon, S. G. (and others)

    2007-06-15

    As a part of research efforts to develop an advanced spent fuel management process, this project focused on the electrochemical reduction technology which can replace the original Li reduction technology of ANL, and we have successfully built a 20 kgHM/batch scale demonstration system. The performance tests of the system in the ACPF hot cell showed more than a 99% reduction yield of SIMFUEL, a current density of 100 mA/cm{sup 2} and a current efficiency of 80%. For an optimization of the process, the prevention of a voltage drop in an integrated cathode, a minimization of the anodic effect and an improvement of the hot cell operability by a modulation and simplization of the unit apparatuses were achieved. Basic research using a bench-scale system was also carried out by focusing on a measurement of the electrochemical reduction rate of the surrogates, an elucidation of the reaction mechanism, collecting data on the partition coefficients of the major nuclides, quantitative measurement of mass transfer rates and diffusion coefficients of oxygen and metal ions in molten salts. When compared to the PYROX process of INL, the electrochemical reduction system developed in this project has comparative advantages in its application of a flexible reaction mechanism, relatively short reaction times and increased process yields.

  14. Complementary and alternative therapies for management of odor in malignant fungating wounds: a critical review

    OpenAIRE

    Gethin G; McIntosh C; Probst S

    2016-01-01

    Georgina Gethin,1 Caroline McIntosh,2 Sebastian Probst3 1School of Nursing and Midwifery, National University of Ireland, Galway, 2Discipline of Podiatric Medicine, National University of Ireland, Galway, Ireland; 3School of Health, University of Applied Sciences Western Switzerland, Geneva, Switzerland Abstract: Malignant fungating wounds (MFWs) affect an estimated 5%–10% of all people with cancer. They have a profound effect on the individual, and their associated symptoms such as bl...

  15. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    Jeschke, Marc

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased lite...

  16. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    AD Rogers; MG, Jeschke

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literatu...

  17. Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis

    OpenAIRE

    Karaaslan F; Erdem Ş; Mermerkaya MU

    2014-01-01

    Fatih Karaaslan,1 Şevki Erdem,2 Musa Ugur Mermerkaya11Department of Orthopaedics and Traumatology, Bozok University Medical School, Yozgat, Turkey; 2Department of Orthopaedics and Traumatology, Haydarpasa Numune Training Hospital, Istanbul, TurkeyObjective: To evaluate the results of negative-pressure wound therapy (NPWT) in the treatment of surgical spinal site infections.Materials and methods: The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar in...

  18. p38 MAPK inhibition reduces diabetes-induced impairment of wound healing

    Directory of Open Access Journals (Sweden)

    Satyanarayana Medicherla

    2009-06-01

    Full Text Available Satyanarayana Medicherla1, Scott Wadsworth2, Breda Cullen3, Derek Silcock3, Jing Y Ma1, Ruban Mangadu1, Irene Kerr1, Sarvajit Chakravarty1, Gregory L Luedtke1, Sundeep Dugar1, Andrew A Protter1, Linda S Higgins11Scios Inc., Fremont, CA, USA; 2Center for Biomaterials and Advanced Technologies, Somerville, NJ, USA; 3Johnson & Johnson Wound Management, Gargrave, UKAbstract: In healthy tissue, a wound initiates an inflammatory response characterized by the presence of a hematoma, infiltration of inflammatory cells into the wound and, eventually, wound healing. In pathological conditions like diabetes mellitus, wound healing is impaired by the presence of chronic nonresolving inflammation. p38 mitogen-activated protein kinase (MAPK inhibitors have demonstrated anti-inflammatory effects, primarily by inhibiting the expression of inflammatory cytokines and regulating cellular traffic into wounds. The db/db mouse model of type 2 diabetes was used to characterize the time course of expression of activated p38 during impaired wound healing. The p38α-selective inhibitor, SCIO-469, was applied topically and effects on p38 activation and on wound healing were evaluated. A topical dressing used clinically, PromogranTM, was used as a comparator. In this study, we established that p38 is phosphorylated on Days 1 to 7 post-wounding in db/db mice. Further, we demonstrated that SCIO-469, at a dose of 10 µg/wound, had a positive effect on wound contraction, granulation tissue formation, and re-epithelialization, and also increased wound maturity during healing. These effects were similar to or greater than those observed with PromogranTM. These results suggest a novel approach to prophylactic and therapeutic management of chronic wounds associated with diabetes or other conditions in which healing is impaired.Keywords: p38 MAPK ihibition, diabetic wound healing, db/db mouse, nonresolving healing, PromogranTM

  19. Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic.

    LENUS (Irish Health Repository)

    Gethin, Georgina

    2012-04-01

    Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management.

  20. The intelligent user interface for NASA's advanced information management systems

    Science.gov (United States)

    Campbell, William J.; Short, Nicholas, Jr.; Rolofs, Larry H.; Wattawa, Scott L.

    1987-01-01

    NASA has initiated the Intelligent Data Management Project to design and develop advanced information management systems. The project's primary goal is to formulate, design and develop advanced information systems that are capable of supporting the agency's future space research and operational information management needs. The first effort of the project was the development of a prototype Intelligent User Interface to an operational scientific database, using expert systems and natural language processing technologies. An overview of Intelligent User Interface formulation and development is given.

  1. Advanced Hybrid Particulate Collector Project Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    Miller, S.J.

    1995-11-01

    As the consumption of energy increases, its impact on ambient air quality has become a significant concern. Recent studies indicate that fine particles from coal combustion cause health problems as well as atmospheric visibility impairment. These problems are further compounded by the concentration of hazardous trace elements such as mercury, cadmium, selenium, and arsenic in fine particles. Therefore, a current need exists to develop superior, but economical, methods to control emissions of fine particles. Since most of the toxic metals present in coal will be in particulate form, a high level of fine- particle collection appears to be the best method of overall air toxics control. However, over 50% of mercury and a portion of selenium emissions are in vapor form and cannot be collected in particulate control devices. Therefore, this project will focus on developing technology not only to provide ultrahigh collection efficiency of particulate air toxic emissions, but also to capture vapor- phase trace metals such as mercury and selenium. Currently, the primary state-of-the-art technologies for particulate control are fabric filters (baghouses) and electrostatic precipitators (ESPs). However, they both have limitations that prevent them from achieving ultrahigh collection of fine particulate matter and vapor-phase trace metals. The objective of this project is to develop a highly reliable advanced hybrid particulate collector (AHPC) that can provide > 99.99 % particulate collection efficiency for all particle sizes between 0.01 and 50 14m, is applicable for use with all U.S. coals, and is cost-0443competitive with existing technologies. Phase I of the project is organized into three tasks: Task I - Project Management, Reporting, and Subcontract Consulting Task 2 - Modeling, Design, and Construction of 200-acfm AHPC Model Task 3 - Experimental Testing and Subcontract Consulting

  2. Burn wound: How it differs from other wounds?

    OpenAIRE

    Tiwari, V K

    2012-01-01

    Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock wh...

  3. Manejo quirúrgico urgente de heridas faciales por mordedura humana Urgent surgical management of facial human bite wounds

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2011-09-01

    Full Text Available Las heridas por mordedura pueden generar algunas dificultades quirúrgicas en su manejo inicial debido a su especial predisposición a las complicaciones sépticas y la importante destrucción tisular frecuentemente asociada. Sin embargo, es importante su reparación inmediata, especialmente en el caso de amputaciones y colgajos por avulsión. Las mordeduras humanas se hallan envueltas además en consideraciones psicológicas que incrementan la dificultad del tratamiento debido a las espectativas estéticas de los pacientes que las sufren. Este trabajo analiza 7 casos de mordedura facial humana desde los puntos de vista epidemiológico y clínico. Presentamos y discutimos el uso de los tejidos amputados como fuente de injertos de piel, injertos condrales y el papel de los colgajos locales en dos tiempos en la cirugía de urgencia de estas lesiones.Bite wounds can create several surgical difficulties in their initial management due to the special facility for infectious complications and the frequent association with extensive tissue damage. However, the immediate repair its desirable, mainly in amputations and flap avulsions. The human bite wounds are also involved by psychological considerations that increase the difficulty of the treatment due to patient´s aesthetic expectations. This article analyzes 7 cases of facial human bites under the epidemiological and clinical points of view. The use of the amputated tissues to obtain skin grafts, condral grafts, and the role of local two stage flaps in the emergency surgery of these wounds are exposed and discussed.

  4. Management of low velocity gunshot wounds to the anterior urethra: the role of primary repair versus urinary diversion alone.

    Science.gov (United States)

    Husmann, D A; Boone, T B; Wilson, W T

    1993-07-01

    The management of partial transection of the anterior urethra following penetrating penile injuries is controversial. Optional therapeutic techniques range from a primary sutured reapproximation to urinary diversion alone. We recently managed 17 low velocity gunshot wounds to the external genitalia in which the missile traversed the penile corpus cavernosum, and was associated with less than 40% transection of the corpus spongiosum and anterior urethra. Nine patients were managed with suprapubic diversion, skin débridement and corporeal closure along with placement of a urethral catheter. Eight patients were managed by suprapubic diversion, débridement, closure of the corporeal bodies and a primary sutured reapproximation of the anterior urethra. Urethral strictures developed in 7 patients (78%) managed by a suprapubic tube and urethral stenting during an average followup of 20 months (range 18 to 24). In contrast, 1 patient (12%) managed by a sutured urethral approximation had a urethral stricture during an average followup of 20 months (range 18 to 30, p placement of a suprapubic catheter and primary repair of the urethra. PMID:8510278

  5. A preliminary study of the effect of closed incision management with negative pressure wound therapy over high-risk incisions

    OpenAIRE

    Perry, Karen L.; Rutherford, Lynda; Sajik, David M. R.; Bruce, Mieghan

    2015-01-01

    Background Certain postoperative wounds are recognised to be associated with more complications than others and may be termed high-risk. Wound healing can be particularly challenging following high-energy trauma where wound necrosis and infection rates are high. Surgical incision for joint arthrodesis can also be considered high-risk as it requires extensive and invasive surgery and postoperative distal limb swelling and wound dehiscence are common. Recent human literature has investigated th...

  6. Hands-Free Image Capture, Data Tagging and Transfer Using Google Glass: A Pilot Study for Improved Wound Care Management

    OpenAIRE

    Aldaz, G.; Shluzas, L.A.; Pickham, D.; Eris, O.; Sadler, J; Joshi, S.; Leifer, L.

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records ...

  7. An international eDelphi study identifying the research and education priorities in wound management and tissue repair.

    OpenAIRE

    Cowman, Seamus; GETHIN, GEORGINA; Clarke, Eric; Moore, Zena; Craig, Gerardine; Jordan-O'Brien, Julie; McLain, Niamh; Strapp, Helen

    2011-01-01

    Aim.  To incorporate an international and multidisciplinary consensus in the determination of the research and education priorities for wound healing and tissue repair. Background.  A compelling reason for the study is the lack of an agreed list of priorities for wound care research and education. Furthermore, there is a growth in the prevalence of chronic wounds, a growth in wound care products and marketing, and an increase in clinician attendance at conferences and education programmes. De...

  8. The role of arthroscopy in the management of low-velocity gunshot wounds of the knee joint.

    Science.gov (United States)

    Parisien, J S; Esformes, I

    1984-05-01

    Eight patients with low-velocity civilian gunshot wounds of the knee were examined and evaluated by arthroscopy. Three of these patients were also treated by surgical arthroscopy and underwent limited arthrotomy for bullet removal. In two patients small arthrotomy incisions were made following arthroscopic exploration for removal of bullets. Two patients underwent diagnostic arthroscopy. One underwent internal fixation for a chondral fracture of the femoral condyle. The majority of patients sustained intra-articular damage and retained foreign materials (denim flecks and metallic shards) and osteochondral fragments. There were no postoperative infections after a minimum follow-up period of one year. Arthroscopy is highly effective in the diagnosis and surgical management of low-velocity gunshot wounds of the knee both alone and in combination with limited arthrotomy depending on the severity of the condylar damage. The length of the hospital stay is reduced (length of stay exceeded 3-4 days only as a result of intravenous antibiotic coverage). Physical therapy requirements are minimal. Active mobility and a full range of motion are regained more rapidly with arthroscopy than with surgical exposure of multiple exploratory incisions or conventional standard arthrotomy. PMID:6705381

  9. Hands-Free Image Capture, Data Tagging and Transfer Using Google Glass: A Pilot Study for Improved Wound Care Management

    NARCIS (Netherlands)

    Aldaz, G.; Shluzas, L.A.; Pickham, D.; Eris, O.; Sadler, J.; Joshi, S.; Leifer, L.

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing p

  10. Advanced Mirror System Demonstrator (AMSD) Risk Management

    Science.gov (United States)

    Byberg, Alicia; Russell, J. Kevin; Kaukler, Donna; Burdine, Robert V. (Technical Monitor)

    2002-01-01

    This paper will report risk issues associated with designing, manufacturing, and testing the Advanced Mirror System Demonstrator (AMSD). The Advanced Mirror System Demonstrator (AMSD) will be developed as a lightweight primary mirror system that can be produced at a low cost and with a short manufacturing schedule. This technology will add to the knowledge base for selection for the Next Generation Space Telescope (NGST), Space Based Laser (SBL), Research Laboratory mission (AFRL), and other government agency programs.

  11. mTOR inhibition in management of advanced breast cancer

    Directory of Open Access Journals (Sweden)

    Shona Nag

    2012-01-01

    Full Text Available The mTOR pathway is becoming increasingly important in several cancers including breast cancer. This review will focus on the role of its inhibition in the management of advanced breast cancer.

  12. Radioactive waste management and advanced nuclear fuel cycle technologies

    International Nuclear Information System (INIS)

    In 2007 ENEA's Department of Nuclear Fusion and Fission, and Related Technologies acted according to national policy and the role assigned to ENEA FPN by Law 257/2003 regarding radioactive waste management and advanced nuclear fuel cycle technologies

  13. Recent advances in the management of choreas

    OpenAIRE

    Burgunder, Jean-Marc

    2013-01-01

    The management of patients with chorea, in particular Huntington’s disease, is a complex task requiring skills in a number of areas. This paper reviews new knowledge on this topic and places it in the context of established procedures. It is focused on Huntington’s disease, since this is the disorder, for which most publications on management have been published in the past few years. Management starts with appropriate diagnosis and differential diagnosis, with the aim of finding disorders wi...

  14. Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

    Directory of Open Access Journals (Sweden)

    Nasir Nur-Azida

    2010-06-01

    Full Text Available Abstract Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml. Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care

  15. Advanced Interval Management (IM) Concepts of Operations

    Science.gov (United States)

    Barmore, Bryan E.; Ahmad, Nash'at N.; Underwood, Matthew C.

    2014-01-01

    This document provides a high-level description of several advanced IM operations that NASA is considering for future research and development. It covers two versions of IM-CSPO and IM with Wake Mitigation. These are preliminary descriptions to support an initial benefits analysis

  16. Individualized management of advanced bladder cancer: Where do we stand?

    Science.gov (United States)

    Burgess, Earle F

    2015-04-01

    Despite recent progress in the development of novel targeted therapies in various malignancies, the management of advanced urothelial cancer has changed little over the past 2 decades. Comorbidities inherent to patients with bladder cancer often preclude the use of standard cisplatin-based chemotherapy and underscore the need for individualized treatment recommendations and the development of more effective therapies. This review discusses current issues relevant to the management of patients with locally advanced and metastatic urothelial carcinoma of the bladder and highlights recent advances in defining molecular aberrations that may ultimately lead to personalized therapeutic decision making. PMID:24332641

  17. Advanced Interference Management Technique: Potentials and Limitations

    OpenAIRE

    Lee, Namyoon; Heath Jr, Robert W.

    2014-01-01

    Interference management has the potential to improve spectrum efficiency in current and next generation wireless systems (e.g. 3GPP LTE and IEEE 802.11). Recently, new paradigms for interference management have emerged to tackle interference in a general class of wireless networks: interference shaping and interference exploitation. Both approaches offer better performance in interference-limited communication regimes than traditionally thought possible. This article provides a high-level ove...

  18. Advances in the management of macular degeneration

    OpenAIRE

    Singer, Michael

    2014-01-01

    Current management of age-related macular degeneration (AMD) can be divided into two categories: first, anti-vasoendothelial growth factor (anti-VEGF) injection for wet macular degeneration; second, anti-oxidant vitamins for dry macular degeneration. New therapies are being developed for both of these diseases using novel technologies and different modes of administration. The hope is that some of these therapies will achieve significant improvement to current management and prevent future lo...

  19. Modulation of matrix metalloproteinases MMP-2 and MMP-9 activity by hydrofiber-foam hybrid dressing – relevant support in the treatment of chronic wounds

    OpenAIRE

    Krejner, Alicja; Grzela, Tomasz

    2015-01-01

    Success in chronic wound therapy requires careful selection of appropriate dressing, which enables effective management of wound exudate. According to current knowledge, exudate may contain large quantities of proteases, including matrix metalloproteinases, MMP-2 and MMP-9, which are responsible for delay in wound healing. Therefore, neutralization of MMPs may be beneficial for treatment efficacy. The aim of the study was to test whether AQUACEL Foam, a novel, technologically advanced hydrofi...

  20. Efficacy of papain-based wound cleanser in promoting wound regeneration.

    Science.gov (United States)

    Ajlia, S A S H; Majid, F A A; Suvik, A; Effendy, M A W; Nouri, H Serati

    2010-06-15

    A new invention, papain-based wound cleanser is formulated by incorporating papain, a proteolytic enzyme extracted from Carica papaya into the formulation. This cleanser is invented to simplify the methods in wound management by combining wound cleansing and wound debridement using a single formulation. This study describes the preparation and preclinical study of papain-based wound cleanser in accelerating wound healing. In this study, papain-based wound cleanser was used to treat wound incision on Sprague-Dawley rats while distilled water and Betadine were used as negative and positive control. Twenty-seven clinically healthy white rats were randomly divided into three groups and treated accordingly until the 21st day post-incision. Wound reduction rates and histological analysis were obtained to asses the healing pattern. Rats treated with papain-based wound cleanser showed a progressive wound healing based on the wound reduction rates and histological analysis when compared with rats treated with distilled water and Betadine. Better collagen deposition and presence of skin organelles in rats treated with papain-based wound cleanser demonstrated its efficacy in promoting wound healing. In addition to its wound healing effect, papain-based wound cleanser is also integrated with antibacterial properties which make it a complete package for wound management. However, further studies should be carried out to ensure its safety for human usage. PMID:21061910

  1. Advanced Fuel Cell System Thermal Management for NASA Exploration Missions

    Science.gov (United States)

    Burke, Kenneth A.

    2009-01-01

    The NASA Glenn Research Center is developing advanced passive thermal management technology to reduce the mass and improve the reliability of space fuel cell systems for the NASA exploration program. An analysis of a state-of-the-art fuel cell cooling systems was done to benchmark the portion of a fuel cell system s mass that is dedicated to thermal management. Additional analysis was done to determine the key performance targets of the advanced passive thermal management technology that would substantially reduce fuel cell system mass.

  2. Pancreatic Pseudocysts: Advances in Endoscopic Management.

    Science.gov (United States)

    Ge, Phillip S; Weizmann, Mikhayla; Watson, Rabindra R

    2016-03-01

    Endoscopic drainage is the first-line therapy in the management of pancreatic pseudocysts. Before endoscopic drainage, clinicians should exclude the presence of pancreatic cystic neoplasms and avoid drainage of immature peripancreatic fluid collections or pseudoaneurysms. The indication for endoscopic drainage is not dependent on absolute cyst size alone, but on the presence of attributable signs or symptoms. Endoscopic management should be performed as part of a multidisciplinary approach in close cooperation with surgeons and interventional radiologists. Drainage may be performed either via a transpapillary approach or a transmural approach; additionally, endoscopic necrosectomy may be performed for patients with walled-off necrosis. PMID:26895678

  3. New Is Old, and Old Is New: Recent Advances in Antibiotic-Based, Antibiotic-Free and Ethnomedical Treatments against Methicillin-Resistant Staphylococcus aureus Wound Infections.

    Science.gov (United States)

    Dou, Jian-Lin; Jiang, Yi-Wei; Xie, Jun-Qiu; Zhang, Xiao-Gang

    2016-01-01

    Staphylococcus aureus is the most common pathogen of wound infections. Thus far, methicillin-resistant S. aureus (MRSA) has become the major causative agent in wound infections, especially for nosocomial infections. MRSA infections are seldom eradicated by routine antimicrobial therapies. More concerning, some strains have become resistant to the newest antibiotics of last resort. Furthermore, horizontal transfer of a polymyxin resistance gene, mcr-1, has been identified in Enterobacteriaceae, by which resistance to the last group of antibiotics will likely spread rapidly. The worst-case scenario, "a return to the pre-antibiotic era", is likely in sight. A perpetual goal for antibiotic research is the discovery of an antibiotic that lacks resistance potential, such as the recent discovery of teixobactin. However, when considering the issue from an ecological and evolutionary standpoint, it is evident that it is insufficient to solve the antibiotic dilemma through the use of antibiotics themselves. In this review, we summarized recent advances in antibiotic-based, antibiotic-free and ethnomedical treatments against MRSA wound infections to identify new clues to solve the antibiotic dilemma. One potential solution is to use ethnomedical drugs topically. Some ethnomedical drugs have been demonstrated to be effective antimicrobials against MRSA. A decline in antibiotic resistance can therefore be expected, as has been demonstrated when antibiotic-free treatments were used to limit the use of antibiotics. It is also anticipated that these drugs will have low resistance potential, although there is only minimal evidence to support this claim to date. More clinical trials and animal tests should be conducted on this topic. PMID:27120596

  4. New Is Old, and Old Is New: Recent Advances in Antibiotic-Based, Antibiotic-Free and Ethnomedical Treatments against Methicillin-Resistant Staphylococcus aureus Wound Infections

    Directory of Open Access Journals (Sweden)

    Jian-Lin Dou

    2016-04-01

    Full Text Available Staphylococcus aureus is the most common pathogen of wound infections. Thus far, methicillin-resistant S. aureus (MRSA has become the major causative agent in wound infections, especially for nosocomial infections. MRSA infections are seldom eradicated by routine antimicrobial therapies. More concerning, some strains have become resistant to the newest antibiotics of last resort. Furthermore, horizontal transfer of a polymyxin resistance gene, mcr-1, has been identified in Enterobacteriaceae, by which resistance to the last group of antibiotics will likely spread rapidly. The worst-case scenario, “a return to the pre-antibiotic era”, is likely in sight. A perpetual goal for antibiotic research is the discovery of an antibiotic that lacks resistance potential, such as the recent discovery of teixobactin. However, when considering the issue from an ecological and evolutionary standpoint, it is evident that it is insufficient to solve the antibiotic dilemma through the use of antibiotics themselves. In this review, we summarized recent advances in antibiotic-based, antibiotic-free and ethnomedical treatments against MRSA wound infections to identify new clues to solve the antibiotic dilemma. One potential solution is to use ethnomedical drugs topically. Some ethnomedical drugs have been demonstrated to be effective antimicrobials against MRSA. A decline in antibiotic resistance can therefore be expected, as has been demonstrated when antibiotic-free treatments were used to limit the use of antibiotics. It is also anticipated that these drugs will have low resistance potential, although there is only minimal evidence to support this claim to date. More clinical trials and animal tests should be conducted on this topic.

  5. Advance on wound non-healing of diabetes mellitus%糖尿病创面难愈机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    孙晓磊; 施森; 何延政

    2008-01-01

    Wound healing is a complicated biological process, which consists of inflammatory cells, re-pairing cells, extracellular matrix, cell factors, et al. These factors participate in the process of wound heal-ing in great harmony and coordination. The sufferers of diabetes mellitus are vulnerable to skin injury ,which often results in non-healing or healing delay, which became an urgent difficulty and warm spot unsolved in clinic. So far, especially for the last few years, great progress has been made in the mechanism of wound non-healing of Diabetes Mellitus, mainly including signal pathways, angiopoiesis, neuropeptides, advanced glycation end products, cell apoptosis and matrix metaltoproteinases.%创面愈合是一个复杂的生物学过程,是炎性细胞、修复细胞、细胞外基质及细胞因子等多因素共同参与并高度协调、相互调控的复杂过程.糖尿病患者皮肤易受损伤,损伤后创面愈合延迟或不愈合,成为临床上亟待解决的难点和热点.近几年来,糖尿病创面难愈机制的研究进展迅速,主要围绕在信号通路、血管生成、神经肽、糖基化终末产物、细胞凋亡及基质金属蛋白酶等方面.本文就此作一综述.

  6. French programs for advanced waste management options

    International Nuclear Information System (INIS)

    Several organizations (CEA, CNRS, EdF, etc.) are cooperating in France on accelerator-driven systems. The major motivation is the investigation of innovative options for the radioactive waste management. The paper describes the ongoing activities and future directions of the cooperative efforts. 11 refs., 3 figs

  7. p38 MAPK inhibition reduces diabetes-induced impairment of wound healing

    OpenAIRE

    Satyanarayana Medicherla; Scott Wadsworth; Breda Cullen; Derek Silcock; et al.

    2009-01-01

    Satyanarayana Medicherla1, Scott Wadsworth2, Breda Cullen3, Derek Silcock3, Jing Y Ma1, Ruban Mangadu1, Irene Kerr1, Sarvajit Chakravarty1, Gregory L Luedtke1, Sundeep Dugar1, Andrew A Protter1, Linda S Higgins11Scios Inc., Fremont, CA, USA; 2Center for Biomaterials and Advanced Technologies, Somerville, NJ, USA; 3Johnson & Johnson Wound Management, Gargrave, UKAbstract: In healthy tissue, a wound initiates an inflammatory response characterized by the presence of a hematoma,...

  8. Wound Care Nursing: Professional Issues and Opportunities

    OpenAIRE

    Corbett, Lisa Q.

    2012-01-01

    As the field of wound care advances and seeks validity as a distinctive healthcare specialty, it becomes imperative to define practice competencies for all related professionals in the arena. As such, the myriad nurses practicing wound care in settings across the continuum should be understood for their unique contribution to the wound care team. Furthermore, the hierarchy of wound care nursing with varying levels of licensure, certification, and scope of practice can be clarified to delineat...

  9. A Global Perspective on Wound Care

    OpenAIRE

    Serena, Thomas E

    2014-01-01

    The development of an interprofessional team approach to the care of acute and chronic wounds is a worldwide challenge. This global unmet need has recently been recognized by the World Health Organization (WHO) and addressed by the Association for the Advancement of Wound Care (AAWC) Global Volunteers program. This article provides an overview of the escalating international wound problem. Current programs established to deal with wounds in resource-poor countries are presented as well as inf...

  10. Management of advanced hair loss patterns.

    Science.gov (United States)

    Beehner, Michael L

    2013-08-01

    This article covers how to manage patients with extensive hair loss in whom complete, dense coverage is not possible. In addition to discussing planning a transplant pattern for already bald men, I discuss a conservative approach for recognizing and transplanting younger patients who have telltale warning signs that may evolve to extensive hair loss. For both groups, a variant of a frontal forelock-type pattern is usually the best course to follow. PMID:24017980

  11. Neonatal Seizures. Advances in Mechanisms and Management.

    OpenAIRE

    Glass, HC

    2013-01-01

    Seizures occur in approximately 1–5 per 1,000 live births, and are among the most common neurologic conditions managed by a neonatal neurocritical care service. There are several, age-specific factors that are particular to the developing brain, which influence excitability and seizure generation, response to medications, and impact of seizures on brain structure and function. Neonatal seizures are often associated with serious underlying brain injury such as hypoxia-ischemia, stroke or hemor...

  12. Advanced User Interfaces for Product Management Systems

    OpenAIRE

    Gundelsweiler, Fredrik; Reiterer, Harald

    2008-01-01

    Few of today s EPDM (electronic product data management) systems make use of valuable approaches in user interface design and information visualization as suggested by researchers. In this paper, we describe a design approach addressing the problems of searching, browsing, visualizing and filtering information in hierarchically structured graphs. The main problem areas we identified are the amount of data, the possibly complex hierarchical structure in combination with a chronological version...

  13. Efficacy of Papain-based Wound Cleanser in Promoting Wound Regeneration

    OpenAIRE

    M.A.W. Effendy; A. Suvik; F.A.A. Majid; S.A.S.H. Ajlia; H. Serati Nouri

    2010-01-01

    A new invention, papain-based wound cleanser is formulated by incorporating papain, a proteolytic enzyme extracted from Carica papayaonstrated its efficacy in promoting wound healing. In addition to its wound healing effect, papain-based wound cleanser is also integrated with antibacterial properties which make it a complete package for wound management. However, further studies should be carried out to ensure its safety for human usage.

  14. Advances in the management of chronic insomnia.

    Science.gov (United States)

    Kay-Stacey, Margaret; Attarian, Hrayr

    2016-01-01

    Chronic insomnia is a common condition that affects people worldwide and has negative effects on patients' health and wellbeing. The treatment of insomnia can be complex and time consuming for patients and providers. Although behavioral interventions are the first line therapy, there are barriers to access for these treatments. However, in recent years, alternative ways of providing these behavioral therapies that make them more widely available have been investigated. Drugs also play an important role in the treatment of insomnia and new drugs have been introduced as options for treating patients with sleep initiation and sleep maintenance insomnia. In this review, we will discuss advances in the past six years in both non-pharmacologic and pharmacologic treatments for patients with chronic insomnia. We will also review the controversies surrounding some of the current drug treatments, as well as the role that technology and personal activity monitoring devices may play in treating insomnia. PMID:27383400

  15. Low-level laser therapy: An experimental design for wound management: A case-controlled study in rabbit model

    Directory of Open Access Journals (Sweden)

    Hossein Hodjati

    2014-01-01

    Full Text Available Background: There is a wide array of articles in medical literature for and against the laser effect on wound healing but without discrete effect determination or conclusion. This experimental study aims to evaluate the efficacy of low-level laser therapy on wound healing. Materials and Methods: Thirty-four rabbits were randomly enrolled in two groups after creating a full thickness of 3 × 3 cm wound. The intervention group received low density laser exposure (4 J/cm 2 on days 0, 3 and 6 with diode helium-neon low-intensity laser device (wl = 808 nm and in control group moist wound dressing applied. Finally, wound-healing process was evaluated by both gross and pathological assessment. Results: Fibrin formation was the same in the two groups (P = 0.4 but epithelialisation was much more in laser group (P = 0.02. Wound inflammation of the laser group was smaller than that of the control groups but statistical significance was not shown (P = 0.09. Although more smooth muscle actin was found in the wounds of the laser group but it was not statistically significant (P = 0.3. Wound diameter showed significant decrease in wound area in laser group (P = 0.003. Conclusion: According to our study, it seems that low-level laser therapy accelerates wound healing at least in some phases of healing process. So, we can conclude that our study also shows some hopes for low level laser therapy effect on wound healing at least in animal model.

  16. Super-oxidized solution (Dermacyn Wound Care) as adjuvant treatment in the postoperative management of complicated diabetic foot osteomyelitis: preliminary experience in a specialized department.

    Science.gov (United States)

    Aragón-Sánchez, Javier; Lázaro-Martínez, Jose Luis; Quintana-Marrero, Yurena; Sanz-Corbalán, Irene; Hernández-Herrero, Maria J; Cabrera-Galván, Juan J

    2013-06-01

    Surgery is usually used to treat diabetic foot osteomyelitis (DFO), whether primarily or in cases in which antibiotics are not able to control infection. In many cases, the bone is only partially removed, which means that residual infection remains in the bone margins, and the wound is left open to heal by secondary intent. The use of culture-guided postoperative antibiotic treatment and adequate management of the wound must be addressed. No trials exist dealing with local treatment in the postoperative management of these cases of complicated DFO. We decided to test a super-oxidized solution, Dermacyn Wound Care (DWC; Oculus Innovative Sciences Netherlands BV, Sittard, Netherlands) to obtain preliminary experience in patients in whom infected bone remained in the surgical wounds. Our hypothesis was that DWC could be useful to control infection in the residual infected bone and surrounding soft tissues and would thus facilitate healing. Fourteen consecutive patients who underwent conservative surgery for DFO, in whom clean bone margins could not be assured, were treated in the postoperative period with DWC. Eleven cases were located in the forefoot, 6 on the first ray and the rest in lesser toes, 1 in the Lisfranc joint, and 2 on the calcaneus. No side effects appeared during treatment. Neither allergies nor skin dermatitis were found. Limb salvage was successfully achieved in 100% of the cases. Healing was achieved in a median period of 6.8 weeks. PMID:23446366

  17. Knowledge Management Platform in Advanced Product Quality Planning

    Science.gov (United States)

    Chiliban, Bogdan; Baral, Lal Mohan; Kifor, Claudiu

    2014-12-01

    Knowledge is an essential part of organizational competitiveness. This vital resource must be managed correctly within organizations in order to achieve desired performance levels within all undertakings. The process of managing knowledge is a very difficult one due to the illusive nature of the resource itself. Knowledge is stored within every aspect of an organization starting from people and ending with documents and processes. The Knowledge Management Platform is designed as a facilitator for managers and employees in all endeavours knowledge related within the Advanced Product Quality Planning Procedure

  18. 建立多学科合作机制精准治疗特殊原因创面%Precise management of extraordinary agent wound by establishment of a multidisciplinary cooperation mechanism

    Institute of Scientific and Technical Information of China (English)

    刘毅

    2016-01-01

    With the development of social economy,people's lifestyle has changed accompanied with the problem of population aging.The spectrum of disease also varied accordingly,thus led to complicated and varied wound aetiology,along with the formation of innumerably changed acute and chronic wounds.Therefore,it is hard to meet the requirement of multidisciplinary knowledge and technique in the diagnosis and treatment of some extraordinary agent wound with a single discipline.The extraordinary agent wound is caused by some uncommon or rare etiological factors,the specialty of which lays on the unique mechanism of wound formation,and a lot of disciplines were involved in the diagnosis and management of the wound.A unification of multiple disciplines is needed to integrate the relevant theory and technique to care the wound by giving consideration of the symptom and the aetiology.The primary diseases which induced the uncommon agent wound should be targeted and treated effectively;meanwhile,a comprehensive treatment combined with multiple new wound management techniques should be carried out to realize the objective of precise treatment.

  19. ENHANCEMENT OF PROJECT MANAGEMENT THROUGH ADVANCED PROJECT MANAGEMENT SOFTWARE

    OpenAIRE

    Manuel, Jaison

    2010-01-01

    Engineering Procurement and Construction firms utilize project management information systems mainly to schedule the project activities, monitor progress of the activities, analyzing the earned value and controlling the budget. This enables project professionals to access greater information quality to enhance productivity and thereby reducing the project complexity. The selection of appropriate project management system for construction firm, implementation and use of these tools are tasks n...

  20. Development of advanced JGIS considering qualify management and project management

    International Nuclear Information System (INIS)

    A system for managing and integrating the technical information of R and D was developed (JGIS: JAEA Geological Disposal Information Integration System). The subjects are to improve the usability as the system and the usability to record the information and the data in order to display the function of the system sufficiently and in order to enable the practical use of the system. In this study the aims are to display the function of JGIS and to enable the researchers as the users to recognize the significance of using JGIS. We built the conceptual design in order to implement the function of quality management and project management to JGIS. We considered that researchers could access the portal site of the research projects which were set as the WBS (Work Breakdown Structure) items and could confirm which WBS item the research project belonged to in the whole plan. We also considered that the research projects could be managed by using the conformity assessment sheets which were adopted for the quality management. The appendix contains the example of application of real projects to JGIS and the user's manual of JGIS (Example of a study of potential impact of natural phenomena). We demonstrated that researchers could confirm which WBS item the research project related to in JGIS and could manage the quality of the research projects by using the conformity assessment sheets in JGIS. (author)

  1. Autosomal dominant polycystic kidney disease: recent advances in clinical management.

    Science.gov (United States)

    Mao, Zhiguo; Chong, Jiehan; Ong, Albert C M

    2016-01-01

    The first clinical descriptions of autosomal dominant polycystic kidney disease (ADPKD) go back at least 500 years to the late 16 (th) century. Advances in understanding disease presentation and pathophysiology have mirrored the progress of clinical medicine in anatomy, pathology, physiology, cell biology, and genetics. The identification of PKD1 and PKD2, the major genes mutated in ADPKD, has stimulated major advances, which in turn have led to the first approved drug for this disorder and a fresh reassessment of patient management in the 21 (st) century. In this commentary, we consider how clinical management is likely to change in the coming decade. PMID:27594986

  2. Overutilization of bracing in the management of penetrating spinal cord injury from gunshot wounds.

    Science.gov (United States)

    Eftekhary, Nima; Nwosu, Kenneth; McCoy, Eric; Fukunaga, Dudley; Rolfe, Kevin

    2016-07-01

    OBJECTIVE Penetrating gunshot wounds (GSWs) to the spinal column are stable injuries and do not require spinal orthoses or bracing postinjury. Nonetheless, a high number of GSW-related spinal cord injury (SCI) patients are referred with a brace to national rehabilitation centers. Unnecessary bracing may encumber rehabilitation, create skin breakdown or pressure ulcers, and add excessive costs. The aim of this study was to confirm the stability of spinal column injuries from GSWs and quantify the overutilization rate of bracing based on long-term follow-up. METHODS This retrospective cohort study was performed at a nationally renowned rehabilitation center. In total, 487 GSW-related SCI patients were transferred for rehabilitation and identified over the last 14 years. Retrospective chart review and telephone interviews were conducted to identify patients who were braced at the initial treating institution and determine if late instability, deformity, or neurological deterioration resulted in secondary surgery or intervention. In addition, 396 unoperated patients were available for analysis after 91 patients were excluded for undergoing an initial destabilizing surgical dissection or laminectomy, thereby altering the natural history of the injury. All of these 396 patients who presented with a brace had bracing discontinued upon reaching the facility. RESULTS In total, 203 of 396 patients were transferred with a spinal brace, demonstrating an overutilization rate of 51%. No patients deteriorated neurologically or needed later surgery for spinal column deformity or instability attributable to the injury. All patients had stable injuries. The patterns of injury and severity of neurological injury did not vary between patients who were initially braced or unbraced. The average follow-up was 7.8 years (range 1-14 years) and the average age was 25 years (range 10-62 years). CONCLUSIONS The incidence of brace overutilization for penetrating GSW-related SCI was 51%. Long

  3. Recommendations for managing cutaneous disorders associated with advancing age.

    Science.gov (United States)

    Humbert, Philippe; Dréno, Brigitte; Krutmann, Jean; Luger, Thomas Anton; Triller, Raoul; Meaume, Sylvie; Seité, Sophie

    2016-01-01

    The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the literature from 2004 to 2014 using PubMed was performed by a working group of six European dermatologists with clinical and research experience in dermatology. Basic topical therapy can restore and protect skin barrier function, which relieves problems associated with xerosis, prevents aggravating moisture-associated skin damage, and enhances quality of life. In conclusion, the authors provide physicians with practical recommendations to assist them in implementing basic skin care for the elderly in an integrated care approach. PMID:26929610

  4. Radiotherapy and wound healing.

    Science.gov (United States)

    Devalia, Haresh L; Mansfield, Lucy

    2008-03-01

    This review article discusses basic radiation physics and effects of radiation on wounds. It examines various postulated hypothesis on the role of circulatory decrease and radiation-induced direct cellular damage. The new concept related to the radiation pathogenesis proposes that there is a cascade of cytokines initiated immediately after the radiation. Sustained activation of myofibroblasts in the wound accounts for its chronicity. Recent advances highlight that transforming growth factor beta1 is the master switch in pathogenesis of radiation fibrosis. This articles overviews its role and summarises the available evidences related to radiation damage. The goal of this article was to provide its modern understanding, as future research will concentrate on antagonising the effects of cytokines to promote wound healing. PMID:18081782

  5. Advanced information processing system: Input/output network management software

    Science.gov (United States)

    Nagle, Gail; Alger, Linda; Kemp, Alexander

    1988-01-01

    The purpose of this document is to provide the software requirements and specifications for the Input/Output Network Management Services for the Advanced Information Processing System. This introduction and overview section is provided to briefly outline the overall architecture and software requirements of the AIPS system before discussing the details of the design requirements and specifications of the AIPS I/O Network Management software. A brief overview of the AIPS architecture followed by a more detailed description of the network architecture.

  6. Advances in the Management of Treatment-Resistant Depression

    OpenAIRE

    Holtzheimer, Paul E.

    2010-01-01

    Treatment-resistant depression (TRD) is a prevalent, disabling, and costly condition affecting 1%–4% of the U.S. population. Current approaches to managing TRD include medication augmentation (with lithium, thyroid hormone, buspirone, atypical antipsychotics, or various antidepressant medications), psychotherapy, and ECT. Advances in understanding the neurobiology of mood regulation and depression have led to a number of new potential approaches to managing TRD, including medications with nov...

  7. Advanced pasture management through innovative robotic pasture maintenance

    OpenAIRE

    Gobor, Z.; Cariou, C.; Seiferth, B.; Thurner, S; Feucker, W.; Tessier, C.; Tekin, B.; Berducat, M.

    2015-01-01

    The results of the i-LEED project should demonstrate an advanced pasture management combining a pasture care and management robot with the i-LEED software in order to provide significantly improved pasture regrowth, biomass quality and consequently better feeding of the grazing cattle. The information from the barn and the pasture complementing one another will lead to a more balanced and demand driven feed supply to the cattle, particularly affecting the improved amount of valuable milk comp...

  8. Management of locally advanced breast cancer: Evolution and current practice

    OpenAIRE

    Rustogi Ashish; Budrukkar Ashwini; Dinshaw Ketayun; Jalali Rakesh

    2005-01-01

    Locally advanced breast cancer (LABC) accounts for a sizeable number (30-60%) of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT) has made a tremendous impact on the management of ...

  9. Recommendations for managing cutaneous disorders associated with advancing age

    Directory of Open Access Journals (Sweden)

    Humbert P

    2016-02-01

    Full Text Available Philippe Humbert,1 Brigitte Dréno,2 Jean Krutmann,3 Thomas Anton Luger,4 Raoul Triller,5 Sylvie Meaume,6 Sophie Seité71Research and Studies Centre on the Integument (CERT, Clinical Investigation Centre (CIC BT506, Department of Dermatology, Besançon University Hospital, University of Franche-Comté, Besançon, France; 2Department of Dermato-Cancerology, Nantes University Hospital, Nantes, France; 3IUF-Leibniz Research Institute for Environmental Medicine, Heinrich-Heine-University, Düsseldorf, Germany; 4Department of Dermatology, University of Münster, Münster, Germany; 5International Centre of Dermatology, Hertford British Hospital, Levallois, France; 6Geriatric Service, Wounds and Healing, Rothschild Hôspital, Paris, France; 7La Roche-Posay Dermatological Laboratories, Asnières, FranceAbstract: The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the

  10. Decision support tools for advanced energy management

    Energy Technology Data Exchange (ETDEWEB)

    Marik, Karel; Schindler, Zdenek; Stluka, Petr [Honeywell Prague Laboratory, Pod vodarenskou vezi 4, 182 08 Prague 8 (Czech Republic)

    2008-06-15

    Rising fuel costs boost energy prices, which is a driving force for improving efficiency of operation of any energy generation facility. This paper focuses on enhancing the operation of distributed integrated energy systems (IES), system that bring together all forms of cooling, heating and power (CCHP) technologies. Described methodology can be applied in power generation and district heating companies, as well as in small-scale systems that supply multiple types of utilities to consumers in industrial, commercial, residential and governmental spheres. Dispatching of such system in an optimal way needs to assess large number of production and purchasing schemes in conditions of continually changing market and variable utility demands influenced by many external factors, very often by weather conditions. The paper describes a combination of forecasting and optimization methods that supports effective decisions in IES system management. The forecaster generates the future most probable utility demand several hours or days ahead, derived from the past energy consumer behaviour. The optimizer generates economically most efficient operating schedule for the IES system that matches these forecasted energy demands and respects expected purchased energy prices. (author)

  11. Decision support tools for advanced energy management

    International Nuclear Information System (INIS)

    Rising fuel costs boost energy prices, which is a driving force for improving efficiency of operation of any energy generation facility. This paper focuses on enhancing the operation of distributed integrated energy systems (IES), system that bring together all forms of cooling, heating and power (CCHP) technologies. Described methodology can be applied in power generation and district heating companies, as well as in small-scale systems that supply multiple types of utilities to consumers in industrial, commercial, residential and governmental spheres. Dispatching of such system in an optimal way needs to assess large number of production and purchasing schemes in conditions of continually changing market and variable utility demands influenced by many external factors, very often by weather conditions. The paper describes a combination of forecasting and optimization methods that supports effective decisions in IES system management. The forecaster generates the future most probable utility demand several hours or days ahead, derived from the past energy consumer behaviour. The optimizer generates economically most efficient operating schedule for the IES system that matches these forecasted energy demands and respects expected purchased energy prices. (author)

  12. Combination of adrenomedullin with its binding protein accelerates cutaneous wound healing.

    Directory of Open Access Journals (Sweden)

    Juan-Pablo Idrovo

    Full Text Available Cutaneous wound continues to cause significant morbidity and mortality in the setting of diseases such as diabetes and cardiovascular diseases. Despite advances in wound care management, there is still an unmet medical need exists for efficient therapy for cutaneous wound. Combined treatment of adrenomedullin (AM and its binding protein-1 (AMBP-1 is protective in various disease conditions. To examine the effect of the combination treatment of AM and AMBP-1 on cutaneous wound healing, full-thickness 2.0-cm diameter circular excision wounds were surgically created on the dorsum of rats, saline (vehicle or AM/AMBP-1 (96/320 μg kg BW was topically applied to the wound daily and wound size measured. At days 3, 7, and 14, skin samples were collected from the wound sites. AM/AMBP-1 treated group had significantly smaller wound surface area than the vehicle group over the 14-day time course. At day 3, AM/AMBP-1 promoted neutrophil infiltration (MPO, increased cytokine levels (IL-6 and TNF-α, angiogenesis (CD31, VEGF and TGFβ-1 and cell proliferation (Ki67. By day 7 and 14, AM/AMBP-1 treatment decreased MPO, followed by a rapid resolution of inflammation characterized by a decrease in cytokines. At the matured stage, AM/AMBP-1 treatment increased the alpha smooth muscle actin expression (mature blood vessels and Masson-Trichrome staining (collagen deposition along the granulation area, and increased MMP-9 and decreased MMP-2 mRNA expressions. TGFβ-1 mRNA levels in AM/AMBP-1 group were 5.3 times lower than those in the vehicle group. AM/AMBP-1 accelerated wound healing by promoting angiogenesis, collagen deposition and remodeling. Treatment also shortened the days to reach plateau for wound closure. Thus, AM/AMBP-1 may be further developed as a therapeutic for cutaneous wound healing.

  13. Taking the trauma out of wound care: the importance of undisturbed healing.

    Science.gov (United States)

    Rippon, M; Davies, P; White, R

    2012-08-01

    Significant advances in wound dressing technology have resulted in a myriad of dressing choices for wound-care clinicians, providing more than just an inert wound cover. The establishment of a moist wound environment under modern wound dressings and the optimisation of the healing response are now the goals expected of these dressings. However, the use of wound dressings, particularly traditional dressings such as gauze, frequently results in wound and peri-wound tissue damage that impairs the wound healing response, counteracting any of the dressings' healing benefits. Therefore, in order to maximise the healing benefits wounds covered by today's wound dressings must minimise tissue disturbance (physical as well as chemical). This review aims to consider the ways traditional, as well as modern, wound dressings may disturb wounds, summarising the potential areas of wound disturbance, and suggesting how best to address this aspect of the use of wound dressings to treat acute as well as chronic wounds. PMID:22885308

  14. Advances in Diagnosis and Management of Prostate Cancer

    OpenAIRE

    Goldenberg, S. Larry

    1990-01-01

    Carcinoma of the prostate accounts for 17% of malignancies in men. Great strides have been made in the understanding of the biology and natural history of this disease. It is clear that earlier diagnosis of the clinical carcinoma will improve overall disease-specific survival rates. The author reviews the diagnostic techniques and advances in management of localized and metastatic disease.

  15. Advances In Mesoscale Thermal Management Technologies for Microelectronics

    OpenAIRE

    Garimella, S V

    2005-01-01

    This paper presents recent advances in a number of novel, high-performance cooling techniques for emerging electronics applications Critical enabling thermal management technologies covered include microchannel transport and micropumps, jet impingement, miniatur flat heat pipes, transient phase change energy storage systems, piezoelectric fans, and prediction of interface contact conductance. (c) 2005 Elsevier Ltd. All rights reserved.

  16. Diabetic foot wounds: the value of negative pressure wound therapy with instillation.

    Science.gov (United States)

    Dalla Paola, Luca

    2013-12-01

    Chronic wounds such as diabetic foot wounds are a tremendous burden to the health care system and often require a multidisciplinary approach to prevent amputations. Advanced technologies such as negative pressure wound therapy (NPWT) and bioengineered tissues have been successfully used in the treatment of these types of complex wounds. However, the introduction of NPWT with instillation (NPWTi) has provided an alternative treatment for treating complex and difficult-to-heal wounds. This article provides an overview of NPWT and the new NPWTi system and describes preliminary experience using NPWTi on patients with complicated infected diabetic foot wounds after surgical debridement and in a multidisciplinary setting. PMID:24251841

  17. Low-Level Laser Therapy: An Experimental Design for Wound Management: A Case-Controlled Study in Rabbit Model

    OpenAIRE

    Hossein Hodjati; Siamak Rakei; Hamed Ghoddusi Johari; Bita Geramizedeh; Babak Sabet; Sam Zeraatian

    2014-01-01

    Background: There is a wide array of articles in medical literature for and against the laser effect on wound healing but without discrete effect determination or conclusion. This experimental study aims to evaluate the efficacy of low-level laser therapy on wound healing. Materials and Methods: Thirty-four rabbits were randomly enrolled in two groups after creating a full thickness of 3 × 3 cm wound. The intervention group received low density laser exposure (4 J/cm 2 ) on days 0, 3 and 6 wi...

  18. Recannulation of a stenosed old tracheostomy wound in vocal-cord palsy: Anaesthetic management

    OpenAIRE

    Rashmi Pal; Arora, K. K.; Pandey, S.

    2011-01-01

    Tracheostomy still remains a life-saving procedure to secure a patent airway in emergency situations. Anaesthetic management of tracheostomy in paediatric patients with bilateral vocal cord immobility and acute respiratory distress in emergency has always been a great challenge to the anaesthesiologists. Administering general anaesthesia in a child for recannulation of tracheostomy in emergency is far more challenging. We report a case of a 4-year-old male child in whom tracheostomy tube was ...

  19. Bacterial cellulose as a material for wound treatment: Properties and modifications. A review.

    Science.gov (United States)

    Sulaeva, Irina; Henniges, Ute; Rosenau, Thomas; Potthast, Antje

    2015-12-01

    Advanced approaches to wound healing have attracted much attention in the last decades due to the use of novel types of dressings that provide a moist environment and take an active part in wound protection and tissue regeneration processes. The materials for novel wound dressings should have a set of features that will contribute to efficient skin recovery. The use of bacterial cellulose (BC) is attractive for advanced wound management because of the favorable characteristics of BC, such as its biocompatibility, non-toxicity, mechanical stability, and high moisture content. Numerous approaches can be taken to modify BC to address the shortcomings of the native material and to optimize its biocompatibility, water uptake and release, and antimicrobial activity. This review highlights possible pathways for functionalization of BC, affecting all levels of its structural organization. The focus is on post-production treatment of BC, although selected studies concerning in situ modifications during the biosynthesis process are also emphasized. PMID:26253857

  20. Enzyme-responsive nanocomposites for wound infection prophylaxis in burn management: in vitro evaluation of their compatibility with healing processes

    Directory of Open Access Journals (Sweden)

    Grützner V

    2015-06-01

    that responsive antimicrobial nanocomposites could be used as an advanced drug delivery system and a promising addition to current best practice wound infection prophylaxis with few side effects.Keywords: enzyme-responsive nanosystems, burn wound infection, endothelial cells, wound healing

  1. Current concepts in negative pressure wound therapy.

    Science.gov (United States)

    Howe, Lisa M

    2015-05-01

    Negative pressure wound therapy (NPWT) is becoming recognized in veterinary medicine as a viable option for the management of complex wounds. NPWT has many advantages over traditional wound care and results in quicker and improved wound healing in many instances. This article discusses the art and science of NPWT, as well as the many current indications, complications, advantages and disadvantages, and future directions of NPWT in small animal veterinary medicine. This therapy will likely have a growing role in veterinary medical practice for complicated wound management and other usages in coming years. PMID:25744142

  2. 创面信息管理系统:一种标准化的创面信息采集、存储和处理方案%Wound information management system: a standardized scheme for acquisition, storage and management of wound information

    Institute of Scientific and Technical Information of China (English)

    刘虎; 苏荣家; 吴敏洁; 张毅; 裘向军; 冯建刚; 谢挺; 陆树良

    2012-01-01

    Objective To form a wound information management scheme with objectivity,standardization,and convenience by means of wound information management system. Methods A wound information management system was set up with the acquisition terminal,the defined wound description,the data bank,and related softwares.The efficacy of this system was evaluated in clinical practice. Results The acquisition terminal was composed of the third generation mobile phone and the software.It was feasible to get access to the wound information,including description,image,and therapeutic plan from the data bank by mobile phone.During 4 months,a collection of a total of 232 wound treatment information was entered,and accordingly standardized data of 38 patients were formed automatically. Conclusions This system can provide standardized wound information management by standardized techniques of acquisition,transmission,and storage of wound information.It can be used widely in hospitals,especially primary medical institutions.Data resource of the system makes it possible for epidemiological study with large sample size in future.%目的 利用新型创面信息管理系统,探讨客观、标准化和便利的创面信息管理方案.方法 选择创面信息采集终端,确定创面信息采集内容,制作相关软件,建立创面信息数据库和创面信息管理系统.在临床应用中评价其效能. 结果 由第3代手机和操作软件共同构成标准化创面信息采集系统,借助终端手机可以从数据库中获取相关信息,包括创面的文字描述、图像及治疗方案等.使用4个月,共录入就诊信息232例次,已自动生成38例患者的完整资料. 结论 该系统能够将创面信息采集标准化并传输储存,适用于医院特别是基层卫生机构,为未来大样本的流行病学调查提供了良好的数据平台.

  3. Bone marrow derived cell-seeded extracellular matrix: A novel biomaterial in the field of wound management

    OpenAIRE

    V. Remya; Naveen Kumar; Sharma, A. K.; Mathew, Dayamon D.; Mamta Negi; S.K. Maiti; Sameer Shrivastava; S. Sonal; KURADE, N.P.

    2014-01-01

    Aim: Extensive or irreversible damage to the skin often requires additional skin substitutes for reconstruction. Biomaterials have become critical components in the development of effective new medical therapies for wound care. Materials and Methods: In the present study, a cell matrix construct (bone marrow-derived cells (BMdc) seeded extracellular matrix [ECM]) was used as a biological substitute for the repair of full-thickness skin wound. ECM was developed by decellularizing fish swim ...

  4. Negative pressure wound therapy management of the “open abdomen” following trauma: a prospective study and systematic review

    OpenAIRE

    Navsaria Pradeep; Nicol Andrew; Hudson Donald; Cockwill John; Smith Jennifer

    2013-01-01

    Abstract Introduction The use of Negative Pressure Wound Therapy (NPWT) for temporary abdominal closure of open abdomen (OA) wounds is widely accepted. Published outcomes vary according to the specific nature and the aetiology that resulted in an OA. The aim of this study was to evaluate the effectiveness of a new NPWT system specifically used OA resulting from abdominal trauma. Methods A prospective study on trauma patients requiring temporary abdominal closure (TAC) with grade 1or 2 OA was ...

  5. Methods for studying fuel management in advanced gas cooled reactors

    International Nuclear Information System (INIS)

    The methods used for studying fuel and absorber management problems in AGRs are described. The basis of the method is the use of ARGOSY lattice data in reactor calculations performed at successive time steps. These reactor calculations may be quite crude but for advanced design calculations a detailed channel-by-channel representation of the whole core is required. The main emphasis of the paper is in describing such an advanced approach - the ODYSSEUS-6 code. This code evaluates reactor power distributions as a function of time and uses the information to select refuelling moves and determine controller positions. (author)

  6. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    Williams ZF

    2015-12-01

    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  7. Advance simulation capability for environmental management (ASCEM) - 59065

    International Nuclear Information System (INIS)

    The United States Department Energy (DOE) Office of Environmental Management (EM) determined that uniform application of advanced modeling in the subsurface could help reduce the cost and risks associated with its environmental cleanup mission. In response to this determination, the EM Office of Technology Innovation and Development (OTID), Groundwater and Soil Remediation (GW and S) began the program Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for integrating data and scientific understanding to enable prediction of contaminant fate and transport in natural and engineered systems. This initiative supports the reduction of uncertainties and risks associated with EM?s environmental cleanup and closure programs through better understanding and quantifying the subsurface flow and contaminant transport behavior in complex geological systems. This involves the long-term performance of engineered components, including cementitious materials in nuclear waste disposal facilities that may be sources for future contamination of the subsurface. This paper describes the ASCEM tools and approach and the ASCEM programmatic accomplishments completed in 2010 including recent advances and technology transfer. The US Department of Energy Office of Environmental Management has begun development of an Advanced Simulation Capability for Environmental Management, (ASCEM). This program will provide predictions of the end states of contaminated areas allowing for cost and risk reduction of EM remedial activities. ASCEM will provide the tools and approaches necessary to standardize risk and performance assessments across the DOE complex. Through its Phase One demonstration, the ASCEM team has shown value to the EM community in the areas of High Performance Computing, Data Management, Visualization, and Uncertainty Quantification. In 2012, ASCEM will provide an initial limited release of a community code for

  8. Bacterial Wound Culture

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? Bacterial Wound Culture Share this page: Was this page helpful? Also known as: Aerobic Wound Culture; Anaerobic Wound Culture Formal name: Culture, wound Related ...

  9. Evaluation of the efficacy of hyperbaric oxygen therapy in the management of chronic nonhealing ulcer and role of periwound transcutaneous oximetry as a predictor of wound healing response: A randomized prospective controlled trial

    Directory of Open Access Journals (Sweden)

    Sarbjot Kaur

    2012-01-01

    Full Text Available Background: Hyperbaric oxygen therapy (HBOT is a treatment option for chronic nonhealing wounds. Transcutaneous oximetry (TCOM is used for wound assessment. We undertook a randomized prospective controlled trial to evaluate the role of HBOT in healing of chronic nonhealing wounds and to determine whether TCOM predicts healing. Materials and Methods: This study was conducted in 30 consenting patients with nonhealing ulcer. The patients were randomized into group HT (receiving HBOT in addition to conventional treatment and group CT (receiving only conventional treatment. Duration of treatment in both the groups was 30 days. Wound ulcer was analyzed based on size of the wound, exudates, presence of granulation tissue, and wound tissue scoring. Tissue oxygenation (TcPO 2 was measured on 0, 10 th , 20 th , and 30 th day. Results: There was 59% reduction in wound area in group HT and 26% increase in wound area in group CT. Ten patients in group HT showed improvement in wound score as compared to five patients in group CT. Complete healing was seen in three patients in group HT as compared to none in group CT. Surgical debridement was required in 6 patients in group HT and 10 patients in group CT. One patient in group HT required amputation as compared to five patients in group CT. A positive correlation was found between TcPO 2 value and various markers of wound healing. Conclusion: HBOT has a definitive adjunctive role in the management of chronic nonhealing ulcers. It decreases the amputation rate and improves patient outcome. Periwound TcPO 2 may be used as a predictor of response to HBOT and has a positive correlation with wound healing.

  10. Advanced Inverter Functions and Communication Protocols for Distribution Management

    Energy Technology Data Exchange (ETDEWEB)

    Nagarajan, Adarsh; Palmintier, Bryan; Baggu, Murali

    2016-05-05

    This paper aims at identifying the advanced features required by distribution management systems (DMS) service providers to bring inverter-connected distributed energy resources into use as an intelligent grid resource. This work explores the standard functions needed in the future DMS for enterprise integration of distributed energy resources (DER). The important DMS functionalities such as DER management in aggregate groups, including the discovery of capabilities, status monitoring, and dispatch of real and reactive power are addressed in this paper. It is intended to provide the industry with a point of reference for DER integration with other utility applications and to provide guidance to research and standards development organizations.

  11. Intelligent Engine Systems: Thermal Management and Advanced Cooling

    Science.gov (United States)

    Bergholz, Robert

    2008-01-01

    The objective is to provide turbine-cooling technologies to meet Propulsion 21 goals related to engine fuel burn, emissions, safety, and reliability. Specifically, the GE Aviation (GEA) Advanced Turbine Cooling and Thermal Management program seeks to develop advanced cooling and flow distribution methods for HP turbines, while achieving a substantial reduction in total cooling flow and assuring acceptable turbine component safety and reliability. Enhanced cooling techniques, such as fluidic devices, controlled-vortex cooling, and directed impingement jets, offer the opportunity to incorporate both active and passive schemes. Coolant heat transfer enhancement also can be achieved from advanced designs that incorporate multi-disciplinary optimization of external film and internal cooling passage geometry.

  12. Advanced information technology for training and emergency management

    International Nuclear Information System (INIS)

    Modern information technology provides many possibilities for improving both the safety and the availability of nuclear installations. A Nordic research programme was started in 1977, in which several organizations in Denmark, Finland, Norway and Sweden has been participating. The work has on a general level been addressing control rooms, human reliability and information technology for nuclear power plants. The research has had impact on the development of the control room solutions and the training simulators in Finland and also in the other Nordic countries. The present phase of the Nordic cooperation is investigating the use of advanced information technology in emergency management. The paper gives a brief introduction to the use of advance information technology for training and emergency management, which is based on the experience from the Nordic projects and other similar application projects in Finland. The paper includes also references to results from several of the projects. (author)

  13. Advanced materials for thermal management of electronic packaging

    CERN Document Server

    Tong, Xingcun Colin

    2011-01-01

    The need for advanced thermal management materials in electronic packaging has been widely recognized as thermal challenges become barriers to the electronic industry's ability to provide continued improvements in device and system performance. With increased performance requirements for smaller, more capable, and more efficient electronic power devices, systems ranging from active electronically scanned radar arrays to web servers all require components that can dissipate heat efficiently. This requires that the materials have high capability of dissipating heat and maintaining compatibility

  14. Intelligent Engine Systems: Thermal Management and Advanced Cooling

    Science.gov (United States)

    Bergholz, Robert

    2008-01-01

    The objective of the Advanced Turbine Cooling and Thermal Management program is to develop intelligent control and distribution methods for turbine cooling, while achieving a reduction in total cooling flow and assuring acceptable turbine component safety and reliability. The program also will develop embedded sensor technologies and cooling system models for real-time engine diagnostics and health management. Both active and passive control strategies will be investigated that include the capability of intelligent modulation of flow quantities, pressures, and temperatures both within the supply system and at the turbine component level. Thermal management system concepts were studied, with a goal of reducing HPT blade cooling air supply temperature. An assessment will be made of the use of this air by the active clearance control system as well. Turbine component cooling designs incorporating advanced, high-effectiveness cooling features, will be evaluated. Turbine cooling flow control concepts will be studied at the cooling system level and the component level. Specific cooling features or sub-elements of an advanced HPT blade cooling design will be downselected for core fabrication and casting demonstrations.

  15. The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing

    Directory of Open Access Journals (Sweden)

    Mui Koon Tan

    2012-01-01

    Full Text Available Honey is one of the oldest substances used in wound management. Efficacy of Gelam honey in wound healing was evaluated in this paper. Sprague-Dawley rats were randomly divided into four groups of 24 rats each (untreated group, saline group, Intrasite Gel group, and Gelam honey group with 2 cm by 2 cm full thickness, excisional wound created on neck area. Wounds were dressed topically according to groups. Rats were sacrificed on days 1, 5, 10, and 15 of treatments. Wounds were then processed for macroscopic and histological observations. Gelam-honey-dressed wounds healed earlier (day 13 than untreated and saline treated groups, as did wounds treated with Intrasite Gel. Honey-treated wounds exhibited less scab and only thin scar formations. Histological features demonstrated positive effects of Gelam honey on the wounds. This paper showed that Gelam honey dressing on excisional wound accelerated the process of wound healing.

  16. Negative pressure wound therapy (NPWT) for spinal wounds: a systematic review

    OpenAIRE

    Ousey, Karen; Atkinson, Ross A.; Williamson, J. Bradley; Lui, Steve

    2013-01-01

    Background context The management of postoperative spinal wound complication remains a challenge, with surgical site infection (SSI) incidence rates ranging from 0.4% to 20% after spinal surgery. Negative pressure wound therapy (NPWT) has been highlighted as an intervention that may stimulate healing and prevent SSI. However, the wound healing mechanism by NPWT and its effectiveness in spinal wounds still remain unclear. Purpose To systematically search, critically appraise, and su...

  17. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Science.gov (United States)

    Aldaz, Gabriel; Shluzas, Lauren Aquino; Pickham, David; Eris, Ozgur; Sadler, Joel; Joshi, Shantanu; Leifer, Larry

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs) requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16), we (i) examined feature preferences for hands-free digital image capture and documentation, and (ii) compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15) = -3.873, p < 0.001, r = 0.71, and double-blinking to take photographs, Z(13) = -3.606, p < 0.001, r = 0.71. In the comparison between SnapCap and Epic Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16) = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study's results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital photography

  18. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Directory of Open Access Journals (Sweden)

    Gabriel Aldaz

    Full Text Available Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16, we (i examined feature preferences for hands-free digital image capture and documentation, and (ii compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15 = -3.873, p < 0.001, r = 0.71, and double-blinking to take photographs, Z(13 = -3.606, p < 0.001, r = 0.71. In the comparison between SnapCap and Epic Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16 = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study's results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital

  19. Advanced methods of microscope control using μManager software

    Directory of Open Access Journals (Sweden)

    Arthur D Edelstein

    2014-07-01

    Full Text Available µManager is an open-source, cross-platform desktop application, to control a wide variety of motorized microscopes, scientific cameras, stages, illuminators, and other microscope accessories. Since its inception in 2005, µManager has grown to support a wide range of microscopy hardware and is now used by thousands of researchers around the world. The application provides a mature graphical user interface and offers open programming interfaces to facilitate plugins and scripts. Here, we present a guide to using some of the recently added advanced µManager features, including hardware synchronization, simultaneous use of multiple cameras, projection of patterned light onto a specimen, live slide mapping, imaging with multi-well plates, particle localization and tracking, and high-speed imaging.

  20. Recent Advances in Management of Pediatric Food Allergy

    Directory of Open Access Journals (Sweden)

    Katherine Anagnostou

    2015-12-01

    Full Text Available Many children now suffer with a food allergy, immunoglobulin E (IgE and/or non-IgE mediated. Food allergies have a significant impact on the child’s quality of life, as well as that of their family, due to the resultant dietary restrictions and the constant threat of a potentially life-threatening reaction. At present, there is no cure for food allergies, but there are exciting advances occurring in the management of IgE mediated allergies, including a more active approach to management with anticipatory screening testing, early introduction of common food allergens, active tolerance induction, use of biologics and active risk management. These areas will be discussed in this review.

  1. Recent Advances in Management of Pediatric Food Allergy.

    Science.gov (United States)

    Anagnostou, Katherine; Swan, Kate; Fox, Adam T

    2015-01-01

    Many children now suffer with a food allergy, immunoglobulin E (IgE) and/or non-IgE mediated. Food allergies have a significant impact on the child's quality of life, as well as that of their family, due to the resultant dietary restrictions and the constant threat of a potentially life-threatening reaction. At present, there is no cure for food allergies, but there are exciting advances occurring in the management of IgE mediated allergies, including a more active approach to management with anticipatory screening testing, early introduction of common food allergens, active tolerance induction, use of biologics and active risk management. These areas will be discussed in this review. PMID:27417375

  2. The development of an advanced information management system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2005-07-01

    Performing a PSA requires a lot of data to analyze, to evaluate the risk, to trace the process of results and to verify the results. KAERI is developing a PSA information database system, AIMS (Advanced Information Management System for PSA). The objective of AIMS development is to integrate and computerize all the distributed information of a PSA into a system and to enhance the accessibility to PSA information for all PSA related activities. We designed the PSA information database system for the following purposes: integrated PSA information management software, sensitivity analysis, quality assurance, anchor to another reliability database. The AIMS consists of a PSA Information database, Information browsing (searching) modules, and PSA automatic quantification manager modules.

  3. Wound Care Nursing: Professional Issues and Opportunities.

    Science.gov (United States)

    Corbett, Lisa Q

    2012-10-01

    As the field of wound care advances and seeks validity as a distinctive healthcare specialty, it becomes imperative to define practice competencies for all related professionals in the arena. As such, the myriad nurses practicing wound care in settings across the continuum should be understood for their unique contribution to the wound care team. Furthermore, the hierarchy of wound care nursing with varying levels of licensure, certification, and scope of practice can be clarified to delineate leadership and reimbursement issues to meet current health care challenges. A review of the role of nursing in wound care from a historical and evolutionary perspective helps to characterize the trend towards advanced practice nursing in the wound care specialty. PMID:24527304

  4. Structural integrity analyses: can we manage the advances?

    International Nuclear Information System (INIS)

    Engineering has been one of a number of disciplines in which significant advances in analysis procedures has taken place in the last two decades. In particular, advances in computer technology and engineering software have revolutionized the assessment of component structural integrity for a wide range of applications. A significant development in computational mechanics directly related to computer technology that has had a profound impact on the field of structural integrity is the finite element method. The finite element method has re-defined and expanded the role of structural integrity assessments by providing comprehensive modelling capabilities to engineers involved in design and failure analyses. As computer processing speeds and capacity have increased, so has the role of computer modelling in assessments of component structural integrity. With new product development cycles shrinking, the role of initial testing is being reduced in favour of computer modelling and simulation to assess component life and durability. For ageing structures, the evaluation of remaining life and the impact of degraded structural integrity becomes tractable with the modern advances in computational methods. The areas of structural integrity that have derived great benefit from the advances in numerical techniques include stress analysis, fracture mechanics, dynamics, heat transfer, structural reliability, probabilistic methods and continuum mechanics in general. One of the salient features of the current methods is the ability to handle large complex steady state or transient dynamic problems that exhibit highly non-linear behaviour. With the ever-increasing usage of these advanced methods, the question is posed: Can we manage the advances? Better still are we managing the advances? As with all technological advances that enter mainstream use, comes the need for education, training and certification in the application of these methods, improved quality assurance procedures and

  5. Managing complex, high risk projects a guide to basic and advanced project management

    CERN Document Server

    Marle, Franck

    2016-01-01

    Maximizing reader insights into project management and handling complexity-driven risks, this book explores propagation effects, non-linear consequences, loops, and the emergence of positive properties that may occur over the course of a project. This book presents an introduction to project management and analysis of traditional project management approaches and their limits regarding complexity. It also includes overviews of recent research works about project complexity modelling and management as well as project complexity-driven issues. Moreover, the authors propose their own new approaches, new methodologies and new tools which may be used by project managers and/or researchers and/or students in the management of their projects. These new elements include project complexity definitions and frameworks, multi-criteria approaches for project complexity measurement, advanced methodologies for project management (propagation studies to anticipate potential behaviour of the project, and clustering approaches...

  6. [Translation medicine in wound healing: successful cases and personal deliberation].

    Science.gov (United States)

    Fu, Xiaobing

    2014-02-01

    Local wound care is the key step in wound management, and it is affected by many factors. The innovation and translation application of some new theories and skills may help accelerate local wound healing velocity and improve wound healing quality. In this paper, the translation medicine in wound healing, such as debridement, dressings, and tissue engineering products, are reviewed. In the meantime, personal consideration concerning their successful and future development is given. PMID:24684981

  7. Hyaluronate nanoparticles included in polymer films for the prolonged release of vitamin E for the management of skin wounds.

    Science.gov (United States)

    Pereira, Gabriela Garrastazu; Detoni, Cassia Britto; Balducci, Anna Giulia; Rondelli, Valeria; Colombo, Paolo; Guterres, Silvia Stanisçuaski; Sonvico, Fabio

    2016-02-15

    Lecithin and hyaluronic acid were used for the preparation of polysaccharide decorated nanoparticles loaded with vitamin E using the cationic lipid dioctadecyldimethylammonium bromide (DODMA). Nanoparticles showed mean particle size in the range 130-350 nm and narrow size distribution. Vitamin E encapsulation efficiency was higher than 99%. These nanoparticles were incorporated in polymeric films containing Aloe vera extract, hyaluronic acid, sodium alginate, polyethyleneoxide (PEO) and polyvinylalcohol (PVA) as an innovative treatment in skin wounds. Films were thin, flexible, resistant and suitable for application on burn wounds. Additionally, in vitro occlusion study highlighted the dependence of the occlusive effect on the presence of nanoparticles. The results obtained show that the bioadhesive films containing vitamin E acetate and Aloe vera could be an innovative therapeutic system for the treatment of skin wounds, such as burns. The controlled release of the vitamin along with a reduction in water loss through damaged skin provided by the nanoparticle-loaded polymer film are considered important features for an improvement in wound healing and skin regeneration. PMID:26769495

  8. Effect of advanced fuel cycles on waste management policies

    International Nuclear Information System (INIS)

    The study aims at analysing a range of future fuel cycle options from the perspective of their impact on waste repository demand and specification. The study would focus on: Assessment of the characteristics of radioactive wastes arising from advanced nuclear fuel cycle options, repository performance analysis studies using source terms for waste arising from such advanced nuclear fuel cycles, identification of new options for waste management and disposal. Three families of fuel cycles having increasing recycling capabilities are assessed. Each cycle is composed of waste generating and management processes. Examples of waste generating processes are fuel factories (7 types) and reprocessing plants (7 types). Packaging and conditioning plants (7) and disposal facilities are examples of waste management processes. The characteristic of all these processes have been described and then total waste flows are summarised. In order to simplify the situation, three waste categories have been defined based on the IAEA definitions in order to emphasize the major effects of different types of waste. These categories are: short-life waste for surface or sub-surface disposal, long-life low heat producing waste for geological disposal, high-level waste for geological disposal. The feasibilities of the fuel cycles are compared in terms of economics, primary resource consumption and amount of waste generated. The effect of high-level waste composition for the repository performance is one of the tools in these comparisons. The results of this will be published as an NEA publication before the end of 2005. (authors)

  9. Recent advances in the management of Hodgkin lymphoma.

    Science.gov (United States)

    Villasboas, Jose C; Ansell, Stephen M

    2016-01-01

    Hodgkin lymphoma (HL) is a rare cancer of the immune system that typically affects lymph nodes and sometimes other organs. Although the majority of patients can be potentially cured with the use of multi-agent chemotherapy and radiotherapy, a proportion of them will relapse or develop resistant disease for which treatment options are limited. In recent years, new agents have been developed and tested in HL with encouraging results. Two classes of drugs stand out as highly active in advanced HL based on recent study results: antibody-drug conjugates and programmed death 1 inhibitors. Clinical trials in HL with these agents have been completed in the past several years and the results have recently become available. In this review, we discuss the recent advances in the management of HL with a focus on strategies to decrease toxicity and a review of the two drug classes that have the potential to change the landscape of treatment of this disease. PMID:27158471

  10. A cost-effectiveness analysis of fistula treatment in the abdominal region using a new integrated fistula and wound management system

    DEFF Research Database (Denmark)

    Keiding, Hans; Skovgaard, Rasmus

    2008-01-01

    -effectiveness analysis with wear time, material costs, and labor costs taken into account. RESULTS: A longer wear time for each pouch as well as simpler handling by nurses amounted to an average lower cost of $83 per day of treatment with the FWMS. A large variation was observed in the collected data. However, the......OBJECTIVE: To evaluate wear time and costs of a new fistula and wound management system (FWMS) compared to standard fistula treatments. METHODS: Data were collected from 22 patients with an abdominal fistula recruited from 5 sites in the United States. This economic evaluation was based on a cost...

  11. Development of the Advanced Nuclear Safety Information Management (ANSIM) System

    International Nuclear Information System (INIS)

    Korea has become a technically independent nuclear country and has grown into an exporter of nuclear technologies. Thus, nuclear facilities are increasing in significance at KAERI (Korea Atomic Energy Research Institute), and it is time to address the nuclear safety. The importance of nuclear safety cannot be overemphasized. Therefore, a management system is needed urgently to manage the safety of nuclear facilities and to enhance the efficiency of nuclear information. We have established ISP (Information Strategy Planning) for the Integrated Information System of nuclear facility and safety management. The purpose of this paper is to develop a management system for nuclear safety. Therefore, we developed the Advanced Nuclear Safety Information Management system (hereinafter referred to as the 'ANSIM system'). The ANSIM system has been designed and implemented to computerize nuclear safety information for standardization, integration, and sharing in real-time. Figure 1 shows the main home page of the ANSIM system. In this paper, we describe the design requirements, contents, configurations, and utilizations of the ANSIM system

  12. Development of the Advanced Nuclear Safety Information Management (ANSIM) System

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Jae Min; Ko, Young Cheol; Song, Tai Gil [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    Korea has become a technically independent nuclear country and has grown into an exporter of nuclear technologies. Thus, nuclear facilities are increasing in significance at KAERI (Korea Atomic Energy Research Institute), and it is time to address the nuclear safety. The importance of nuclear safety cannot be overemphasized. Therefore, a management system is needed urgently to manage the safety of nuclear facilities and to enhance the efficiency of nuclear information. We have established ISP (Information Strategy Planning) for the Integrated Information System of nuclear facility and safety management. The purpose of this paper is to develop a management system for nuclear safety. Therefore, we developed the Advanced Nuclear Safety Information Management system (hereinafter referred to as the 'ANSIM system'). The ANSIM system has been designed and implemented to computerize nuclear safety information for standardization, integration, and sharing in real-time. Figure 1 shows the main home page of the ANSIM system. In this paper, we describe the design requirements, contents, configurations, and utilizations of the ANSIM system

  13. Advanced thermal management needs for Lunar and Mars missions

    International Nuclear Information System (INIS)

    Significant improvements in thermal management technologies will be required to support NASA's planned Lunar and Mars missions. The developments needed include the application of advanced materials to reduce radiator system masses, enhanced survivability, and the use of alternative working fluids. Current thermal management systems utilize one of two heat rejection alternatives; either single phase pumped loops, or two phase heat pipes constructed with thick walled metal casings. These two technologies have proven themselves to be reliable performers in the transport and rejection of waste heat from spacecraft. As thermal management needs increase with increased power consumption and activity required on spacecraft, these metal based thermal management systems will become mission limiting. Investigations into the use of light weight ceramic materials for high temperature thermal management systems have been conducted by NASA, the Department of Energy, and the Department of Defense since the early 1980s, with results showing that significant mass savings can be obtained by replacing some of the metallic functions with ceramic materials

  14. [Modern wound dressings].

    Science.gov (United States)

    Triller, Ciril; Huljev, Dubravko; Planinsek Rucigaj, Tanja

    2013-10-01

    Chronic wounds are, due to the slow healing, a major clinical problem. In addition to classic materials, a great number of supportive wound dressings for chronic wound treatment, developed on the basis of new knowledge about the pathophysiological events in non-healing wounds, are available on the market. Today we know that modern wound dressings provide the best local environment for optimal healing (moisture, warmth, appropriate pH). Wound dressings control the amount of exudate from the wound and bacterial load, thus protecting local skin from the wound exudate and the wound from secondary infections from the environment. Using supportive wound dressings makes sense only when the wound has been properly assessed, the etiologic factors have been clarified and the obstacles making the wound chronic identified. The choice of dressing is correlated with the characteristics of the wound, the knowledge and experience of the medical staff, and the patient's needs. We believe that the main advantage of modern wound dressing versus conventional dressing is more effective wound cleaning, simple dressing application, painless bandaging owing to reduced adhesion to the wound, and increased absorption of the wound exudate. Faster wound granulation shortens the length of patient hospitalization, and eventually facilitates the work of medical staff. The overall cost of treatment is a minor issue due to faster wound healing despite the fact that modern supportive wound dressings are more expensive than conventional bandaging. The article describes different types of modern supportive wound dressings, as well as their characteristics and indications for use. PMID:24371980

  15. Advanced fuels for plutonium management in pressurized water reactors

    International Nuclear Information System (INIS)

    Several fuel concepts are under investigation at CEA with the aim of manage plutonium inventories in pressurized water reactors. This options range from the use of mature technologies like MOX adapted in the case of MOX-EUS (enriched uranium support) and COmbustible Recyclage A ILot (CORAIL) assemblies to more innovative technologies using IMF like DUPLEX and advanced plutonium assembly (APA). The plutonium burning performances reported to the electrical production go from 7 to 60 kg (TW h)-1. More detailed analysis covering economic, sustainability, reliability and safety aspects and their integration in the whole fuel cycle would allow identifying the best candidate

  16. Advanced construction management for lunar base construction - Surface operations planner

    Science.gov (United States)

    Kehoe, Robert P.

    1992-01-01

    The study proposes a conceptual solution and lays the framework for developing a new, sophisticated and intelligent tool for a lunar base construction crew to use. This concept integrates expert systems for critical decision making, virtual reality for training, logistics and laydown optimization, automated productivity measurements, and an advanced scheduling tool to form a unique new planning tool. The concept features extensive use of computers and expert systems software to support the actual work, while allowing the crew to control the project from the lunar surface. Consideration is given to a logistics data base, laydown area management, flexible critical progress scheduler, video simulation of assembly tasks, and assembly information and tracking documentation.

  17. Development of advanced mixed oxide fuels for plutonium management

    International Nuclear Information System (INIS)

    A number of advanced Mixed Oxide (MOX) fuel forms are currently being investigated at Los Alamos National Laboratory that have the potential to be effective plutonium management tools. Evolutionary Mixed Oxide (EMOX) fuel is a slight perturbation on standard MOX fuel, but achieves greater plutonium destruction rates by employing a fractional nonfertile component. A pure nonfertile fuel is also being studied. Initial calculations show that the fuel can be utilized in existing light water reactors and tailored to address different plutonium management goals (i.e., stabilization or reduction of plutonium inventories residing in spent nuclear fuel). In parallel, experiments are being performed to determine the feasibility of fabrication of such fuels. Initial EMOX pellets have successfully been fabricated using weapons-grade plutonium

  18. Ultra-low microcurrent in the management of diabetes mellitus, hypertension and chronic wounds: Report of twelve cases and discussion of mechanism of action

    Directory of Open Access Journals (Sweden)

    Bok Y. Lee, Noori AL-Waili, Dean Stubbs, Keith Wendell, Glenn Butler, Thia AL-Waili, Ali AL-Waili

    2010-01-01

    Full Text Available Oxidative stress plays a major role in the pathogenesis of both types of diabetes mellitus and cardiovascular diseases including hypertension. The low levels of antioxidants accompanied by raised levels of markers of free radical damage play a major role in delaying wound healing. Ultra-low microcurrent presumably has an antioxidant effect, and it was shown to accelerate wound healing. The purpose of the study is to investigate the efficacy of ultra-low microcurrent delivered by the Electro Pressure Regeneration Therapy (EPRT device (EPRT Technologies-USA, Simi Valley, CA in the management of diabetes, hypertension and chronic wounds. The EPRT device is an electrical device that sends a pulsating stream of electrons in a relatively low concentration throughout the body. The device is noninvasive and delivers electrical currents that mimic the endogenous electric energy of the human body. It is a rechargeable battery-operated device that delivers a direct current (maximum of 3 milliAmperes of one polarity for 11.5 minutes, which then switched to the opposite polarity for another 11.5 minutes. The resulting cycle time is approximately 23min or 0.000732 Hz and delivers a square wave bipolar current with a voltage ranging from 5V up to a maximum of 40 V. The device produces a current range of 3 mA down to 100 nA. Twelve patients with long standing diabetes, hypertension and unhealed wounds were treated with EPRT. The patients were treated approximately for 3.5 h/day/5 days a week. Assessment of ulcer was based on scale used by National Pressure Ulcer Advisory Panel Consensus Development Conference. Patients were followed-up with daily measurement of blood pressure and blood glucose level, and their requirement for medications was recorded. Treatment continued from 2-4 months according to their response. Results showed that diabetes mellitus and hypertension were well controlled after using this device, and their wounds were markedly healed (30

  19. Waste management planned for the advanced fuel cycle facility

    International Nuclear Information System (INIS)

    The U.S. Department of Energy (DOE) Global Nuclear Energy Partnership (GNEP) program has been proposed to develop and employ advanced technologies to increase the proliferation resistance of spent nuclear fuels, recover and reuse nuclear fuel resources, and reduce the amount of wastes requiring permanent geological disposal. In the initial GNEP fuel cycle concept, spent nuclear fuel is to be reprocessed to separate re-usable transuranic elements and uranium from waste fission products, for fabricating new fuel for fast reactors. The separated wastes would be converted to robust waste forms for disposal. The Advanced Fuel Cycle Facility (AFCF) is proposed by DOE for developing and demonstrating spent nuclear fuel recycling technologies and systems. The AFCF will include capabilities for receiving and reprocessing spent fuel and fabricating new nuclear fuel from the reprocessed spent fuel. Reprocessing and fuel fabrication activities will generate a variety of radioactive and mixed waste streams. Some of these waste streams are unique and unprecedented. The GNEP vision challenges traditional U.S. radioactive waste policies and regulations. Product and waste streams have been identified during conceptual design. Waste treatment technologies have been proposed based on the characteristics of the waste streams and the expected requirements for the final waste forms. Results of AFCF operations will advance new technologies that will contribute to safe and economical commercial spent fuel reprocessing facilities needed to meet the GNEP vision. As conceptual design work and research and design continues, the waste management strategies for the AFCF are expected to also evolve. (authors)

  20. Advanced Mission Management System for Unmanned Aerial Vehicles

    Directory of Open Access Journals (Sweden)

    R. Anand Raji

    2014-09-01

    Full Text Available The paper presents advanced mission management system (MMS for unmanned aerial vehicles, based on integrated modular avionics (IMA architecture. IMA architecture enables the MMS to host high end functions for autonomous navigation and attack. MMS is a collection of systems to execute the mission objectives. The system constitutes mission computer (MC, sensors and other sub-systems. The MMS-MC needs to execute advanced algorithms like terrain referenced navigation, vision-aided navigation, automatic target recognition, sensor fusion, online path planning, and tactical planning for autonomy and safety. This demands high-end architecture in terms of hardware, software, and communication. The MMS-MC is designed to exploit the benefits of IMA concepts such as open system architecture, hardware and software architecture catering for portability, technology transparency, scalability, system reconfigurability and fault tolerance. This paper investigates on advanced navigation methods for augmenting INS with terrain-referenced navigation and vision-aided navigation during GPS non-availability. This paper also includes approach to implement these methods and simulation results are provided accordingly, and also discusses in a limited way, the approach for implementing online path planning.Defence Science Journal, Vol. 64, No. 5, September 2014, pp.438-444, DOI:http://dx.doi.org/10.14429/dsj.64.5992

  1. Concurrent In Vitro Release of Silver Sulfadiazine and Bupivacaine From Semi-Interpenetrating Networks for Wound Management

    OpenAIRE

    Kleinbeck, Kyle R.; Bader, Rebecca A.; Kao, Weiyuan John

    2009-01-01

    In situ photopolymerized semi-interpenetrating networks (sIPNs) composed of poly(ethylene glycol) and gelatin are promising multifunctional matrices for a regenerative medicine approach to dermal wound treatment. In addition to previously demonstrated efficacy in critical defects, sIPNs also function as drug delivery matrices for compounds loaded as either soluble or covalently linked components. Simultaneous release of silver sulfadiazine and bupivacaine from the sIPN would provide multiple-...

  2. Sulfadiazine—Chitosan Conjugates and Their Polyelectrolyte Complexes with Hyaluronate Destined to the Management of Burn Wounds

    OpenAIRE

    Raluca Petronela Dumitriu; Lenuta Profire; Loredana Elena Nita; Oana Maria Dragostin; Nicolae Ghetu; Dragoș Pieptu; Cornelia Vasile

    2015-01-01

    In the present study polyelectrolyte complexes (PECs) based on new sulfadiazine-chitosan conjugates with sodium hyaluronate have been developed with potential use in treatment of burn wounds. The PECs were chemically characterized using Fourier Transform—Infrared Spectroscopy, Scanning Electon Microscopy and Near Infrared Chemical Imaging Technique. The swelling behavior and in vitro sulfadiazine release were also investigated. The antimicrobial activity was evaluated towards three bacterial ...

  3. BALANCED SCORECARD AS AN ADVANCED MANAGEMENT CONCEPT WITHIN THE INTEGRATED QUALITY MANAGEMENT MODEL

    Directory of Open Access Journals (Sweden)

    Stevan Zivojinovic

    2008-03-01

    Full Text Available The significance of >Integratedquality management< (IQM model, originating form St.Gallen-model, is reflected in the need for synergic application of new and advanced concepts of management theory and practise. Balanced score card (BSC within IQM model becomes a catalyst of business success for a modern organization by focusing on organizational variables-business strategy, organization structure and corporate culture. BSC is the leading system of performance tracking and strategy implementation, consistent with other management concepts and methods for managing process improvement. Through BSC, IQM processes' activities correlate with organization business results. BSC management processes enable integration of all decision-making levels, from institutional via strategic to operative, in the process starting from planing, i.e. formulating and implementation of strategy, to feed back by performance measurement and control.

  4. Management of locally advanced breast cancer: Evolution and current practice

    Directory of Open Access Journals (Sweden)

    Rustogi Ashish

    2005-01-01

    Full Text Available Locally advanced breast cancer (LABC accounts for a sizeable number (30-60% of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT has made a tremendous impact on the management of LABC. NACT was initiated to institute systemic therapy upfront at the earliest in this group of patients with a high risk of micrometastasis burden. While NACT did not yield a survival advantage, it has however made breast conservation possible in selected group of cases. Large number of studies and many randomised trials have been done in women with LABC in order to improve the therapeutic decisions and also the local control and survival. With this background we have reviewed various treatment options in patients with LABC which should possibly help in guiding the clinicians for optimal management of LABC.

  5. The management of localized and locally advanced prostate cancer - 1995

    International Nuclear Information System (INIS)

    Purpose/Objectives: The intent of this course is to review the issues involved in the management of non-metastatic adenocarcinoma of the prostate. - The value of pre-treatment prognostic factors including stage, grade and PSA value will be presented, and their value in determining therapeutic strategies will be discussed. - Controversies involving the simulation process and treatment design will be presented. The value of CT scanning, Beams-Eye View, 3-D planning, intravesicle, intraurethral and rectal contrast will be presented. The significance of prostate and patient movement and strategies for dealing with them will be presented. - The management of low stage, low to intermediate grade prostate cancer will be discussed. The dose, volume and timing of irradiation will be discussed as will the role of neo-adjuvant hormonal therapy, neutron irradiation and brachy therapy. The current status of radical prostatectomy and cryotherapy will be summarized. - Treatment of locally advanced, poorly differentiated prostate cancer will be presented including a discussion of neo-adjuvant and adjuvant hormones, dose-escalation and neutron irradiation. - Strategies for post-radiation failures will be presented including data on cryotherapy, salvage prostatectomy and hormonal therapy (immediate, delayed and/or intermittent). New areas for investigation will be reviewed. - The management of patients post prostatectomy will be reviewed. Data on adjuvant radiation and therapeutic radiation for biochemical or clinically relapsed patients will be presented. This course hopes to present a realistic and pragmatic overview for treating patients with non-metastatic prostatic cancer

  6. Managements of open wounds from an earthquake%地震伤员开放伤口的手术治疗策略

    Institute of Scientific and Technical Information of China (English)

    陈欣; 周业平; 黄富国; 岑石强; 覃凤均; 陈忠

    2012-01-01

    Objective To explore the surgical managements of open wounds from 5 · 12 Wenchuan Earthquake.Methods In this report,fifty one patients with open wounds were treated after transported into West China Hospital from May 12 to 26 in 2008 after 5 · 12 Wenchuan Earthquake.Among 51 cases,open wounds were due to open fractures (n =8),fasciotomy (n =6),exposed bone (n =8) and defects of skin and soft tissue (n =29).All cases had wound infections.Sixty operations were performed,including muscle and myocutaneous flap ( n =4 ),skin grafting ( n =30 ),NPWT ( negative pressure wound therapy ) ( n =2 )and debridement ( n =24 ). Results Four cases of muscle and myocutaneous flaps survived with an excellent blood circulation.And 30 cases of skin grafting had a survival rate of over 90%,2 cases of NPWT and 24 cases of debridement required further treatment.Conclusion With adequate surgical managements,open wound healing from an earthquake may be accelerated and the functions maximally preserved.%目的 探讨地震伤员开放伤口的手术处理方法.方法 总结5· 12汶川地震中于2008年5月12-26口转入华西医院骨科接受手术治疗的51例开放伤口伤员的术前情况、手术治疗方法及术后效果.51例中,开放骨折8例,切开减张创面6例,骨外露8例,单纯皮肤软组织缺损29例.创面感染率100%.共进行60次手术,手术方法:皮瓣、肌皮瓣手术4例,植皮术30例(包括邮票植皮、整张植皮和网状植皮),创面负压引流治疗(NPWT)2例,扩创术24例.结果 4例皮瓣、肌瓣手术后皮瓣、肌瓣成活良好;30例植皮手术皮片成活率均达到90%以上;2例NPWT、24例扩创术后创面感染减轻,继续换药处理或择期手术.结论 恰当的创面手术处理方法可以加速地震伤员开放创面的愈合、最大限度地保存功能.

  7. Impact of advanced fuel cycle options on waste management policies

    International Nuclear Information System (INIS)

    OECD/NEA has performed a study on the impact of advanced fuel cycle options on waste management policies with 33 experts from 12 member countries, 1 non-member country and 2 international organizations. The study extends a series of previous ones on partitioning and transmutation (P and T) issues, focusing on the performance assessments for repositories of high-level waste (HLW) arising from advanced fuel cycles. This study covers a broader spectrum than previous studies, from present industrial practice to fully closed cycles via partially closed cycles (in terms of transuranic elements); 9 fuel cycle schemes and 4 variants. Elements of fuel cycles are considered primarily as sources of waste, the internal mass flows of each scheme being kept for the sake of mass conservation. The compositions, activities and heat loads of all waste flows are also tracked. Their impact is finally assessed on the waste repository concepts. The study result confirms the findings from the previous NEA studies on P and T on maximal reduction of the waste source term and maximal use of uranium resources. In advanced fuel cycle schemes the activity of the waste is reduced by burning first plutonium and then minor actinides and also the uranium consumption is reduced, as the fraction of fast reactors in the park is increased to 100%. The result of the repository performance assessments, analysing the effect of different HLW isotopic composition on repository performance and on repository capacity, shows that the maximum dose released to biosphere at any time in normal conditions remains, for all schemes and for all the repository concepts examined, well below accepted radiation protection thresholds. The major impact is on the detailed concept of the repositories, through heat load and waste volume. Advanced fuel cycles could allow a repository to cover waste produced from 5 to 20 times more electricity generation than PWR once-through cycle. Given the flexibility of the advanced fuel

  8. Comparison of conventional gauze therapy with vacuum assisted closure wound therapy in acute traumatic wounds

    International Nuclear Information System (INIS)

    Objective: To compare the Vacuum Assisted Closure (Vac) wound therapy with Conventional Gauze Therapy (CGT) in management of acute traumatic wounds on the basis of time taken to achieve a vital red wound ready for definitive surgical closure. Study Design: Randomized control trial. Place and Duration of Study: Department of Surgery Combined Military Hospital Rawalpindi from Mar 2009 to Sep 2009. Patients and Methods: This study included 82 patients of acute traumatic wounds. Patients were randomly allotted to group A, in which wound was treated with new method of vacuum assisted closure (VAC) wound therapy and to group B, in which wound was managed by conventional gauze therapy (CGT). Outcomes were measured by the presence of vital red wound ready to be closed by surgical intervention. Patients with concomitant systemic pathology were not included in study. Results: Comparison between the two groups revealed mean time for wound healing 13 days in group A and 16.9 days in group B with significant difference (p value =0.029). Conclusion: Vacuum assisted closure wound therapy is an effective method in reducing time of wound healing for definitive surgical closure. (author)

  9. Second Annual Symposium On Advanced Traffic Management Systems (ATMS) And Advanced Traveler Information Systems (ATIS), November 5, 1990

    OpenAIRE

    Haldors, Bruce; Bozzini, Anna; May, Adolf D.

    1991-01-01

    The purpose of the Symposium on Advanced Traffic Management Systems (ATMS) and Advanced Traveler Information Systems (ATIS) was to allow researchers involved in ATM/ATIS work to become familiar with other research in those areas in the state of California. This document provides a brief summary outlining the presentations made at the symposium.

  10. Methods and Systems for Advanced Spaceport Information Management

    Science.gov (United States)

    Fussell, Ronald M. (Inventor); Ely, Donald W. (Inventor); Meier, Gary M. (Inventor); Halpin, Paul C. (Inventor); Meade, Phillip T. (Inventor); Jacobson, Craig A. (Inventor); Blackwell-Thompson, Charlie (Inventor)

    2007-01-01

    Advanced spaceport information management methods and systems are disclosed. In one embodiment, a method includes coupling a test system to the payload and transmitting one or more test signals that emulate an anticipated condition from the test system to the payload. One or more responsive signals are received from the payload into the test system and are analyzed to determine whether one or more of the responsive signals comprises an anomalous signal. At least one of the steps of transmitting, receiving, analyzing and determining includes transmitting at least one of the test signals and the responsive signals via a communications link from a payload processing facility to a remotely located facility. In one particular embodiment, the communications link is an Internet link from a payload processing facility to a remotely located facility (e.g. a launch facility, university, etc.).

  11. Recent advances in the diagnosis and management of cardiac amyloidosis.

    Science.gov (United States)

    Sher, Taimur; Gertz, Morie A

    2014-01-01

    The heart is commonly involved in various forms of amyloidosis and cardiomyopathy is a major cause of morbidity and mortality in these patients. Diagnosis of cardiac amyloidosis is often delayed due to nonspecific presenting symptoms and failure to recognize early signs of amyloid heart disease on routine cardiac imaging. Treatment of cardiac amyloidosis depends upon the type of amyloid protein. Systemic chemotherapy with or without stem cell transplantation is used to treat immunoglobulin-related amyloidosis and liver transplantation is used for familial transthyretin amyloidosis in select patients. Clinical trials with siRNA for the treatment of transthyretin amyloid cardiomyopathies and amyloid protein stabilizers are ongoing. Prognosis depends on the type of amyloid protein with poorer outcomes noted in immunoglobulin light-chain amyloidosis. Supportive care forms the cornerstone of management and advancements in cardiac imaging and proteomics are expected to positively impact our ability to diagnose, prognosticate and treat cardiac amyloidosis. PMID:24344669

  12. Advanced techniques using the plant as indicator of irrigation management

    Directory of Open Access Journals (Sweden)

    Barbara dos Santos Esteves

    2015-05-01

    Full Text Available The methodologies which are considered the most promising for irrigation management are those based on the analysis of the water status of the plants themselves. This justifies the study and improvement of indicators based on automatic and continuous measures to enable real-time monitoring data, as indices from sap flow, dendrometry and leaf turgor pressure techniques. The aim of this paper is to analyze such methodologies in order to demonstrate their principles, advantages and challenges. In conclusion, the methodologies analyzed still have many technological advances and challenges before being presented to the final user. The future research should work these tools for elaboration of technical indexes that allow their simplification, on the instrumental point of view, and the interpretation of their results.

  13. Advances in the Management of Cerebral Vascular Disease

    Directory of Open Access Journals (Sweden)

    Muhammad Imran Qadir

    2015-06-01

    Full Text Available A cerebral vascular disease occurred with the arteries of brain due to the less supply of blood.  Stroke is mostly caused by cerebral vascular disease and it is also a common cause of vascular dementia due to reduced oxygen supply and blood flow to the brain. In industrialized countries, neurologic disability is most frequently caused by cerebeovascular disease. Individuals with cardiovascular disease, diabetes and high blood pressure etc are at higher possibility for cerebral vascular disease. After malignancy and heart disease, cerebral vascular disease is the third leading of death and estimated that an average 500,000 new stroke occurred in each year. Advance techniques such as Carotid Endarterectomy, Magnetic resonance imaging, Angiography and Single photon emission computed tomography etc are used for management of cerebral vascular disease.

  14. Incorporating outage management principles into the advanced light water reactor

    International Nuclear Information System (INIS)

    In the United States there are 110 light water reactor (LWR) plants currently in operation, with a total generating capacity of 102 580 MW(electric). These plants include 37 boiling water reactor (BWR) and 73 pressurized water reactor (PWR) units. Since 1980, more than 40 nuclear power plants have entered service in the United States. However, no new plants have been ordered by utilities and owners groups since 1978. There will come a time in the not-too-distant future that new, large electricity generating units will be needed to supply expected increases in base-load capacity. Will the new advanced LWR (ALWR) designs be able to pass muster and be chosen to help meet that need? With outage management at operating plants improving every year, what can the ALWR designs offer that has not already been incorporated?

  15. Surgical amputation of a digit and vacuum-assisted-closure (V.A.C.) management in a case of osteomyelitis and wound care in an eastern black rhinoceros (Diceros bicornis michaeli).

    Science.gov (United States)

    Harrison, Tara M; Stanley, Bryden J; Sikarskie, James G; Bohart, George; Ames, N Kent; Tomlian, Janice; Marquardt, Mark; Marcum, Annabel; Kiupel, Matti; Sledge, Dodd; Agnew, Dalen

    2011-06-01

    A 14-yr-old female eastern black rhinoceros (Diceros bicornis michaeli) presented with progressive suppurative osteomyelitis in her left hind lateral toe. beta-Hemolytic Streptococcus sp. was isolated. The animal was treated with multiple systemic antibiotics, and topical wound cleansing. Repeated debridements and nail trimmings were performed for 5 mo prior to electing amputation. The toe was surgically amputated under general anesthesia between the first and second phalanges. Analgesia was diffused into the wound topically via a catheter and elastomeric pump. The open amputation site was covered with adherent drapes and a negative-pressure wound therapy device provided vacuum-assisted closure (V.A.C.) for 72 hr. Three months later this animal developed a deep dermal ulcer on the lateral aspect of the right hind limb, at the level of the stifle. Methicillin-resistant Staphylococcus aureus was isolated. The wound was managed by initial daily lavage, followed by 1 mo of V.A.C. therapy, with 72 hr between dressing changes. Clinically, this therapy expedited the formation of healthy granulation tissue and overall healing was accelerated. The animal tolerated the machine and bandage changes well via operant conditioning. The use of negative-pressure wound therapy appeared to shorten time to resolution of slow-healing wounds in black rhinoceros. PMID:22946413

  16. Sulfadiazine—Chitosan Conjugates and Their Polyelectrolyte Complexes with Hyaluronate Destined to the Management of Burn Wounds

    Directory of Open Access Journals (Sweden)

    Raluca Petronela Dumitriu

    2015-01-01

    Full Text Available In the present study polyelectrolyte complexes (PECs based on new sulfadiazine-chitosan conjugates with sodium hyaluronate have been developed with potential use in treatment of burn wounds. The PECs were chemically characterized using Fourier Transform—Infrared Spectroscopy, Scanning Electon Microscopy and Near Infrared Chemical Imaging Technique. The swelling behavior and in vitro sulfadiazine release were also investigated. The antimicrobial activity was evaluated towards three bacterial strains: Escherichia coli, Listeria monocytogenes and Salmonella thyphymurium. The developed PECs demonstrated their antimicrobial efficiency against tested bacterial strains, the PECs containing sulfadiazine-modified chitosan being more active than PECs containing unmodified chitosan.

  17. Hyperbaric oxygen and wound healing

    Directory of Open Access Journals (Sweden)

    Sourabh Bhutani

    2012-01-01

    Full Text Available Hyperbaric oxygen therapy (HBOT is the use of 100% oxygen at pressures greater than atmospheric pressure. Today several approved applications and indications exist for HBOT. HBOT has been successfully used as adjunctive therapy for wound healing. Non-healing wounds such as diabetic and vascular insufficiency ulcers have been one major area of study for hyperbaric physicians where use of HBOT as an adjunct has been approved for use by way of various studies and trials. HBOT is also indicated for infected wounds like clostridial myonecrosis, necrotising soft tissue infections, Fournier′s gangrene, as also for traumatic wounds, crush injury, compartment syndrome, compromised skin grafts and flaps and thermal burns. Another major area of application of HBOT is radiation-induced wounds, specifically osteoradionecrosis of mandible, radiation cystitis and radiation proctitis. With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, HBOT should be considered in these situations as an essential part of the overall management strategy for the treating surgeon.

  18. Masters Study in Advanced Energy and Fuels Management

    Energy Technology Data Exchange (ETDEWEB)

    Mondal, Kanchan [Southern Illinois Univ., Carbondale, IL (United States)

    2014-12-08

    There are currently three key drivers for the US energy sector a) increasing energy demand and b) environmental stewardship in energy production for sustainability and c) general public and governmental desire for domestic resources. These drivers are also true for energy nation globally. As a result, this sector is rapidly diversifying to alternate sources that would supplement or replace fossil fuels. These changes have created a need for a highly trained workforce with a the understanding of both conventional and emerging energy resources and technology to lead and facilitate the reinvention of the US energy production, rational deployment of alternate energy technologies based on scientific and business criteria while invigorating the overall economy. In addition, the current trends focus on the the need of Science, Technology, Engineering and Math (STEM) graduate education to move beyond academia and be more responsive to the workforce needs of businesses and the industry. The SIUC PSM in Advanced Energy and Fuels Management (AEFM) program was developed in response to the industries stated need for employees who combine technical competencies and workforce skills similar to all PSM degree programs. The SIUC AEFM program was designed to provide the STEM graduates with advanced technical training in energy resources and technology while simultaneously equipping them with the business management skills required by professional employers in the energy sector. Technical training include core skills in energy resources, technology and management for both conventional and emerging energy technologies. Business skills training include financial, personnel and project management. A capstone internship is also built into the program to train students such that they are acclimatized to the real world scenarios in research laboratories, in energy companies and in government agencies. The current curriculum in the SIUC AEFM will help fill the need for training both recent

  19. Negative pressure wound therapy management of the “open abdomen” following trauma: a prospective study and systematic review

    Directory of Open Access Journals (Sweden)

    Navsaria Pradeep

    2013-01-01

    Full Text Available Abstract Introduction The use of Negative Pressure Wound Therapy (NPWT for temporary abdominal closure of open abdomen (OA wounds is widely accepted. Published outcomes vary according to the specific nature and the aetiology that resulted in an OA. The aim of this study was to evaluate the effectiveness of a new NPWT system specifically used OA resulting from abdominal trauma. Methods A prospective study on trauma patients requiring temporary abdominal closure (TAC with grade 1or 2 OA was carried out. All patients were treated with NPWT (RENASYS AB Smith & Nephew to achieve TAC. The primary outcome measure was time taken to achieve fascial closure and secondary outcomes were complications and mortality. Results A total of 20 patients were included. Thirteen patients (65% achieved fascial closure following a median treatment period of 3 days. Four patients (20% died of causes unrelated to NPWT. Complications included fistula formation in one patient (5% with spontaneous resolution during NPWT, bowel necrosis in a single patient (5% and three cases of infection (15%. No fistulae were present at the end of NPWT. Conclusion This new NPWT kit is safe and effective and results in a high rate of fascial closure and low complication rates in the severely injured trauma patient.

  20. Advanced Simulation Capability for Environmental Management: Development and Demonstrations - 12532

    International Nuclear Information System (INIS)

    The U.S. Department of Energy Office of Environmental Management (EM), Technology Innovation and Development is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high-performance computing tool facilitates integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of capabilities, which are organized into Platform and Integrated Tool-sets and a High-Performance Computing Multi-process Simulator. The Platform capabilities target a level of functionality to allow end-to-end model development, starting with definition of the conceptual model and management of data for model input. The High-Performance Computing capabilities target increased functionality of process model representations, tool-sets for interaction with Platform, and verification and model confidence testing. The new capabilities are demonstrated through working groups, including one focused on the Hanford Site Deep Vadose Zone. The ASCEM program focused on planning during the first year and executing a prototype tool-set for an early demonstration of individual components. Subsequently, ASCEM has focused on developing and demonstrating an integrated set of capabilities, making progress toward a version of the capabilities that can be used to engage end users. Demonstration of capabilities continues to be implemented through working groups. Three different working groups, one focused on EM problems in the deep vadose zone, another investigating attenuation mechanisms for metals and radionuclides, and a third focusing on waste tank performance assessment, continue to make progress. The project

  1. Understanding the role of nutrition and wound healing.

    Science.gov (United States)

    Stechmiller, Joyce K

    2010-02-01

    Optimal wound healing requires adequate nutrition. Nutrition deficiencies impede the normal processes that allow progression through stages of wound healing. Malnutrition has also been related to decreased wound tensile strength and increased infection rates. Malnourished patients can develop pressure ulcers, infections, and delayed wound healing that result in chronic nonhealing wounds. Chronic wounds are a significant cause of morbidity and mortality for many patients and therefore constitute a serious clinical concern. Because most patients with chronic skin ulcers suffer micronutrient status alterations and malnutrition to some degree, current nutrition therapies are aimed at correcting nutrition deficiencies responsible for delayed wound healing. This review provides current information on nutrition management for simple acute wounds and complex nonhealing wounds and offers some insights into innovative future treatments. PMID:20130158

  2. 造口伤口小组在压疮管理中的应用%The role of stoma & wound team in pressure ulcer management

    Institute of Scientific and Technical Information of China (English)

    夏永梅; 李金凤; 徐丽; 刘凯

    2014-01-01

    Objective: To explore the role of stoma & wound team in pressure ulcer management. Methods: The stoma &wound team was established and their responsibilities were clariifed. They implemented specialized staff training and evaluation. Patients and high-risk patients with pressure ulcers were management by Enterostomal Therapists and team members. The incidence and cure rate of pressure ulcer in hospitals, pressure ulcer related knowledge of the team members and patients' satisfaction were collected and compared before and after the stoma & wound team established. Results: The incidence of pressure ulcer was lower than before (1.4‰ vs 4.0‰). The cure rate of pressure ulcer was 68.7%. The pressure ulcer related knowledge of the team members was (25.6±1.5) and patient satisfaction score was (4.1±0.2). Both of them were higher than before. Conclusion: The establishment of stoma & wound team could improve the quality of basic nursing care and relfect the professional level of stoma & wound care.%目的:探讨造口伤口小组在压疮管理中的作用。方法:成立造口伤口小组,确定小组职责并进行专业化培训及考核,由造口治疗师及小组成员对压疮患者和压疮高危患者进行统一、全程管理。造口伤口小组成立前后,统计院内压疮的发生率、治愈率,调查小组成员对压疮知识的知晓率及压疮高危患者的满意度。结果:造口伤口小组成立后,压疮发生率(1.4‰)低于小组成立前(4.0‰);压疮治愈率(68.7%)、造口伤口小组成员对压疮知识掌握情况(25.6±1.5)及压疮高危患者满意度评分(4.1±0.2)均高于成立前。结论:造口伤口小组的成立,提高了压疮护理质量,减轻了压疮患者痛苦,充分体现了造口伤口专科护理水平。

  3. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

    Science.gov (United States)

    Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

    2016-03-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network. PMID:27222729

  4. Recent advances in the understanding and management of delayed puberty.

    Science.gov (United States)

    Wei, Christina; Crowne, Elizabeth Clare

    2016-05-01

    Delayed puberty, especially in boys, is a common presentation in paediatrics. Recent advances have improved our understanding of the neuroendocrine, genetic and environmental factors controlling pubertal development, and hence inform the pathophysiology of delayed puberty. The discovery of kisspeptin signalling through its receptor identified neuroendocrine mechanisms controlling the gonadotrophin-releasing hormone (GnRH) pulse generator at the onset of puberty. Genetic mechanisms from single gene mutations to single nucleotide polymorphism associated with delayed puberty are being identified. Environmental factors, including nutritional factors and endocrine disruptors, have also been implicated in changes in secular trends and abnormal timing of puberty. Despite these advances, the key clinical question is to distinguish delayed puberty associated with an underlying pathology or hypogonadism from constitutional delay in growth and puberty, which remains challenging as biochemical tests are not always discriminatory. The diagnostic accuracies of newer investigations, including 36-hour luteinising hormone releasing hormone (LHRH) tests, GnRH-agonist tests, antimullerian hormone and inhibin-B, require further evaluation. Sex hormone replacement remains the main available treatment for delayed puberty, the choice of which is largely dictated by clinical practice and availability of the various sex steroid preparations. Spontaneous reversal of hypogonadism has been reported in boys with idiopathic hypogonadotrophic hypogonadism after a period of sex steroid treatment, highlighting the importance of reassessment at the end of pubertal induction. Novel therapies with a more physiological basis such as gonadotrophins or kisspeptin-agonist are being investigated for the management of hypogonadotrophic hypogonadism. Careful clinical assessment and appreciation of the normal physiology remain the key approach to patients with delayed puberty. PMID:26353794

  5. EDF advanced fuel management strategies for the next century

    International Nuclear Information System (INIS)

    The French nuclear fleet represents 57 PWRs in operation, accounting for 80 % of France's total electricity production. The performance achieved by EDF reactors, in terms of availability (82.6% in 1997) and good cost control, have allowed to improve the nuclear KWh cost by 2% since 1992. The implementation of longer fuel cycles on the 1300 MW reactors from 1996 has contributed to this improvement and, as competitiveness is one of the main challenges for EDF, improving core management strategies is still at the order of the day. With this aim, a thinking process has been initiated to evaluate the benefit brought by the use of a fuel assembly like ALLIANCE, the new fuel product developed by Framatome-Fragema and FCF (Framatome Cogema Fuels) in close cooperation with EDF. The considered product provides enhanced performance, particularly as regards discharge burnup (at least up to 70 GWd/t) and thermal-hydraulic and mechanical behaviour. Fuel management improvements rely on the expertise gained by Framatome through designing core management strategies in a wide range of operating conditions prevailing in nuclear reactors all over the world. It will however be taken into account the necessity for EDF to adopt a policy of stepwise change owing to the potential impact of a 'series effect' on its numerous units. The proposed paper will describe innovative fuel managements, achievable thanks to advanced fuel assembly performance, that are jointly investigated by EDF and Framatome. It includes the following optimization schemes: extending cycle length by using higher enrichments up to 5%, while keeping the same reload size (1/3 core for example for the 1300 MW reactors); decreasing reload size (from 1/3 to 1/4 core), while keeping the same cycle length, using more enriched (up to 5 %) fuel assemblies; reaching annual cycle, with maximization of fuel cycle cost optimization (1/5 core). Beyond such schemes, combinations of optimized loading patterns and neutronic features of

  6. Recovery Act. Advanced Load Identification and Management for Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yi [Eaton Corporation, Menomonee Falls, WI (United States); Casey, Patrick [Eaton Corporation, Menomonee Falls, WI (United States); Du, Liang [Eaton Corporation, Menomonee Falls, WI (United States); He, Dawei [Eaton Corporation, Menomonee Falls, WI (United States)

    2014-02-12

    , in particular, advanced power strips (APSs) was studied. The project evaluated the market potential for Smart Power Strips (SPSs) with load identification and the likely impact of a load identification feature on APS adoption and effectiveness. The project also identified other success factors required for widespread APS adoption and market acceptance. Even though the developed technology is applicable for both residential and commercial buildings, this project is focused on effective plug-in load control and management for commercial buildings, accomplished through effective load identification. The project has completed Smart Receptacle (SR) prototype development with integration of Load ID, Control/Management, WiFi communication, and Web Service. Twenty SR units were built, tested, and demonstrated in the Eaton lab; eight SR units were tested in the National Renewable Energy Lab (NREL) for one-month of field testing. Load ID algorithm testing for extended load sets was conducted within the Eaton facility and at local university campuses. This report is to summarize the major achievements, activities, and outcomes under the execution of the project.

  7. Colgajo de omento para tratamiento de dehiscencia de herida esternal Omental flap for management of sternal wound dehiscence

    Directory of Open Access Journals (Sweden)

    A. Pérez García

    2013-03-01

    Full Text Available La mediastinitis es una de las complicaciones más graves de la cirugía cardíaca. Aparece en el 0,5-5 % de las esternotomías y esta incidencia es mucho mayor en pacientes diabéticos, obesos, inmunodeprimidos, con enfermedad pulmonar obstructiva crónica (EPOC, etc. Presentamos el caso de una paciente diabética, obesa mórbida, que sufre mediastinitis tras doble by-pass coronario. Para la cobertura del defecto se empleó un colgajo de epiplon tunelizado transdiafragmático. El colgajo omental permite cubrir grandes defectos además de que posee capacidad antimicrobiana y favorece la revascularización tisular. Las características de este colgajo hacen que actualmente deba considerarse como primera elección en pacientes con grandes defectos esternales y trastornos de la inmunidad y la cicatrización.Mediastinitis is one of the most serious complications from cardiac surgery. It is reported to occur in 0'5-5 % of sternotomy incisions, and this incidence is much higher in diabetic patients, obese, immunocompromised, COPD, etc. We report a case of a diabetic and morbid obese woman suffering mediastinitis after double coronary bypass surgery. For the reconstruction a transdiaphragmatic tunnelled omental flap was used. The omentum is useful to cover large defects. It has antiinfective properties and promotes revascularization of neighbouring tissues. Omental flap can be a highly effective treatment for patients with large sternal wounds and immune disorders and wound healing disorders.

  8. Formulation of Novel Layered Sodium Carboxymethylcellulose Film Wound Dressings with Ibuprofen for Alleviating Wound Pain

    OpenAIRE

    Lenka Vinklárková; Ruta Masteiková; David Vetchý; Petr Doležel; Jurga Bernatonienė

    2015-01-01

    Effective assessment and management of wound pain can facilitate both improvements in healing rates and overall quality of life. From a pharmacological perspective, topical application of nonsteroidal anti-inflammatory drugs in the form of film wound dressings may be a good choice. Thus, the aim of this work was to develop novel layered film wound dressings containing ibuprofen based on partially substituted fibrous sodium carboxymethylcellulose (nonwoven textile Hcel NaT). To this end, an in...

  9. Use of an Acellular Regenerative Tissue Matrix Over Chronic Wounds

    OpenAIRE

    Stacey, D. Heath

    2013-01-01

    Objectives: Bioengineered skin grafts, including acellular dermal matrices, may be effective in treating lower extremity and trunk wounds that are not responsive to traditional wound management. Acellular dermal wound matrix is derived from human acellular dermal wound matrix (HADWM) tissue and provides a scaffold that supports cellular repopulation and revascularization. The major structural components of the dermis are retained during processing, and a single application has been shown to h...

  10. Informative Top-k Retrieval for Advanced Skill Management

    Science.gov (United States)

    Colucci, Simona; di Noia, Tommaso; Ragone, Azzurra; Ruta, Michele; Straccia, Umberto; Tinelli, Eufemia

    The paper presents a knowledge-based framework for skills and talent management based on an advanced matchmaking between profiles of candidates and available job positions. Interestingly, informative content of top-k retrieval is enriched through semantic capabilities. The proposed approach allows to: (1) express a requested profile in terms of both hard constraints and soft ones; (2) provide a ranking function based also on qualitative attributes of a profile; (3) explain the resulting outcomes (given a job request, a motivation for the obtained score of each selected profile is provided). Top-k retrieval allows to select most promising candidates according to an ontology formalizing the domain knowledge. Such a knowledge is further exploited to provide a semantic-based explanation of missing or conflicting features in retrieved profiles. They also indicate additional profile characteristics emerging by the retrieval procedure for a further request refinement. A concrete case study followed by an exhaustive experimental campaign is reported to prove the approach effectiveness.

  11. Development of Experimental Facilities for Advanced Spent Fuel Management Technology

    International Nuclear Information System (INIS)

    The advanced spent fuel management process(ACP), proposed to reduce the overall volume of the PWR spent fuel and improve safety and economy of the long-term storage of spent fuel, is under research and development. This technology convert spent fuels into pure metal-base uranium with removing the highly heat generating materials(Cs, Sr) efficiently and reducing of the decay heat, volume, and radioactivity from spent fuel by 1/4. In the next phase(2004∼2006), the demonstration of this technology will be carried out for verification of the ACP in a laboratory scale. For this demonstration, the hot cell facilities of α-γ type and auxiliary facilities are required essentially for safe handling of high radioactive materials. As the hot cell facilities for demonstration of the ACP, a existing hot cell of β-γ type will be refurbished to minimize construction expenditures of hot cell facility. In this study, the design requirements are established, and the process detail work flow was analysed for the optimum arrangement to ensure effective process operation in hot cell. And also, the basic and detail design of hot cell facility and process, and safety analysis was performed to secure conservative safety of hot cell facility and process

  12. Disinfecting wounds with radiation

    International Nuclear Information System (INIS)

    Infection with clostridium bacteria, which live in the soil, is most often associated with war wounds, car accidents, complicated abortions, etc. The incidence is highest in areas with poor access to proper wound care. Such infections lead to gas gangrene, a deadly disease that spreads very quickly in the body and causes rapid death. Present-day treatment consists of administering antibiotics and surgical removal of dead, damaged and infected tissue. Amputation is usually necessary to control the spread of the infection, which can advance at the rate of six inches per hour. Before the 1940s, this disease was treated successfully with low doses (50 rad) of radiation (X-rays) in the area of infection. A review of 364 cases treated in this manner, from 1928 until 1940, indicated that patient mortality would be reduced from 50 percent (or higher) to ∼5 percent if patients were treated reasonably early and with the correct technique. X-ray therapy stopped the infection without the need for amputation to control its spread. Low-dose irradiation (LDI) therapy, given immediately, acted as a prophylaxis to prevent the onset of gas gangrene. This is but one example of the extensive use of radiation treatment of many types of infections, before the advent of antibiotics. Low doses are inadequate to kill invading bacteria directly, however, they will stimulate our defences to destroy the infection. The observed beneficial effects are consistent with the large amount of scientific evidence of radiation hormesis - the stimulation of an organism's own defences by low doses of radiation (to destroy invaders and heal wounds). In view of the ineffectiveness of antibiotics in many cases and the evolution of antibiotic-resistant strains of bacteria, physicians should start to use LDI therapies again. Many patients would benefit greatly. (author)

  13. Negative Pressure Wound Therapy in Infected Wound following Posterior Spinal Instrumentation using Simple Self-assembled System: A Case Report

    OpenAIRE

    Chang, CW; Chan, HZ; Lim, SW; Khoo, EH; Zulkiflee, O

    2014-01-01

    Abstract Postoperative wound infection in an instrumented spine patient is often disastrous. Management includes implant removal leading to spine instability. Negative pressure wound therapy (NPWT) applied to the spine surgical wound is one of the wound care technique with successful results. We report a case of a man who sustained Chance fracture of Lumbar 1 (L1) vertebra treated with long segment posterior instrumentation, who unfortunately developed Extended-spectrum beta-lactamase (ESBL) ...

  14. Application of the Single Use Negative Pressure Wound Therapy Device (PICO) on a Heterogeneous Group of Surgical and Traumatic Wounds

    OpenAIRE

    Payne, Caroline; Edwards, Daren

    2014-01-01

    Objectives: Traumatic wounds and surgery inherently have their complications. Localized infections, wound dehiscence, and excessive wound leakage can be devastating to the patient with a prolonged recovery, but it is also costly to the hospital with an increased length of stay, extra workload, and dressing changes. The single use PICO (Smith and Nephew Healthcare, Hull, United Kingdom) negative pressure wound therapy (NPWT) dressing has revolutionized our management of various acute, chronic,...

  15. Practice and prospect of advanced fuel management and fuel technology application in PWR in China

    International Nuclear Information System (INIS)

    Since Daya Bay nuclear power plant implemented 18-month refueling strategy in 2001, China has completed a series of innovative fuel management and fuel technology projects, including the Ling Ao Advanced Fuel Management (AFM) project (high-burnup quarter core refueling) and the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. First, this paper gives brief introduction to China's advanced fuel management and fuel technology experience. Second, it introduces practices of the advanced fuel management in China in detail, which mainly focuses on the implementation and progress of the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. Finally, the paper introduces the practices of advanced fuel technology in China and gives the outlook of the future advanced fuel management and fuel technology in this field. (author)

  16. Patient and caregiver perspectives on managing pain in advanced cancer: A qualitative longitudinal study

    OpenAIRE

    Hackett, J; Godfrey, M.; Bennett, MI

    2015-01-01

    Background: Despite advances in treatment of pain in advanced cancer, it remains a major source of suffering with adverse effects on patients’ life quality. There is increasing understanding of its multi-dimensional nature and the variable responsiveness of medication to complex pain. Less clear is how patients and their caregivers respond to, and manage pain complexity. Aim: To explore patients’ and carers’ experiences of advanced cancer pain and the processes that they engage in to manage p...

  17. Advancements in the Management of Pancreatic Cancer: 2013

    Directory of Open Access Journals (Sweden)

    Muhammad Wasif Saif

    2013-03-01

    Full Text Available Pancreatic cancer still remains a significant, unresolved therapeutic challenge and is the most lethal type of gastrointestinal cancer with a 5-year survival rate of 5%. Adjuvant chemotherapy remains to be gemcitabine alone, though fluorouracil offers the same survival and role of radiation remains controversial. Nevertheless, only a few patients survive for at least 5 years after R0 resection and adjuvant therapy. Borderline resectable pancreatic cancer remains an area that requires multi-disciplinary approach. Neoadjuvant therapy very likely plays a role to downstage to a resectable state in these subgroup patients. There are different treatment approaches to locally advanced pancreatic cancer management, including single or multi-agent chemotherapy, chemotherapy followed by chemoradiation, or immediate concurrent chemoradiation. Most patients need palliative treatment. Once pancreatic cancer becomes metastatic, it is uniformly fatal with an overall survival of generally 6 months from time of diagnosis. Gemcitabine has been the standard since 1997. FOLFIRINOX (5-fluorouracil, oxaliplatin, irinotecan, leucovorin has already shown superiority over gemcitabine in both progression-free survival and overall survival, but this regimen is suitable only for selected patients in ECOG performance status 0-1. FOLFIRINOX has already trickled down to the clinic in various modifications and in different patient groups, both locally advanced and metastatic. Many targeted agents, including bevacizumab, cetuximab showed negative results, except mild benefit with addition of erlotinib with gemcitabine, which was not considered clinically significant. There is no consensus regarding treatment in the second-line setting. It will be true to say that there was a real medical breakthrough with regards to improving the prognosis of pancreatic cancer as of 2013 with the results of MPACT study. In this study, patients whoreceived nab-paclitaxel plus gemcitabine lived a

  18. Biomarkers for wound healing and their evaluation.

    Science.gov (United States)

    Patel, S; Maheshwari, A; Chandra, A

    2016-01-01

    A biological marker (biomarker) is a substance used as an indicator of biological state. Advances in genomics, proteomics and molecular pathology have generated many candidate biomarkers with potential clinical value. Research has identified several cellular events and mediators associated with wound healing that can serve as biomarkers. Macrophages, neutrophils, fibroblasts and platelets release cytokines molecules including TNF-α, interleukins (ILs) and growth factors, of which platelet-derived growth factor (PDGF) holds the greatest importance. As a result, various white cells and connective tissue cells release both matrix metalloproteinases (MMPs) and the tissue inhibitors of metalloproteinases (TIMPs). Studies have demonstrated that IL-1, IL-6, and MMPs, levels above normal, and an abnormally high MMP/TIMP ratio are often present in non-healing wounds. Clinical examination of wounds for these mediators could predict which wounds will heal and which will not, suggesting use of these chemicals as biomarkers of wound healing. There is also evidence that the application of growth factors like PDGF will alleviate the recuperating process of chronic, non-healing wounds. Finding a specific biomarker for wound healing status would be a breakthrough in this field and helping treat impaired wound healing. PMID:26762498

  19. The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

    OpenAIRE

    Rahmi Yücel; Kayhan Ahmetoğulları

    2015-01-01

    This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively....

  20. [Malignant wounds in palliative care].

    Science.gov (United States)

    Fromantin, Isabelle; Rollot, Florence; Nicodeme, Marguerite; Kriegel, Iréne

    2015-01-01

    In the alsence of effective cancer treatment, malignant wounds evolve. The decisions taken by the multi-disciplinary team with regard to their care vary depending on whether the patient is in the initial, advanced or terminal phase of palliative care. Modern dressings can be used to control bleeding, odours and drainage. The aim is to control the symptoms and improve the quality of life, until its end. PMID:26027186

  1. Difficult wounds: an update.

    Science.gov (United States)

    Edlich, Richard F; Winters, Kathryne L; Britt, L D; Long, William B; Gubler, K Dean; Drake, David B

    2005-01-01

    The purpose of this collective review is to describe revolutionary advances in the treatment of Gardner's syndrome (GS), pseudofolliculitis barbae, nasal septal perforation, factitious wounds, and hidradenitis suppurativa (HS). Gardner's syndrome or familial polyposis has various manifestations that appear to be controlled by a single genetic locus. Apart from the large bowel adenomas, which are always present, a common extracolonic symptom of Gardner's syndrome is the occurrence of epidermal cysts. These cysts can be seen before the intestinal polyps are evident. Because epidermal cysts in patients with Gardner's syndrome are always benign, we excise these cysts using incisions that are commonly used for rhytidectomy. Pseudofolliculitis barbae, a pseudofolliculitis caused by ingrown hairs, effects 85% of blacks who shave their beards. When this disease is allowed to progress to keloid formation, we use a surgical approach that includes excision of the keloidal scar, meticulous debridement of all residual ingrown hairs in the underlying wound, and coverage of the defect with a split-thickness skin graft. More recently, laser therapy has revolutionized the treatment of pseudofolliculitis barbae and has enabled a cure for the first time for those plagued with this disorder and for whom a beardless face is acceptable. Nasal septal perforation is a well recognized complication of septal surgery. Other iatrogenic causes of perforation include cryosurgery, electrocoagulation for epitaxis, nasotracheal intubation, or nose packing. In recent years drugs such as cocaine account for an increasing number of perforations. It has only been with the use of an external approach for the repair of the nasal septal defect that surgical closure has become easier and more reliable. The external approach allows for greater surgical closure and enables the surgeon to use both hands with the aid of binocular vision to mobilize and suture local mucosal advancement flaps and the

  2. How wounds heal

    Science.gov (United States)

    ... PA: Mosby Elsevier; 2010: chap. 7. Richardson M. Acute wounds: an overview of the physiological healing process. Nursing Times . 2004; 100(4): 50. Von Der Heyde RL, Evans RB. Wound classification ...

  3. Managing occupations in everyday life for people with advanced cancer at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen;

    Background: People with advanced cancer are increasingly able to live for extended periods of time. Advanced cancer influences the ability to manage occupations in the everyday life. Although studies have showed that people with advanced cancer experience occupational difficulties, there are...... limited research that more specifically explore how these are managed. The objective was to describe and explore how people with advanced cancer manage occupations at home. Material and methods: A qualitative descriptive design was applied. 73 participants were consecutively recruited from a Danish...... “Everyday life under change” and two sub-categories 1) Appling strategies to manage occupations in everyday life and 2) Preserving a meaningful everyday life. Significance: The findings suggest that people with advanced cancer, to a greater extent, should be supported in exploring familiar as well as new...

  4. Advanced Simulation Capability for Environmental Management (ASCEM) Phase II Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Freshley, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hubbard, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Flach, G. [Savannah River National Lab. (SRNL), Aiken, SC (United States); Freedman, V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Agarwal, D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Andre, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bott, Y. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chen, X. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Davis, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faybishenko, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gorton, I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Murray, C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Moulton, D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Meyer, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rockhold, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Shoshani, A. [LBNL; Steefel, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wainwright, H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Waichler, S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2012-09-28

    In 2009, the National Academies of Science (NAS) reviewed and validated the U.S. Department of Energy Office of Environmental Management (EM) Technology Program in its publication, Advice on the Department of Energy’s Cleanup Technology Roadmap: Gaps and Bridges. The NAS report outlined prioritization needs for the Groundwater and Soil Remediation Roadmap, concluded that contaminant behavior in the subsurface is poorly understood, and recommended further research in this area as a high priority. To address this NAS concern, the EM Office of Site Restoration began supporting the development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific approach that uses an integration of toolsets for understanding and predicting contaminant fate and transport in natural and engineered systems. The ASCEM modeling toolset is modular and open source. It is divided into three thrust areas: Multi-Process High Performance Computing (HPC), Platform and Integrated Toolsets, and Site Applications. The ASCEM toolsets will facilitate integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. During fiscal year 2012, the ASCEM project continued to make significant progress in capabilities development. Capability development occurred in both the Platform and Integrated Toolsets and Multi-Process HPC Simulator areas. The new Platform and Integrated Toolsets capabilities provide the user an interface and the tools necessary for end-to-end model development that includes conceptual model definition, data management for model input, model calibration and uncertainty analysis, and model output processing including visualization. The new HPC Simulator capabilities target increased functionality of process model representations, toolsets for interaction with the Platform, and model confidence testing and verification for

  5. The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

    Directory of Open Access Journals (Sweden)

    Rahmi Yücel

    2015-10-01

    Full Text Available This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively. Furthermore, there is a positive and significant relation between long-term strategy based on management accounting practices and non-financial company performance and between activity based on management accounting practices and financial performance.

  6. Improved wound care product

    DEFF Research Database (Denmark)

    2012-01-01

    The present invention pertains to use of sodium diacetate (NaHAc 2) as an antimicrobial agent against bacteria growing in biofilms. The aspects of the invention include a wound care product comprising sodium diacetate, a kit comprising a wound care product,and a methodof treating an infected wound....

  7. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: A randomized controlled trial

    NARCIS (Netherlands)

    Braakenburg, A.; Obdeijn, M.C.; Feitz, R.; van Rooij, I.A.L.M.; van Griethuysen, A.J.; Klinkenbijl, J.H.G.

    2006-01-01

    Background: Vacuum-assisted closure therapy is a relatively new concept described in the literature that increases wound-healing capacity. The authors aimed to investigate the effect of vacuum-assisted closure therapy on wound healing, granulation tissue formation, bacterial clearance, pain, time in

  8. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds : A randomized controlled trial

    NARCIS (Netherlands)

    Braakenburg, Assa; Obdeijn, Miryam C.; Feitz, Reinier; van Rooij, Iris A. L. M.; van Griethuysen, Arjanne J.; Klinkenbijl, Jean H. G.

    2006-01-01

    Background: Vacuum-assisted closure therapy is a relatively new concept described in the literature that increases wound-healing capacity. The authors aimed to investigate the effect of vacuum-assisted closure therapy on wound healing, granulation tissue formation, bacterial clearance, pain, time in

  9. The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing

    OpenAIRE

    Mui Koon Tan; Durriyyah Sharifah Hasan Adli; Mohd Amzari Tumiran; Mahmood Ameen Abdulla; Kamaruddin Mohd Yusoff

    2012-01-01

    Honey is one of the oldest substances used in wound management. Efficacy of Gelam honey in wound healing was evaluated in this paper. Sprague-Dawley rats were randomly divided into four groups of 24 rats each (untreated group, saline group, Intrasite Gel group, and Gelam honey group) with 2 cm by 2 cm full thickness, excisional wound created on neck area. Wounds were dressed topically according to groups. Rats were sacrificed on days 1, 5, 10, and 15 of treatments. Wounds were then processed ...

  10. Managing the Perception of Advanced Technology Risks in Mission Proposals

    Science.gov (United States)

    Bellisario, Sebastian Nickolai

    2012-01-01

    Through my work in the project proposal office I became interested in how technology advancement efforts affect competitive mission proposals. Technology development allows for new instruments and functionality. However, including technology advancement in a mission proposal often increases perceived risk. Risk mitigation has a major impact on the overall evaluation of the proposal and whether the mission is selected. In order to evaluate the different approaches proposals took I compared the proposals claims of heritage and technology advancement to the sponsor feedback provided in the NASA debriefs. I examined a set of Discovery 2010 Mission proposals to draw patterns in how they were evaluated and come up with a set of recommendations for future mission proposals in how they should approach technology advancement to reduce the perceived risk.

  11. Wireless Sensor Network for Advanced Energy Management Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Peter J. Theisen; Bin Lu, Charles J. Luebke

    2009-09-23

    Eaton has developed an advanced energy management solution that has been deployed to several Industries of the Future (IoF) sites. This demonstrated energy savings and reduced unscheduled downtime through an improved means for performing predictive diagnostics and energy efficiency estimation. Eaton has developed a suite of online, continuous, and inferential algorithms that utilize motor current signature analysis (MCSA) and motor power signature analysis (MPSA) techniques to detect and predict the health condition and energy usage condition of motors and their connect loads. Eaton has also developed a hardware and software platform that provided a means to develop and test these advanced algorithms in the field. Results from lab validation and field trials have demonstrated that the developed advanced algorithms are able to detect motor and load inefficiency and performance degradation. Eaton investigated the performance of Wireless Sensor Networks (WSN) within various industrial facilities to understand concerns about topology and environmental conditions that have precluded broad adoption by the industry to date. A Wireless Link Assessment System (WLAS), was used to validate wireless performance under a variety of conditions. Results demonstrated that wireless networks can provide adequate performance in most facilities when properly specified and deployed. Customers from various IoF expressed interest in applying wireless more broadly for selected applications, but continue to prefer utilizing existing, wired field bus networks for most sensor based applications that will tie into their existing Computerized Motor Maintenance Systems (CMMS). As a result, wireless technology was de-emphasized within the project, and a greater focus placed on energy efficiency/predictive diagnostics. Commercially available wireless networks were only utilized in field test sites to facilitate collection of motor wellness information, and no wireless sensor network products were

  12. Inventory Management with Advance Demand Information and Flexible Delivery

    OpenAIRE

    Tong Wang; Beril L. Toktay

    2008-01-01

    This paper considers inventory models with advance demand information and flexible delivery. Customers place their orders in advance, and delivery is flexible in the sense that early shipment is allowed. Specifically, an order placed at time t by a customer with demand lead time T should be fulfilled by period t + T; failure to fulfill it within the time window [t, t + T] is penalized. We consider two situations: (1) Customer demand lead times are homogeneous and demand arriving in period t i...

  13. [Toilet of chronic wound].

    Science.gov (United States)

    Strok, Nevenka; Huljev, Dubravko

    2013-10-01

    Chronic wound toilet, with appropriate care of the surrounding skin, is one of the basic steps that must be performed in the treatment of patients with chronic wound. On wound cleaning and bandaging, it is of utmost importance to choose an appropriate technique of cleansing, select an appropriate solution for leaching and choose an appropriate wound dressing. In this way, the wound is protected from dirt from the environment and microorganisms, while protecting the surrounding tissue from the wound exudate, providing optimal conditions for better and faster wound healing and contributing to improved patient quality of life. The frequency of dressing change is individual and must be tailored to each patient in correlation with the psychosocial status of the patient, the type of the wound, the amount and type of wound exudate, as well as what is to be put on the wound. One of the most important elements in wound toilet is appropriate care for the surrounding skin. Basic guidelines for skin care must meet three basic criteria: adequate washing and cleansing of the skin, maintain the physiological balance of the skin and protect the skin from external damage. PMID:24371977

  14. Advanced Product Water Removal and Management (APWR) Fuel Cell System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed innovation is a passive, self-regulating, gravity-independent Advanced Product Water Removal and management (APWR) system for incorporation into...

  15. Regional approaches to the management of patients with advanced, radioactive iodine-refractory differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Brose, M.S.; Smit, J.W.; Capdevila, J.; Elisei, R.; Nutting, C.; Pitoia, F.; Robinson, B.; Schlumberger, M.; Shong, Y.K.; Takami, H.

    2012-01-01

    For patients with advanced, radioactive iodine-refractory differentiated thyroid cancer, current treatment guidelines recommend clinical trial enrollment or small-molecule kinase inhibitor therapy. However, details of patient management vary between countries depending on trial availability and nati

  16. Dynamic Workflows and Advanced Data Management for Problem Solving Environments

    OpenAIRE

    Moisa, Dan

    2004-01-01

    Workflow management in problem solving environments (PSEs) is an emerging topic that aims to combine both data-oriented and execution-oriented views of scientific experiments, and closely integrate the processes underlying the practice of computational science with the software artifacts constituted by the PSE. This thesis presents a workflow management solution called BREW (BetteR Experiments through Workflow management) that provides functionality along four dimensions: components and insta...

  17. The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting: a systematic review of the literature.

    Science.gov (United States)

    Goodwin, Nicholas S; Spinks, Anneliese; Wasiak, Jason

    2016-08-01

    The aim of this systematic review was to determine the supporting evidence for the clinical use of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting. Two authors searched three databases (Ovid Medline, Ovid Embase and The Cochrane Library) for relevant English language articles published through September 2014. Reference lists, conference proceedings and non-indexed academic journals were manually searched. A separate search was conducted using the Internet search engine Google to source additional studies from burns advisory agencies, first aid bodies, military institutions, manufacturer and paramedic websites. Two authors independently assessed study eligibility and relevance of non-traditional data forms for inclusion. Studies were independently assessed and included if Hydrogel-based burn dressings (HBD) were examined in first aid practices in the pre-hospital setting. A total of 129 studies were considered for inclusion, of which no pre-hospital studies were identified. The review highlights that current use of HBD in the pre-hospital setting appears to be driven by sources of information that do not reflect the paramedic environment. We recommend researchers in the pre-hospital settings undertake clinical trials in this field. More so, the review supports the need for expert consensus to identify key demographic, clinical and injury outcomes for clinicians and researchers undertaking further research into the use of dressings as a first aid measure. PMID:26177570

  18. Automated Contingency Management for Advanced Propulsion Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Impact Technologies LLC, in cooperation the Georgia Institute of Technology, proposes to develop and demonstrate an innovative Automated Contingency Management...

  19. Automated Contingency Management for Advanced Propulsion Systems Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Automated Contingency Management (ACM), or the ability to confidently and autonomously adapt to fault conditions with the goal of still achieving mission...

  20. Pre-hospital advanced airway management by experienced anaesthesiologists: a prospective descriptive study

    OpenAIRE

    Rognås, Leif; Hansen, Troels Martin; Kirkegaard, Hans; Tønnesen, Else

    2013-01-01

    Introduction We report data from the first Utstein-style study of physician-provided pre-hospital advanced airway management. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) prospectively registered data according to the template for reporting data from pre-hospital advanced airway management. Data collection took place from February 1st 2011 to October 31st 2012. ...

  1. Stem cells in skin wound healing: are we there yet?

    OpenAIRE

    Cerqueira, M. T.; Pirraco, Rogério P.; Marques, A. P.

    2015-01-01

    Significance: Cutaneous wound healing is a serious problem worldwide that affects patients with various wound types, resulting from burns, traumatic injuries, and diabetes. Despite the wide range of clinically available skin substitutes and the different therapeutic alternatives, delayed healing and scarring are often observed. Recent Advances: Stem cells have arisen as powerful tools to improve skin wound healing, due to features such as effective secretome, self-renewal, low immunogenicity,...

  2. Clinical review: surgical management of locally advanced and recurrent colorectal cancer.

    LENUS (Irish Health Repository)

    Courtney, D

    2014-01-01

    Recurrent and locally advanced colorectal cancers frequently require en bloc resection of involved organs to achieve negative margins. The aim of this review is to evaluate the most current literature related to the surgical management of locally advanced and recurrent colorectal cancer.

  3. Advanced Technologies and Data Management Practices in Environmental Science: Lessons from Academia

    Science.gov (United States)

    Hernandez, Rebecca R.; Mayernik, Matthew S.; Murphy-Mariscal, Michelle L.; Allen, Michael F.

    2012-01-01

    Environmental scientists are increasing their capitalization on advancements in technology, computation, and data management. However, the extent of that capitalization is unknown. We analyzed the survey responses of 434 graduate students to evaluate the understanding and use of such advances in the environmental sciences. Two-thirds of the…

  4. Advances in the management of differentiated thyroid cancer with follicular cell strain.

    Science.gov (United States)

    Ben Slimène, Faouzi; Mhiri, Aida; Ben Ali, Moez; Slimène, Hédia; Ben Raies, Nouzha; Karboua, Esma; Schlumberger, Martin

    2016-03-01

    The management of nodules and thyroid cancer is evolving. The aim is to individualize the treatment, decreasing aggression in the forms low risk and instead seeking new therapeutic options in advanced disease. This update shows the main recent advances in this field. PMID:27575497

  5. Maggot debridement therapy in chronic wound care

    OpenAIRE

    Patil, NG; Leung, GKK; Chan, DCW; Fong, DHF; Leung, JYY

    2007-01-01

    Objective: To review the current evidence on the mechanism of actions and clinical applications of maggot debridement therapy. Data sources: Literature search of PubMed and Medline was performed up to January 2007. Study selection: Original and major review articles related to maggot debridement therapy were reviewed. Key words used in the literature search were 'maggot debridement therapy', 'wound healing', and 'chronic wound management'. Data extraction: All relevant English and Chinese art...

  6. Advances in the research of the role of mesenchymal stem cell in wound healing%间充质干细胞在创面愈合中的作用研究进展

    Institute of Scientific and Technical Information of China (English)

    刘玲英; 柴家科; 郁永辉; 侯玉森

    2014-01-01

    Wound healing is a dynamic and complicated process,which generally takes three overlapping phases:inflammation,proliferation,and remodeling.If wounds complicated by severe trauma,diabetes,vascular dysfunction disease,or a massive burn injury failed to pass through the three normal phases of healing,they might end up as chronic and refractory wounds.Mesenchymal stem cells (MSCs) play different important roles in the regulation of all the phases of wound healing.MSCs can be recruited into wound and differentiated into wound repair cells,as well as promote wound healing by exerting functions like anti-inflammation,anti-apoptosis,and neovascularization.This review focuses on the role and mechanism of MSCs in each phase of the wound healing process.

  7. Role of negative pressure wound therapy in total hip and knee arthroplasty

    OpenAIRE

    Siqueira, Marcelo BP; Ramanathan, Deepak; Klika, Alison K.; Higuera, Carlos A; Barsoum, Wael K.

    2016-01-01

    Negative-pressure wound therapy (NPWT) has been a successful modality of wound management which is in widespread use in several surgical fields. The main mechanisms of action thought to play a role in enhancing wound healing and preventing surgical site infection are macrodeformation and microdeformation of the wound bed, fluid removal, and stabilization of the wound environment. Due to the devastating consequences of infection in the setting of joint arthroplasty, there has been some interes...

  8. Diabetic cornea wounds produce significantly weaker electric signals that may contribute to impaired healing

    OpenAIRE

    Yunyun Shen; Trisha Pfluger; Fernando Ferreira; Jiebing Liang; Navedo, Manuel F.; Qunli Zeng; Brian Reid; Min Zhao

    2016-01-01

    Wounds naturally produce electric signals which serve as powerful cues that stimulate and guide cell migration during wound healing. In diabetic patients, impaired wound healing is one of the most challenging complications in diabetes management. A fundamental gap in knowledge is whether diabetic wounds have abnormal electric signaling. Here we used a vibrating probe to demonstrate that diabetic corneas produced significantly weaker wound electric signals than the normal cornea. This was conf...

  9. An advanced microcosting system for forecasting and managing radiology expenses

    International Nuclear Information System (INIS)

    The new prospective payment system encourages hospital cost containment and necessitates understanding actual cost for radiology procedures. The automated microcosting system described in this paper, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning

  10. Advances in Operational Flood Risk Management in the Netherlands

    NARCIS (Netherlands)

    Wojciechowska, K.A.

    2015-01-01

    Operational flood risk management refers to activities that aim to reduce the probability and/or negative consequences of flooding just prior to the expected flood event. An inherent feature of operational flood risk management is that outcomes of decisions taken are uncertain. The main goal of this

  11. An Advanced Microcosting System for Forecasting and Managing Radiology Expenses

    OpenAIRE

    Arenson, Ronald; Viale, Richard; van der Voorde, Frans

    1985-01-01

    The new prospective payment system encourages hospital cost containment and necessitates understanding actual costs for radiology procedures. The automated microcosting system described here, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning.

  12. Angiogenesis is induced and wound size is reduced by electrical stimulation in an acute wound healing model in human skin.

    Directory of Open Access Journals (Sweden)

    Sara Ud-Din

    Full Text Available Angiogenesis is critical for wound healing. Insufficient angiogenesis can result in impaired wound healing and chronic wound formation. Electrical stimulation (ES has been shown to enhance angiogenesis. We previously showed that ES enhanced angiogenesis in acute wounds at one time point (day 14. The aim of this study was to further evaluate the role of ES in affecting angiogenesis during the acute phase of cutaneous wound healing over multiple time points. We compared the angiogenic response to wounding in 40 healthy volunteers (divided into two groups and randomised, treated with ES (post-ES and compared them to secondary intention wound healing (control. Biopsy time points monitored were days 0, 3, 7, 10, 14. Objective non-invasive measures and H&E analysis were performed in addition to immunohistochemistry (IHC and Western blotting (WB. Wound volume was significantly reduced on D7, 10 and 14 post-ES (p = 0.003, p = 0.002, p0.05 on day 14 in VEGF-A expression post-ES compared to controls. Furthermore, organisation of granulation tissue was improved on day 14 post-ES. This randomised controlled trial has shown that ES enhanced wound healing by reduced wound dimensions and increased VEGF-A and PLGF expression in acute cutaneous wounds, which further substantiates the role of ES in up-regulating angiogenesis as observed over multiple time points. This therapeutic approach may have potential application for clinical management of delayed and chronic wounds.

  13. Advances in the management of chronic thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Papamatheakis, Demosthenes G; Kim, Nick H

    2015-09-01

    Chronic thromboembolic pulmonary hypertension (CTEPH), a potentially curable form of pulmonary hypertension with pulmonary thromboendarterectomy surgery, has been the focus of significant medical advances. In addition to new imaging modalities that are now used to help recognize and diagnose CTEPH, additional treatment options have emerged for inoperable cases. These include a newly approved medical therapy for inoperable disease or persistent/recurrent CTEPH as well as percutaneous balloon angioplasty of the pulmonary arteries. In this article, we summarize these recent advances in the field and review the related literature. PMID:26239014

  14. Advances in the management of cerebral malaria in adults

    DEFF Research Database (Denmark)

    Mishra, Saroj K; Wiese, Lothar

    2009-01-01

    into large clinical trials. SUMMARY: Advances have been made in terms of antiparasitic treatment, but the identification of a well tolerated and effective adjuvant treatment to increase survival and reduce brain damage is still pending. The search for new approaches is a major challenge, not least of which...

  15. The Use Of Negative Pressure Wound Therapy (NPWT In The Management Of Enteroatmospheric Fistula – Case Report And Literature Review

    Directory of Open Access Journals (Sweden)

    Jaguścik Rajmund

    2015-10-01

    Full Text Available An enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions.

  16. Manejo terapéutico inicial de las heridas por arma de fuego en el territorio maxilofacial Initial therapeutic management of firearm wounds in the maxillofacial area

    Directory of Open Access Journals (Sweden)

    L. Ruiz Laza

    2006-10-01

    Full Text Available Introducción. Las heridas por armas de fuego son poco frecuentes en nuestro medio, de ahí que la experiencia en el manejo de las mismas sea limitada. En este artículo mostramos la experiencia de nuestro Servicio en el tratamiento de estas lesiones y realizamos una revisión del tema para intentar protocolizar la actuación inicial ante este tipo de pacientes. Material y Método. Presentamos seis casos tratados en nuestro Servicio durante el año 2002. Estudiamos las características demográficas, etiología, patrón de lesiones y tratamiento recibido. Resultados. Cinco hombres y una mujer presentaron heridas por arma de fuego durante este período, con una edad media de 38 años (Rango 13-74. La etiología más frecuente fue la agresión, seguido del intento de autolisis. Sólo un paciente requirió estabilización urgente de vía aérea mediante traqueotomía. No existieron complicaciones postoperatorias y sólo un enfermo requirió intervenciones secundarias por secuelas. Discusión. El aspecto más controvertido en el tratamiento de estas lesiones es el manejo quirúrgico de pacientes con lesiones extensas de la cara que involucran partes blandas y hueso, ya que pueden tratarse con técnicas reconstructivas complejas en el primer acto operatorio o, por el contrario, esta reconstrucción se puede realizar de forma diferida tras una primera fase de tratamiento quirúrgico de desbridamiento, estabilización de fracturas y cierre de partes blandas con técnicas simples. Pensamos que la elección del tipo de tratamiento debe ser individualizada en cada caso, aunque solemos optar por una reconstrucción diferida de los defectos tan pronto como sea posible.Introduction. The firearm injuries are not very common in our country, and the experience in its management is limited. In this review we show the experience of our Service in this wounds and review the literature to systematize the initial management of the firearm injuries in maxillofacial

  17. Advanced methods of microscope control using μManager software.

    OpenAIRE

    Edelstein, Arthur D.; Tsuchida, Mark A.; Nenad Amodaj; Henry Pinkard; Vale, Ronald D.; Nico Stuurman

    2014-01-01

    µManager is an open-source, cross-platform desktop application, to control a wide variety of motorized microscopes, scientific cameras, stages, illuminators, and other microscope accessories. Since its inception in 2005, µManager has grown to support a wide range of microscopy hardware and is now used by thousands of researchers around the world. The application provides a mature graphical user interface and offers open programming interfaces to facilitate plugins and scripts. Here, we presen...

  18. Security and Reliability Requirements for Advanced Security Event Management

    OpenAIRE

    RIEKE, Roland; COPPOLINO, Luigi; Hutchinson, Andrew; PRIETO, Elsa; Gaber, Chrystel

    2012-01-01

    This paper addresses security information management in complex application scenarios. Security Information and Event Management (SIEM) systems collect and examine security related events, with the goal of providing a unified view of the monitored systems' security status. While various SIEMs are in production, there is scope to extend the capability and resilience of these systems. The use of SIEM technology in four disparate scenario areas is used in this paper as a catalyst for the develop...

  19. Acute and Impaired Wound Healing: Pathophysiology and Current Methods for Drug Delivery, Part 1: Normal and Chronic Wounds: Biology, Causes, and Approaches to Care

    OpenAIRE

    Tatiana N Demidova-Rice; Michael R Hamblin; Herman, Ira M.

    2012-01-01

    This is the first installment of 2 articles that discuss the biology and pathophysiology of wound healing, review the role that growth factors play in this process, and describe current ways of growth factor delivery into the wound bed. Part 1 discusses the latest advances in clinicians’ understanding of the control points that regulate wound healing. Importantly, biological similarities and differences between acute and chronic wounds are considered, including the signaling pathways that ini...

  20. The advancement of regulation fee, budget system, and set-up time management

    Energy Technology Data Exchange (ETDEWEB)

    Jung, J. S.; Choi, E. S.; Cho, J. I.; Jung, S. C.; Lee, J. H. [Caleb and Company, Seoul (Korea, Republic of)

    2001-07-15

    Analyze the government's charging fee amendment and suggest the national regulation fee system. Suggest the future business portfolio based in the current business analysis. Design the advanced budget code structure, the performance management of the project budget and the survice level agreement between divisions. Develop the time management and the methodology of the standard man-hour calculation.

  1. Advances in Financial Risk Management and Economic Policy Uncertainty: An Overview

    NARCIS (Netherlands)

    S.M. Hammoudeh (Shawkat); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ Financial risk management is difficult at the best of times, but especially so in the presence of economic uncertainty and financial crises. The purpose of this special issue on “Advances in Financial Risk Management and Economic Policy Uncertainty” is to highlight some

  2. EFFICACY OF VACUUM ASSISTED CLOSURE DRESSINGS WHEN COMPARED TO MOIST WOUND DRESSINGS IN THE MANAGEMENT OF DIABETIC FOOT ULCERS : A PROSPECTIVE COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ballapalli Hari

    2015-10-01

    Full Text Available INTRODUCTION: F oot ulceration is mainly responsible for the morbidity of diabetes mellitus. They deprive the patient of quality working days and add to his financial burden. Several novel methods of wound healing came to vogue among which vacuum assisted dressing is becoming quite popular. Present study aim s to evaluate its efficacy when compared to regular moist wound dressings. OBJECTIVES: To study the effectiveness of vacuum assisted dressings in terms of Rate of wound healing. MATERIALS AND METHODS: we carried out a prospective study at Narayana medical college hospital on two groups (group A and group B of diabetic foot ulcer patients, whom we selected randomly after considering inclusion and exclusion criteria . Vacuum assisted dressings were done in group A patients and normal moist wound dressings in group B. At the start of the treatment and every week thereafter, size and depth of ulcers were recorded and results were compared at complete wound healing or at the end of 12 weeks of treatment whichever is earlier. S trict glycaemic control was maintaine d throughout the treatment period. RESULTS : significant healing was noticed in group A patients (vacuum assisted dressings group both in terms of ulcer size and depth. Wounds appeared more - healthy i.e. with less slough and more red granulation tissue in g roup A patients. CONCLUSION: vacuum assisted dressing is an efficacious method in the treatment of diabetic foot ulcers with significantly reduced hospital stay

  3. Diabetes and wound healing

    OpenAIRE

    Svendsen, Rikke; Irakunda, Gloire; Knudsen List, Karoline Cecilie; Sønderstup-Jensen, Marie; Hölmich Rosca, Mette Maria

    2014-01-01

    Diabetes is a disease where the glucose level in the blood is high, due to either insulin resistance, impaired insulin sensitivity or no insulin production. The high glucose level causes several complications, one of them being an impaired wound healing process, which might lead to chronic wounds, ulcers. Several factors play a role in the development of ulcers, and recent research indicates that microRNA might play a significant role in skin development and wound healing. The purpose of this...

  4. Complex wounds Feridas complexas

    OpenAIRE

    Marcus Castro Ferreira; Paulo Tuma Júnior; Viviane Fernandes de Carvalho; Fábio Kamamoto

    2006-01-01

    Complex wound is the term used more recently to group those well-known difficult wounds, either chronic or acute, that challenge medical and nursing teams. They defy cure using conventional and simple "dressings" therapy and currently have a major socioeconomic impact. The purpose of this review is to bring these wounds to the attention of the health-care community, suggesting that they should be treated by multidisciplinary teams in specialized hospital centers. In most cases, surgical treat...

  5. Factors Affecting Wound Healing

    OpenAIRE

    Guo, S; DiPietro, L. A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutane...

  6. Management of Advanced-Phase Chronic Myelogenous Leukemia.

    Science.gov (United States)

    Radich, Jerald P

    2016-05-01

    Chronic myelogenous leukemia represents the poster child of successful precision medicine in cancer, with amazing survival results achieved with targeted tyrosine kinase inhibitors (TKIs) in many patients with chronic-phase disease. Unfortunately, however, this good news has not extended to patients in blast crisis, for whom survival has not clearly been improved with TKIs. During his presentation at the NCCN 21st Annual Conference, Jerald P. Radich, MD, briefly explored the biology behind advanced-stage disease and several of the molecular findings in disease progression. He also reviewed some of the therapeutic options in advanced disease, emphasizing that transplantation, although fraught with some difficulties, offers the best long-term prognosis for patients in blast crisis. PMID:27226510

  7. Wound care matrices for chronic leg ulcers: role in therapy

    Directory of Open Access Journals (Sweden)

    Sano H

    2015-07-01

    Full Text Available Hitomi Sano,1 Sachio Kouraba,2 Rei Ogawa11Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan; 2Sapporo Wound Care and Anti-Aging Laboratory, Sapporo, JapanAbstract: Chronic leg ulcers are a significant health care concern. Although deep wounds are usually treated by flap transfers, the operation is invasive and associates with serious complications. Skin grafts may be a less invasive means of covering wounds. However, skin grafts cannot survive on deep defects unless high-quality granulation tissue can first be generated in the defects. Technologies that generate high-quality granulation tissue are needed. One possibility is to use wound care matrices, which are bioengineered skin and soft tissue substitutes. Because they all support the healing process by providing a premade extracellular matrix material, these matrices can be termed “extracellular matrix replacement therapies”. The matrix promotes wound healing by acting as a scaffold for regeneration, attracting host cytokines to the wound, stimulating wound epithelialization and angiogenesis, and providing the wound bed with bioactive components. This therapy has lasting benefits as it not only helps large skin defects to be closed with thin skin grafts or patch grafts but also restores cosmetic appearance and proper function. In particular, since it acts as a layer that slides over the subcutaneous fascia, it provides skin elasticity, tear resistance, and texture. Several therapies and products employing wound care matrices for wound management have been developed recently. Some of these can be applied in combination with negative pressure wound therapy or beneficial materials that promote wound healing and can be incorporated into the matrix. To date, the clinical studies on these approaches suggest that wound care matrices promote spontaneous wound healing or can be used to facilitate skin grafting, thereby avoiding the need to use

  8. MANAGEMENT OF INTRINSIC DISCOLORATION - ADVANCED TREATMENT OPTIONS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Rashmi G

    2014-01-01

    Full Text Available Aesthetics of the teeth is of great importance to patients , including tooth color. Of the various causes of tooth discoloration fluorosis , enamel hypoplasia , medication staining etc. is commonly encountered. The treatment options for discoloration are varied depending on individual case basis. The purpose of this article is to report the advanced treatment options for generalized intrinsic discoloration encompassing power bleaching to veneers to full mouth rehabilitation w ith porcelain laminates and ceramic crowns

  9. Advanced measurement approach with loss distribution in operational risk management

    OpenAIRE

    Atilla ÇİFTER; Chambers, Nurgül

    2007-01-01

    According to the last proposal by Basel Committee, commercial banks are allowed to use advanced measurement approach for operational risk. Since basic indicator and standard approach considers operational risk as a percentage of gross profit, these methodologies are not satisfactory as real lost or probability of lost are not taken into consideration. In this article, loss distribution approach is applied with simulated data. 20 nonparametric loss distributions and mixing internal and externa...

  10. Advances in Nanotechnology for the Management of Coronary Artery Disease

    OpenAIRE

    Rhee, June-Wha; Wu, Joseph C.

    2012-01-01

    Nanotechnology holds tremendous potential to advance the current treatment of coronary artery disease. Nanotechnology may assist medical therapies by providing a safe and efficacious delivery platform for a variety of drugs aimed at modulating lipid disorders, decreasing inflammation and angiogenesis within atherosclerotic plaques, and preventing plaque thrombosis. Nanotechnology may improve coronary stent applications by promoting endothelial recovery on a stent surface utilizing bio-mimetic...

  11. Surgical site infections after primary antiseptic cleansing of dirty-contaminated wounds by polihexanide, PVP iodine resp. hydrogen peroxide

    Directory of Open Access Journals (Sweden)

    Kramer, Axel

    2007-12-01

    Full Text Available The aim of this retrospective, multi-center, randomized controlled cohort study was to investigate the frequency of wound infection in patients derived from a rural-agricultural setting with dirty-contaminated wounds after wound debridement and a single wound cleansing using ringer solution or hydrogen-peroxide, or a single wound antiseptic using polihexanide or povidone-iodine, respectively. Wound cleansing or antiseptic was performed regardless if wounds were primarily closed, partially closed or left open. The lowest frequency of wound infection was observed in patients where the wound was treated with polihexanide after wound debridement. It can be concluded that polihexanide-based wound antiseptics can be recommended to be used for the management of traumatic contaminated wounds.

  12. Advances in Financial Risk Management andEconomic Policy Uncertainty: An Overview

    OpenAIRE

    Hammoudeh, Shawkat; McAleer, Michael

    2014-01-01

    Financial risk management is difficult at the best of times, but especially so in the presence of economic uncertainty and financial crises. The purpose of this special issue on “Advances in Financial Risk Management and Economic Policy Uncertainty” is to highlight some areas of research in which novel econometric, financial econometric and empirical finance methods have contributed significantly to the analysis of financial risk management when there is economic uncertainty, especiallythe po...

  13. Advances in Financial Risk Management and Economic Policy Uncertainty: An Overview

    OpenAIRE

    Hammoudeh, Shawkat; McAleer, Michael

    2014-01-01

    markdownabstract__Abstract__ Financial risk management is difficult at the best of times, but especially so in the presence of economic uncertainty and financial crises. The purpose of this special issue on “Advances in Financial Risk Management and Economic Policy Uncertainty” is to highlight some areas of research in which novel econometric, financial econometric and empirical finance methods have contributed significantly to the analysis of financial risk management when there is economic ...

  14. Advances in multi-agency disaster management: Key elements in disaster research

    OpenAIRE

    Janssen, M.; Lee, J.; Bharosa, N.; Cresswell, A.

    2009-01-01

    Multi-agency disaster management requires collaboration among geographically distributed public and private organizations to enable a rapid and effective response to an unexpected event. Many disaster management systems often lack the capability to cope with the complexity and uncertainty. In this introduction to the special issues on advances in multi-agency disaster management we discuss the role of information, enterprise architecture, coordination and related human efforts aimed at improv...

  15. [Advances in low impact development technology for urban stormwater management].

    Science.gov (United States)

    Liu, Wen; Chen, Wei-ping; Peng, Chi

    2015-06-01

    Low impact development ( LID), as an innovative technology for stormwater management, is effective to mitigate urban flooding and to detain pollutants. This paper systemically introduced the LID technology system, and summarized the reduction effects of three typical LID facilities (i.e. , bio-retention, green roof and permeable pavement) on stormwater runoff and main pollutants in recent literature, as well as research outcomes and experiences of LID technology on model simulation, cost-benefit analysis and management system. On this basis, we analyzed the problems and limitations of current LID technology studies. Finally, some suggestions about future research directions, appropriate design and scientific management were put forth. This work intended to provide scientific basis and suggestions for widespread use and standard setting of LID technology in China by referencing overseas studies. PMID:26572048

  16. Dopamine regulates angiogenesis in normal dermal wound tissues.

    Science.gov (United States)

    Shome, Saurav; Rana, Tapasi; Ganguly, Subhalakshmi; Basu, Biswarup; Chaki Choudhury, Sandipan; Sarkar, Chandrani; Chakroborty, Debanjan; Dasgupta, Partha Sarathi; Basu, Sujit

    2011-01-01

    Cutaneous wound healing is a normal physiological process and comprises different phases. Among these phases, angiogenesis or new blood vessel formation in wound tissue plays an important role. Skin is richly supplied by sympathetic nerves and evidences indicate the significant role of the sympathetic nervous system in cutaneous wound healing. Dopamine (DA) is an important catecholamine neurotransmitter released by the sympathetic nerve endings and recent studies have demonstrated the potent anti-angiogenic action of DA, which is mediated through its D(2) DA receptors. We therefore postulate that this endogenous catecholamine neurotransmitter may have a role in the neovascularization of dermal wound tissues and subsequently in the process of wound healing. In the present study, the therapeutic efficacy of D(2) DA receptor antagonist has been investigated for faster wound healing in a murine model of full thickness dermal wound. Our results indicate that treatment with specific D(2) DA receptor antagonist significantly expedites the process of full thickness normal dermal wound healing in mice by inducing angiogenesis in wound tissues. The underlined mechanisms have been attributed to the up-regulation of homeobox transcription factor HoxD3 and its target α5β1 integrin, which play a pivotal role in wound angiogenesis. Since D(2) DA receptor antagonists are already in clinical use for other disorders, these results have significant translational value from the bench to the bedside for efficient wound management along with other conventional treatment modalities. PMID:21949884

  17. Advanced information management tools for investigation and case management support in a networked heterogeneous computing environment

    Science.gov (United States)

    Clifton, T. E., III; Lehrer, Nancy; Klopfenstein, Mark; Hoshstrasser, Belinda; Campbell, Rachel

    1997-02-01

    The right information, at the right time and place, is key to successful law enforcement. The information exists; the challenge is in getting the information to the law enforcement professionals in a usable form, when they need it. Over the last year, the authors have applied advanced information management technologies towards addressing this challenge, in concert with a complementary research effort in secure wireless network technology by SRI International. The goal of the combined efforts is to provide law enforcement professionals the ability to access a wide range of heterogeneous and legacy data sources (structured, as well as free text); process information into digital multimedia case folders; and create World Wide Web-based multimedia products, accessible by selected field investigators via Fortezza-enhanced secure web browsers over encrypted wireless communications. We discuss the results of our knowledge acquisition activities at federal, regional, and local law enforcement organizations; our technical solution; results of the one year development and demonstration effort; and plans for future research.

  18. High cost of NHS wound care could be reduced by wider training for clinical staff.

    Science.gov (United States)

    2016-04-01

    Training non-specialist clinicians in the fundamentals of wound management would help improve health outcomes and reduce the huge economic burden that wounds impose on the NHS, new research suggests. PMID:27049986

  19. Advances in Service and Operations for ATLAS Data Management

    CERN Document Server

    Stewart, GA; The ATLAS collaboration

    2011-01-01

    ATLAS has recorded almost 5PB of RAW data since the LHC started running at the end of 2009. Many more derived data products and complimentary simulation data have also been produced by the collaboration and, in total, 55PB is currently stored in the Worldwide LHC Computing Grid by ATLAS. All of this data is managed by the ATLAS Distributed Data Management system, called Don Quixote 2 (DQ2). DQ2 has evolved rapidly to help ATLAS Computing operations to manage these large quantities of data across the many grid sites at which ATLAS runs and to help ATLAS physicists get access to this data. In this paper we describe new and improved DQ2 services: - Popularity service, which measures usage of data across ATLAS. - Space monitoring and accounting at sites. - Automated blacklisting service. - Cleaning agents, which trigger deletion of unused data at sites. - Deletion agents, to reliably delete unwanted data from sites. We describe the experience of data management operation in ATLAS computing, showing how these serv...

  20. CISM Advanced School on Crashworthiness : Energy Management and Occupant Protection

    CERN Document Server

    2001-01-01

    From the fundamentals of impact mechanics and biomechanics to modern analysis and design techniques in impact energy management and occupant protection this book provides an overview of the application of nonlinear finite elements, conceptual modeling and multibody procedures, impact biomechanics, injury mechanisms, occupant mathematical modeling, and human surrogates in crashworthiness.

  1. Wounded, Ill, and Injured Challenges.

    Science.gov (United States)

    Jones, Stephen L

    2016-01-01

    The Washington Post articles of February 2007 led to a close examination of the care provided Wounded Warriors at Walter Reed Army Medical Center. Subsequent reports by the President's Commission, Independent Review Group, and Defense Health Board all recommended ways to improve care. Joint Task Force National Capital Region Medical was established to implement the recommended improvements in Warrior care, and the recommendations of the Base Realignment and Closure Commission to close Walter Reed and realign the staff into a new Walter Reed National Military Medical Center and Fort Belvoir Community Hospital. It accomplished these tasks, maintained existing wounded, ill, and injured care, and safely transferred patients during the height of the fighting season in Afghanistan. It successfully accomplished its mission through engaged leadership, establishing an appropriate environment for Warrior care, careful management of casualty flow, and robust communication with all parties affected by the changes. The lessons learned in Warrior care should be considered when planning future military medical operations. PMID:27215871

  2. Maggot Debridement Therapy in the Treatment of Complex Diabetic Wounds

    OpenAIRE

    Marineau, Michelle L; Herrington, Mark T; Swenor, Karen M; Eron, Lawrence J

    2011-01-01

    The growth and aging of the population of Hawai‘i with a high incidence of diabetes mandates a need for more effective strategies to manage the healing of complicated wounds. Maggot debridement therapy (MDT) is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment m...

  3. Development of Experimental Facilities for Advanced Spent Fuel Management Technology

    International Nuclear Information System (INIS)

    The Advanced spent fuel Conditioning Process Facility(ACPF) and hotcell system technologies were developed in this program for demonstrating safely and effectively the Advanced spent fuel Conditioning Process(ACP) on a lab-scale. With the analysis of work flow and characteristics of the process, ACP was successively demonstrated on a lab-scale experiments and the performance of process was evaluated. The hotcell system was comprehensively evaluated with those results and the design data for the engineering-scale demonstration was derived to propose the direction for the future research and development. The main items performed in this project were as follows. - The reconstruction of ACPF hotcell and demonstration of the ACP - The design and operation technologies for α-γ type nuclear hot cell facility - The overall evaluation of the performance, safety and operation ability of the hotcell system - The acquisition of the government licences for construction and operation and the IAEA licence for using nuclear materials The results of safety analysis and environmental effects assessment and performance data for ACPF had been used for acquiring the government licence for facility operation. The valuable experiences on pyroprocess facility design and operation knowledges would be applied to new Mock-up Facility being scheduled to be a previous stage facility of Integrated Pyroprocess Facility

  4. Progress in corneal wound healing.

    Science.gov (United States)

    Ljubimov, Alexander V; Saghizadeh, Mehrnoosh

    2015-11-01

    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal

  5. Age-Induced Loss of Wound-Healing Ability in Potato Tubers is Regulated by ABA

    Science.gov (United States)

    Wounding of potato tubers stimulates the development of a suberized wound periderm that resists desiccation and microbial invasion. Wound-healing ability declines with advancing tuber age (storage period). The mechanism of age-induced loss in healing capacity is not known; however, older tubers ha...

  6. Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-09-01

    This report describes the application functions for distribution management systems (DMS). The application functions are those surveyed by the IEEE Power and Energy Society’s Task Force on Distribution Management Systems. The description of each DMS application includes functional requirements and the key features and characteristics in current and future deployments, as well as a summary of the major benefits provided by each function to stakeholders — from customers to shareholders. Due consideration is paid to the fact that the realizable benefits of each function may differ by type of utility, whether investor-owned, cooperative, or municipal. This report is sufficient to define the functional requirements of each application for system procurement (request-for-proposal [RFP]) purposes and for developing preliminary high-level use cases for those functions. However, it should not be considered a design document that will enable a vendor or software developer to design and build actual DMS applications.

  7. Advances in the Surgical Management of Chronic Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Wright Erin D

    2005-03-01

    Full Text Available Abstract The surgical management of chronic rhinosinusitis has evolved considerably in the last decade. We currently have a more refined understanding of the various disease entities that make up the generic diagnosis of chronic rhinosinusitis. This has led to the development of more sophisticated medical and surgical therapy for the different entities. Failure of maximal medical therapy leads to the consideration of surgical intervention with the general intent of improving the patient's quality of life. Recent technical innovations such as mucosa-preserving instrumentation and image guidance systems for intraoperative localization have given surgeons increased confidence and enabled more complete and effective surgical management of chronic rhinosinusitis, particularly in revision surgeries or in the presence of distorted landmarks. Improved packing materials and refinement of postoperative care are active areas of investigation and innovation that, it is hoped, will also translate into improved patient care.

  8. Understanding methods of wound debridement

    OpenAIRE

    Atkin, Leanne

    2014-01-01

    Autolytic debridement describes the body's natural method of wound-bed cleansing, helping it to prepare the wound bed for healing. In acute wounds, autolytic debridement occurs automatically and often does not require intervention, as during the inflammatory stage of a wound, neutrophils and macrophages digest and removes devitalised tissue, cell debris and contaminants, clearing the wound of any cellular barriers to healing. In chronic wounds, by contrast, healing is often delayed, frequentl...

  9. Advances in Watershed Management: Modeling, Monitoring, and Assessment

    OpenAIRE

    Benham, B. L.; Yagow, G.; Chaubey, I.; Douglas-Mankin, K. R.

    2011-01-01

    This article introduces a special collection of nine articles that address a wide range of topics all related to improving the application of watershed management planning. The articles are grouped into two broadly defined categories.. modeling applications, and monitoring and assessment. The modeling application articles focus on one of two widely used watershed-scale water quality modeling packages: HSPF or SWAT The HSPF article assesses the model's robustness when applied to watersheds acr...

  10. Management of human immunodeficiency virus infection in advanced age

    OpenAIRE

    Greene, M; Justice, AC; Lampiris, HW; Valcour, V

    2013-01-01

    Importance: Human immunodeficiency virus (HIV) - positive patients treated with antiretroviral therapy now have increased life expectancy and develop chronic illnesses that are often seen in older HIV-negative patients. Objective: To address emerging issues related to aging with HIV. Screening older adults for HIV, diagnosis of concomitant diseases, management of multiple comorbid medical illnesses, social isolation, polypharmacy, and factors associated with end-of-life care are reviewed. Evi...

  11. Advances in Service and Operations for ATLAS Data Management

    CERN Document Server

    Stewart, G A; The ATLAS collaboration; Lassnig, M; Molfetas, A; Baristis, M; Zhang, D; Calvet, I; Beermann, T; Barreiro Megino, F; Tykhonov, A; Campana, S; Serfon, C; Oleynik, O; Petrosyan, A

    2012-01-01

    ATLAS has recorded almost 5PB of RAW data since the LHC started running at the end of 2009. Many more derived data products and complimentary simulation data have also been produced by the collaboration and, in total, 70PB is currently stored in the Worldwide LHC Computing Grid by ATLAS. All of this data is managed by the ATLAS Distributed Data Management system, called Don Quixote 2 (DQ2). DQ2 has evolved rapidly to help ATLAS Computing operations manage these large quantities of data across the many grid sites at which ATLAS runs and to help ATLAS physicists get access to this data. In this paper we describe new and improved DQ2 services: egin{itemize} item hspace{2mm} Popularity service, which measures usage of data across ATLAS. item hspace{2mm} Space monitoring and accounting at sites. item hspace{2mm} Automated exclusion service. item hspace{2mm} Cleaning agents, which trigger deletion of unused data at sites. item hspace{2mm} Deletion agents, to reliably delete unwanted data from sites. end{itemize} We...

  12. Advanced modeling of management processes in information technology

    CERN Document Server

    Kowalczuk, Zdzislaw

    2014-01-01

    This book deals with the issues of modelling management processes of information technology and IT projects while its core is the model of information technology management and its component models (contextual, local) describing initial processing and the maturity capsule as well as a decision-making system represented by a multi-level sequential model of IT technology selection, which acquires a fuzzy rule-based implementation in this work. In terms of applicability, this work may also be useful for diagnosing applicability of IT standards in evaluation of IT organizations. The results of this diagnosis might prove valid for those preparing new standards so that – apart from their own visions – they could, to an even greater extent, take into account the capabilities and needs of the leaders of project and manufacturing teams. The book is intended for IT professionals using the ITIL, COBIT and TOGAF standards in their work. Students of computer science and management who are interested in the issue of IT...

  13. Wound healing potential of Pañcavalkala formulations in a postfistulectomy wound

    Science.gov (United States)

    Meena, Rakesh Kumar; Dudhamal, Tukaram; Gupta, Sanjay Kumar; Mahanta, Vyasadeva

    2015-01-01

    SUMMARY Sushruta mentioned sixty measures for management of wounds. Panchavalkal is the combination of five herbs having properties like Shodhana (cleaning) and Ropana (healing) of wounds. Individual drugs and in combination have Kashaya rasa (astringent) dominant and useful in the management of Vrana (wounds) as well as Shotha (inflammations). A 35 years old male patient consulted in Shalya OPD with complaints like discharge per anum, induration and intermittent pain at perianal region since last five years. On inspection external opening was observed at anterior portion 1 O’ clock position which was four centimeter away from anal verge. That case was diagnosed as Bhagandara (fistula-in-ano) and was treated with partial fistulectomy and application of Guggulu based Ksharasutra in the remaining tract. The big fistulectomy wound was treated with local application of Panchavalkal ointment daily and simultaneous change of Ksharasutra. The wound was assessed daily for pain, swelling, discharge, size, and shape. The wound healed completely within two and half month with normal scar having good tissue strength. This case demonstrated that post fistulectomy wound can be treated with Panchavalkal ointment. PMID:26865745

  14. Surgical wound care

    Science.gov (United States)

    ... F for more than 4 hours Alternate Names Surgical incision care; Open wound care Images Proper hand washing References Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills . Philadelphia, PA: Lippincott Williams and Wilkins, Wolters ...

  15. Diabetic Wound Care

    Science.gov (United States)

    ... RSS Home » Learn About Feet » Foot Health Information Diabetic Wound Care What is a Diabetic Foot Ulcer? A diabetic foot ulcer is an open sore or wound ... key factors in the appropriate treatment of a diabetic foot ulcer: Prevention of infection Taking the pressure ...

  16. Principled negotiation and distributed optimization for advanced air traffic management

    Science.gov (United States)

    Wangermann, John Paul

    Today's aircraft/airspace system faces complex challenges. Congestion and delays are widespread as air traffic continues to grow. Airlines want to better optimize their operations, and general aviation wants easier access to the system. Additionally, the accident rate must decline just to keep the number of accidents each year constant. New technology provides an opportunity to rethink the air traffic management process. Faster computers, new sensors, and high-bandwidth communications can be used to create new operating models. The choice is no longer between "inflexible" strategic separation assurance and "flexible" tactical conflict resolution. With suitable operating procedures, it is possible to have strategic, four-dimensional separation assurance that is flexible and allows system users maximum freedom to optimize operations. This thesis describes an operating model based on principled negotiation between agents. Many multi-agent systems have agents that have different, competing interests but have a shared interest in coordinating their actions. Principled negotiation is a method of finding agreement between agents with different interests. By focusing on fundamental interests and searching for options for mutual gain, agents with different interests reach agreements that provide benefits for both sides. Using principled negotiation, distributed optimization by each agent can be coordinated leading to iterative optimization of the system. Principled negotiation is well-suited to aircraft/airspace systems. It allows aircraft and operators to propose changes to air traffic control. Air traffic managers check the proposal maintains required aircraft separation. If it does, the proposal is either accepted or passed to agents whose trajectories change as part of the proposal for approval. Aircraft and operators can use all the data at hand to develop proposals that optimize their operations, while traffic managers can focus on their primary duty of ensuring

  17. Bringing Advanced Directives and Symptom Assessment and Management to Community Oncology Practices

    OpenAIRE

    Lesperance, Mary; Shannon, Robert; Phyllis K. Pumphrey; Dunbar, Erin; Genther, Renee; Coleman, C. Lynn; Tabano, Margaret; Maurer, Jennifer; Vazquez, Adrienne; Capp, Elizabeth; McMillan, Jessica; Wilkerson, Katie; Robbins, Gerald; Phillips, Dorothy Green; Howick, Priscilla

    2013-01-01

    Palliative care services are not available in most outpatient oncology practices. A program training 11 mid-level providers from oncology practices on advanced directive discussions and supportive symptom assessment and management performed by palliative care specialists was completed. A follow-up session 9 months later identified barriers to implementation. Of the 11 mid-level providers, 8 participated in the follow-up session, and 9 of the 11 providers implemented advanced directive’s discu...

  18. Use of Platelet Rich Plasma Gel on Wound Healing: A Systematic Review and Meta-Analysis

    OpenAIRE

    Marissa J Carter; Fylling, Carelyn P.; Parnell, Laura K.S.

    2011-01-01

    Objective: Autologous platelet rich plasma is an advanced wound therapy used in hard-to-heal acute and chronic wounds. To better understand the use and clinical outcomes of the therapy, a systematic review of the published literature in cutaneous wounds was performed. Methods: Electronic and hand searches for randomized controlled trials and comparative group studies using platelet rich plasma therapy in cutaneous wounds and published over the last 10 years was conducted. Eligible studies com...

  19. Trends in Energy Management Technology - Part 4: Review ofAdvanced Applications in Energy Management, Control, and InformationSystems

    Energy Technology Data Exchange (ETDEWEB)

    Yee, Gaymond; Webster, Tom

    2003-08-01

    In this article, the fourth in a series, we provide a review of advanced applications in Energy Management, Control, and Information Systems (EMCIS). The available features for these products are summarized and analyzed with regard to emerging trends in EMCIS and potential benefits to the Federal sector. The first article [1] covered enabling technologies for emerging energy management systems. The second article [2] serves as a basic reference for building control system (BCS) networking fundamentals and includes an assessment of current approaches to open communications. The third article [3] evaluated several products that exemplify the current state of practice in EMCIS. It is important for energy managers in the Federal sector to have a high level of knowledge and understanding of these complex energy management systems. This series of articles provides energy practitioners with some basic informational and educational tools to help make decisions relative to energy management systems design, specification, procurement, and energy savings potential.

  20. Autosomal dominant polycystic kidney disease: recent advances in clinical management [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Zhiguo Mao

    2016-08-01

    Full Text Available The first clinical descriptions of autosomal dominant polycystic kidney disease (ADPKD go back at least 500 years to the late 16th century. Advances in understanding disease presentation and pathophysiology have mirrored the progress of clinical medicine in anatomy, pathology, physiology, cell biology, and genetics. The identification of PKD1 and PKD2, the major genes mutated in ADPKD, has stimulated major advances, which in turn have led to the first approved drug for this disorder and a fresh reassessment of patient management in the 21st century. In this commentary, we consider how clinical management is likely to change in the coming decade.

  1. Pazopanib in the management of advanced soft tissue sarcomas

    Science.gov (United States)

    Cranmer, Lee D; Loggers, Elizabeth T; Pollack, Seth M

    2016-01-01

    Therapy of soft tissue sarcomas represents an area of significant unmet need in oncology. Angiogenesis has been explored as a potential target both preclinically and clinically, with suggestions of activity. Pazopanib is a multitargeted tyrosine kinase inhibitor with prominent antiangiogenic effects. In a Phase II study, pazopanib demonstrated activity in strata enrolling patients with leiomyosarcomas, synovial sarcomas, or other sarcomas but not those enrolling adipocytic sarcomas. PALETTE, the pivotal Phase III trial, demonstrated improved progression-free survival versus placebo in pazopanib-treated patients previously treated for advanced soft tissue sarcomas. No survival benefit was observed, and adipocytic sarcomas were excluded. Health-related quality-of-life assessments indicated significant decrements in several areas affected by pazopanib toxicities, but no global deterioration. Cost-effectiveness analyses indicate that pazopanib therapy may or may not be cost-effective in different geographic settings. Pazopanib provides important proof-of-concept for antiangiogenic therapy in soft tissue sarcomas. Its use can be improved by further biological studies of its activity profile in sarcomas, studies of biological rational combinations, and clinicopathologic/biological correlative studies of activity to allow better drug targeting. PMID:27354810

  2. Advances in management of type 1 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Ravindranath; Aathira; Vandana; Jain

    2014-01-01

    Treatment of type 1 diabetes mellitus has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes. The quest for newer therapies is continuing and this review attempts to outline the recent developments. The insulin molecule itself has got moulded into different analogues by minor changes in its structure to ensure well controlled delivery, stable half-lives and lesser side effects. Insulin delivery systems have also consistently undergone advances from subcutaneous injections to continuous infusion to trials of inhalational delivery. Continuous glucose monitoring systems are also becoming more accurate and user friendly. Smartphones have also made their entry into therapy of diabetes by integrating blood glucose levels and food intake with calculated adequate insulin required. Artificial pancreas has enabled to a certain extent to close the loop between blood glucose level and insulin delivery with devices armed with meal and exercise announcements, dual hormone delivery and pramlintide infusion. Islet, pancreas-kidney and stem cells transplants are also being attempted though complete success is still a far way off. Incorporating insulin gene and secretary apparatus is another ambitious leap to achieve insulin independence though the search for the ideal vector and target cell is still continuing. Finally to stand up to the statement, prevention is better than cure, immunological methods are being investigated to be used as vaccine to prevent the onset of diabetes mellitus.

  3. Recent advances in the management of sexual precocity in girls.

    Science.gov (United States)

    Schriock, E A; Martin, M C

    1991-12-01

    Sexual precocity has important psychosocial implications for the prematurely developing child, as well as being associated in some cases with significant pathology. Conscientious evaluation and initiation of effective therapy can have a significant impact on improving long-term outcome. The differentiation between complete sexual precocity with activation of the hypothalamic-pituitary axis and incomplete sexual precocity without activation of the central reproductive system is of paramount importance. In incomplete sexual precocity, the sex steroids are of exogenous, adrenal, or gonadal origin. Premature adrenarche presents with the early development of pubic hair only and must be distinguished from adrenal hyperplasia or an androgen-secreting neoplasm, which may be associated with accelerated growth, advanced bone age, and virilization. When incomplete sexual precocity involves the ovary, ovarian tumors must be considered. Other causes of incomplete sexual precocity include hypothyroidism and gonadotropin-independent precocity such as McCune-Albright syndrome. Complete sexual precocity or precocious puberty of central origin is diagnosed in girls by gonadotropin-releasing hormone challenge yielding a stimulated luteinizing hormone peak greater than 15 IU/L. Radiologic evaluation of the central axis is necessary. Treatment of precocious puberty relies on the use of potent agonists of gonadotropin-releasing hormone that reversibly suppress the prematurely activated pituitary. Depot preparations are efficacious. Early initiation and careful monitoring of treatment can reduce physical signs of development, improve the likelihood for normal adult height, and postpone normal pubertal progression to a more appropriate age. PMID:1818719

  4. Advances in the Management of Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Kamala Swarnam

    2012-01-01

    Full Text Available Meconium aspiration syndrome (MAS is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN. This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO use. In this paper, we review the current understanding of the pathophysiology and management of MAS.

  5. Recent Advances in the Clinical Management of Lead Poisoning.

    Directory of Open Access Journals (Sweden)

    Sina Kianoush

    2015-06-01

    Full Text Available Lead poisoning is a historic universal disease. Acute or chronic lead exposure may cause reversible or even permanent damages in human beings. Environmental lead exposure is a global health concern in children. Occupational lead poisoning is still a health issue, particularly in developing countries. During the last decades, new methods and medications have been advocated for the prevention and treatment of lead poisoning. This review deals mainly with recent developments in the management of lead poisoning. Sources of lead exposure are introduced, and methods for the primary prevention of lead poisoning are discussed. Details for the screening of adults and children are also explained to serve as a practical guideline for the secondary prevention. Standard chelation therapy in different groups and up-to-date less toxic new medications for the treatment of lead poisoning are finally discussed. Our published clinical research on the therapeutic effects of garlic tablets in mild to moderate occupational lead poisoning will also be discussed.

  6. Recent Advances in Understanding and Managing Tourette Syndrome.

    Science.gov (United States)

    Thenganatt, Mary Ann; Jankovic, Joseph

    2016-01-01

    Tourette syndrome (TS) is a neurologic and behavioral disorder consisting of motor and phonic tics with onset in childhood or adolescence. The severity of tics can range from barely perceptible to severely impairing due to social embarrassment, discomfort, self-injury, and interference with daily functioning and school or work performance. In addition to tics, most patients with TS have a variety of behavioral comorbidities, including attention deficit hyperactivity disorder and obsessive-compulsive disorder. Studies evaluating the pathophysiology of tics have pointed towards dysfunction of the cortico-striato-thalamo-cortical circuit, but the mechanism of this hyperkinetic movement disorder is not well understood. Treatment of TS is multidisciplinary, typically involving behavioral therapy, oral medications, and botulinum toxin injections. Deep brain stimulation may be considered for "malignant" TS that is refractory to conventional therapy. In this review, we will highlight recent developments in the understanding and management strategies of TS. PMID:26918185

  7. Advanced water treatment as a tool in water scarcity management

    DEFF Research Database (Denmark)

    Harremoes, Poul

    2000-01-01

    until recently. This paper sets the stage with respect to perspective and management options related to implementation of water reuse. Water treatment has to be interpreted as the means by which to purify the water from any degree of impurity to any degree of purity that fits the desired use, including......The water resource is under increasing pressure, both from the increase in population and from the wish to improve the living standards of the individual. Water scarcity is defined as the situation where demand is greater than the resource. Water scarcity has two distinctly different dimensions......: water availability and water applicability. The availability is a question of quantitative demand relative to resource. The applicability is a question of quality suitability for the intended use of the water. There is a significant difference in this regard with respect to rural versus urban use of...

  8. Advanced Radio Resource Management for Multi Antenna Packet Radio Systems

    CERN Document Server

    Nonchev, Stanislav; 10.5121/ijwmn.2010.2201

    2010-01-01

    In this paper, we propose fairness-oriented packet scheduling (PS) schemes with power-efficient control mechanism for future packet radio systems. In general, the radio resource management functionality plays an important role in new OFDMA based networks. The control of the network resource division among the users is performed by packet scheduling functionality based on maximizing cell coverage and capacity satisfying, and certain quality of service requirements. Moreover, multiantenna transmit-receive schemes provide additional flexibility to packet scheduler functionality. In order to mitigate inter-cell and co-channel interference problems in OFDMA cellular networks soft frequency reuse with different power masks patterns is used. Stemming from the earlier enhanced proportional fair scheduler studies for single-input multiple-output (SIMO) and multiple-input multipleoutput (MIMO) systems, we extend the development of efficient packet scheduling algorithms by adding transmit power considerations in the ove...

  9. Antiplatelet Management for Coronary Heart Disease: Advances and Challenges.

    Science.gov (United States)

    Gillette, Michael; Morneau, Kathleen; Hoang, Vu; Virani, Salim; Jneid, Hani

    2016-06-01

    Coronary heart disease (CHD) remains the leading cause of death in the USA. CHD accounts for 48 % of all cardiovascular mortality or approximately one of every seven deaths. Disruption of atherosclerotic plaques-usually by rupture or erosion-and superimposed thrombosis can result in acute coronary syndromes and sudden cardiac death. Silent plaque disruption may also occur and result in coronary plaque progression and ultimately the symptomatic manifestations of stable CHD. Antiplatelet agents remain the cornerstone therapy for acute thrombotic coronary syndromes and are essential for thromboprophylaxis against these events in patients with stable CHD. Antiplatelet drugs are also important adjunct therapies during percutaneous coronary intervention (PCI) as they mitigate equipment-associated thrombotic complications that are partially induced by iatrogenic plaque rupture by interventionalists during balloon angioplasty in the cardiac catheterization laboratory. Since the introduction of clopidogrel, there has been considerable development in this field with at least three novel P2Y12 antagonists approved by the Food and Drug Administration (FDA) over the past decade. Rapidly accumulating evidence is helping to guide the optimal duration of treatment with dual antiplatelet therapy after stenting, especially with the newer drug-eluting stents. More data are also emerging on the hazards and long-term safety of these agents. It is therefore prudent for clinicians to remain current on treatment options and recent advances in this area. We herein review current and emerging antiplatelet therapies and summarize their characteristics and indications of use as well as challenges and areas of ongoing research. PMID:27139709

  10. Pathophysiology and recent advances in the management of renal osteodystrophy.

    Science.gov (United States)

    Elder, Grahame

    2002-12-01

    Bone disease is observed in 75-100% of patients with chronic renal failure as the glomerular filtration rate (GFR) falls below 60 ml/minute. Hyperparathyroid (high turnover) bone disease is found most frequently followed by mixed osteodystrophy, low-turnover bone disease, and osteomalacia. With advancing renal impairment, "skeletal resistance" to parathyroid hormone (PTH) occurs. To maintain bone turnover, intact PTH (iPTH) targets from two to four times the upper normal range have been suggested, but whole PTH(1-84) assays indicate that amino-terminally truncated fragments, which accumulate in end-stage renal disease (ESRD), account for up to one-half of the measured iPTH. PTH levels and bone-specific alkaline phosphatase (BSAP) provide some information on bone involvement but bone biopsy and histomorphometry remains the gold standard. Calcitriol and calcium salts can be used to suppress PTH and improve osteomalacia but there is growing concern that these agents predispose to the development of vascular calcification, cardiovascular morbidity, low-turnover bone disease and fracture. Newer therapeutic options include less calcemic vitamin D analogues, calcimimetics and bisphosphonates for hyperparathyroidism, and sevelamer for phosphate control. Calcitriol and hormone-replacement therapy (HRT) have been shown to maintain bone mineral density (BMD) in certain patients with end-stage renal disease (ESRD). After renal transplantation, renal osteodystrophy generally improves but BMD often worsens. Bisphosphonate therapy may be appropriate for some patients at risk of fracture. When renal bone disease is assessed using a combination of biochemical markers, histology and bone densitometry, early intervention and the careful use of an increasing number of effective therapies can reduce the morbidity associated with this common problem. PMID:12469904

  11. Biomass supply management for advanced energy: applications in developing countries

    International Nuclear Information System (INIS)

    Advanced biomass energy systems, including new biomass resource enhancement technologies, should be developed only where compelling situations for investors or communities exist to economically do so. These situations, or minimum viable operating conditions, are assessed from a pragmatic perspective. They are determined by specific circumstances and divergent interests that take time to define and integrate. Customized solutions are necessary and can change quickly with geography and market circumstances New technologies offer more options but are not necessarily the best. The example of energy crop technology is used to demonstrate the interdependencies that exist between new resource enhancement technology and biomass energy systems operations. The ability to genetically increase the energy density of energy crops is compared to other enhancement measures such as increasing the number of tonnes grown per hectare-year, reducing costs per tonne and improving other characteristics. Issues that need to be considered include significant knowledge gaps, lack of commitments in R and D, specificity of conversion system requirements, handling capabilities and opportunity costs. Broader biomass procurement strategies, which may be more important than resource enhancement technologies, are discussed. Biomass cost-supply is utilized as a strong analytical feature to evaluate the effectiveness of biomass procurement strategies and new biomass production technologies. Some past experiences are reviewed. Cost-supply is assessed from the perspective of the whole biomass energy system to expose the interdependencies between production operations, conversion scale and technologies, and community markets and service. Investment limits, for example, may be as important a determinant as the cost-efficiency of a new technology, which, in turn, affects biomass cost-supply-quality requirements. The cost of new technologies can then be compared to the changed performance of the overall

  12. Advanced Radio Resource Management for Multi Antenna Packet Radio Systems

    Directory of Open Access Journals (Sweden)

    Stanislav Nonchev

    2010-05-01

    Full Text Available In this paper, we propose fairness-oriented packet scheduling (PS schemes with power-efficientcontrol mechanism for future packet radio systems. In general, the radio resource managementfunctionality plays an important role in new OFDMA based networks. The control of the networkresource division among the users is performed by packet scheduling functionality based on maximizingcell coverage and capacity satisfying, and certain quality of service requirements. Moreover, multiantennatransmit-receive schemes provide additional flexibility to packet scheduler functionality. Inorder to mitigate inter-cell and co-channel interference problems in OFDMA cellular networks softfrequency reuse with different power masks patterns is used. Stemming from the earlier enhancedproportional fair scheduler studies for single-input multiple-output (SIMO and multiple-input multipleoutput(MIMO systems, we extend the development of efficient packet scheduling algorithms by addingtransmit power considerations in the overall priority metrics calculations and scheduling decisions.Furthermore, we evaluate the proposed scheduling schemes by simulating practical orthogonal frequencydivision multiple access (OFDMA based packet radio system in terms of throughput, coverage andfairness distribution among users. In order to completely reveal the potential of the proposed schemes weinvestigate the system performance of combined soft frequency reuse schemes with advanced powerawarepacket scheduling algorithms for further optimization. As a concrete example, under reducedoverall transmit power constraint and unequal power distribution for different sub-bands, wedemonstrate that by using the proposed power-aware multi-user scheduling schemes, significant coverageand fairness improvements in the order of 70% and 20%, respectively, can be obtained, at the expense ofaverage throughput loss of only 15%.

  13. Breast cancer: Postoperative irradiation and management of locally advanced disease

    International Nuclear Information System (INIS)

    Purpose/Objective: This course will review current indications for postoperative irradiation, present a videotape demonstration of a simulation technique for comprehensive chest wall/nodal irradiation, and discuss multimodality approaches to the difficult problem of locally advanced breast cancer. As part of an expanding role for the radiation oncologist in the treatment of all stages of breast cancer, recent data has inspired a reevaluation of chest wall and nodal irradiation following mastectomy. A decade ago, adjuvant irradiation was considered by many oncologists to be of no survival advantage or perhaps even harmful. Studies leading to this conclusion will be reviewed with special attention to the inadequacies and flawed constructs which biased these studies against adjuvant chest wall/nodal irradiation. The Fischer hypothesis or 'new paradigm' will be challenged. Can improvement in local control result in improved survival? If the goal of treatment is simply to reduce local-regional recurrence, a three-field technique covering the chest wall and supraclavicular nodes may suffice. But if the goal is an improvement in survival based on the treatment of all locoregional sites which may not be sterilized by chemotherapy and mastectomy, a more complex set of fields is required. Based on this premise, we designed a 5-field technique of comprehensive chest wall and nodal irradiation. Simulation of these fields will be demonstrated on videotape. Treatment strategies for both non-inflammatory and inflammatory non-metastatic breast cancer will be presented. Current recommendations include various combinations of chemohormonotherapy, radiation therapy, and mastectomy, but controversies abound regarding the proper sequencing of these modalities, whether breast conservation therapy can be offered to patients who have a dramatic response to systemic therapy, and whether or not any one of these treatment modalities can be dropped under specific clinical scenarios

  14. Breast cancer: Postoperative irradiation and management of locally advanced disease

    International Nuclear Information System (INIS)

    Purpose/Objective: This course will review current indications for postoperative irradiation, present a videotape demonstration of a simulation technique for comprehensive chest wall/nodal irradiation, and discuss multimodality approaches to the difficult problem of locally advanced breast cancer. As part of an expanding role for the radiation oncologist in the treatment of all stages of breast cancer, recent data has inspired a reevaluation of chest wall and nodal irradiation following mastectomy. A decade ago, adjuvant irradiation was considered by many oncologists to be of no survival advantage or perhaps even harmful. Studies leading to this conclusion will be reviewed with special attention to the inadequacies and flawed constructs which biased these studies against adjuvant chest wall/nodal irradiation. The Fischer hypothesis or 'new paradigm' will be challenged. Can improvement in local control result in improved survival? If the goal of treatment is simply to reduce local-regional recurrence, a three-field technique covering the chest wall and supraclavicular nodes may suffice. But if the goal is an improvement in survival based on the treatment of all locoregional sites which may not be sterilized by chemotherapy and mastectomy, a more complex set of fields is required. Based on this premise, we designed a 5-field technique of comprehensive chest wall and nodal irradiation. Simulation of these fields will be demonstrated on videotape. Treatment strategies for both non-inflammatory and inflammatory non-metastatic breast cancer will be presented. Current recommendations include various combinations of chemohormonotherapy, radiation therapy, and mastectomy, but Controversies abound regarding the proper sequencing of these modalities, whether breast conservation therapy can be offered to patients who have a dramatic response to systemic therapy, and whether or not any one of these treatment modalities can be dropped under specific clinical scenarios

  15. Developing a toolbox for analysis of warrior wound biopsies: vibrational spectroscopy

    Science.gov (United States)

    Crane, Nicole J.; O'Brien, Frederick P.; Forsberg, Jonathan A.; Potter, Benjamin K.; Elster, Eric A.

    2011-03-01

    The management of modern traumatic war wounds remains a significant challenge for clinicians. This is a reflection of the extensive osseous and soft-tissue damage caused by blasts and high-energy projectiles. The ensuing inflammatory response ultimately dictates the pace of wound healing and tissue regeneration. Consequently, the eventual timing of wound closure or definitive coverage is often subjectively based. Some wounds require an extended period of time to close or fail to remain closed, despite the use and application of novel wound-specific treatment modalities. Aside from impaired wound healing, additional wound complications include wound infection, biofilm formation, and heterotopic ossification (the pathological mineralization of soft tissues). An understanding of the molecular environment of acute wounds throughout the debridement process can provide valuable insight into the mechanisms associated with the eventual wound outcome. The analysis of Raman spectra of ex vivo wound biopsy tissue obtained from serial traumatic wound debridements reveals a decreased 1665 cm-1/1445 cm-1 band area ratio in impaired healing wounds, indicative of an impaired remodeling process, in addition to a decreased 1240 cm-1/1270cm-1. The examination of debrided tissue exhibits mineralization during the early development of heterotopic ossification. Finally, preliminary results suggest that Fourier transform infrared (FT-IR) images of wound effluent may be able to provide early microbiological information about the wound.

  16. Australia's TERN: Advancing Ecosystem Data Management in Australia

    Science.gov (United States)

    Phinn, S. R.; Christensen, R.; Guru, S.

    2013-12-01

    Globally, there is a consistent movement towards more open, collaborative and transparent science, where the publication and citation of data is considered standard practice. Australia's Terrestrial Ecosystem Research Network (TERN) is a national research infrastructure investment designed to support the ecosystem science community through all stages of the data lifecycle. TERN has developed and implemented a comprehensive network of ';hard' and ';soft' infrastructure that enables Australia's ecosystem scientists to collect, publish, store, share, discover and re-use data in ways not previously possible. The aim of this poster is to demonstrate how TERN has successfully delivered infrastructure that is enabling a significant cultural and practical shift in Australia's ecosystem science community towards consistent approaches for data collection, meta-data, data licensing, and data publishing. TERN enables multiple disciplines, within the ecosystem sciences to more effectively and efficiently collect, store and publish their data. A critical part of TERN's approach has been to build on existing data collection activities, networks and skilled people to enable further coordination and collaboration to build each data collection facility and coordinate data publishing. Data collection in TERN is through discipline based facilities, covering long term collection of: (1) systematic plot based measurements of vegetation structure, composition and faunal biodiversity; (2) instrumented towers making systematic measurements of solar, water and gas fluxes; and (3) satellite and airborne maps of biophysical properties of vegetation, soils and the atmosphere. Several other facilities collect and integrate environmental data to produce national products for fauna and vegetation surveys, soils and coastal data, as well as integrated or synthesised products for modelling applications. Data management, publishing and sharing in TERN are implemented through a tailored data

  17. A New Advanced Logistics Supply Chain for Food Management Based on Green Logistics Theory

    OpenAIRE

    Lanqing Liu

    2013-01-01

    The study aims to investigate the advanced logistics supply chain for food management using green logistics. To protect the food logistics environment and prevent the environmental pollution, it is crucial to establish powerful modern supply chains to support the food management in transportation. The construction speed of the food companies is very fast; however, the food supply lags behind the food companies. As a result, the environmental pollution caused in the food logistics becomes seve...

  18. Wireless Sensors and Networks for Advanced Energy Management

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, J.E.

    2005-05-06

    Numerous national studies and working groups have identified low-cost, very low-power wireless sensors and networks as a critical enabling technology for increasing energy efficiency, reducing waste, and optimizing processes. Research areas for developing such sensor and network platforms include microsensor arrays, ultra-low power electronics and signal conditioning, data/control transceivers, and robust wireless networks. A review of some of the research in the following areas will be discussed: (1) Low-cost, flexible multi-sensor array platforms (CO{sub 2}, NO{sub x}, CO, humidity, NH{sub 3}, O{sub 2}, occupancy, etc.) that enable energy and emission reductions in applications such as buildings and manufacturing; (2) Modeling investments (energy usage and savings to drive capital investment decisions) and estimated uptime improvements through pervasive gathering of equipment and process health data and its effects on energy; (3) Robust, self-configuring wireless sensor networks for energy management; and (4) Quality-of-service for secure and reliable data transmission from widely distributed sensors. Wireless communications is poised to support technical innovations in the industrial community, with widespread use of wireless sensors forecasted to improve manufacturing production and energy efficiency and reduce emissions. Progress being made in wireless system components, as described in this paper, is helping bring these projected improvements to reality.

  19. Advances in hormone replacement therapy: making the menopause manageable

    Directory of Open Access Journals (Sweden)

    Palacios Santiago

    2008-11-01

    Full Text Available Abstract The importance of the results of some large, randomized controlled trials (RCTs on Hormone Replacement Therapy (HRT has modified the risk/benefit perception of HRT. Recent literature review supports a different management. The differences in age at initiation and the duration of HRT are key points. HRT appears to decrease coronary disease in younger women, near menopause; yet, in older women, HRT increases risk of a coronary event. Although HRT is a recognized method in the prevention and treatment of osteoporosis, it is not licensed for the prevention of osteoporosis as a first-line treatment. The effectiveness of low and ultra-low estrogen doses has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss, with fewer side-effects than the standard dose therapy. Further research, however, is needed to determine the effect both on fractures, as well as on cardiovascular and breast diseases. Newer progestins show effects that are remarkably different from those of other assays. The effectiveness of testosterone at improving both sexual desire and response in surgically and naturally postmenopausal women is shown by the testosterone patch. The intention, dose and regimen of HRT need to be individualized, based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and the time and menopause age.

  20. Microgrid Controller and Advanced Distribution Management System Survey Report

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Guodong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Starke, Michael R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Herron, Andrew N. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-07-01

    A microgrid controller, which serves as the heart of a microgrid, is responsible for optimally managing the distributed energy resources, energy storage systems, and responsive demand and for ensuring the microgrid is being operated in an efficient, reliable, and resilient way. As the market for microgrids has blossomed in recently years, many vendors have released their own microgrid controllers to meet the various needs of different microgrid clients. However, due to the absence of a recognized standard for such controllers, vendor-supported microgrid controllers have a range of functionalities that are significantly different from each other in many respects. As a result the current state of the industry has been difficult to assess. To remedy this situation the authors conducted a survey of the functions of microgrid controllers developed by vendors and national laboratories. This report presents a clear indication of the state of the microgrid-controller industry based on analysis of the survey results. The results demonstrate that US Department of Energy funded research in microgrid controllers is unique and not competing with that of industry.

  1. Advances in Data Management in Remote Sensing and Climate Modeling

    Science.gov (United States)

    Brown, P. G.

    2014-12-01

    Recent commercial interest in "Big Data" information systems has yielded little more than a sense of deja vu among scientists whose work has always required getting their arms around extremely large databases, and writing programs to explore and analyze it. On the flip side, there are some commercial DBMS startups building "Big Data" platform using techniques taken from earth science, astronomy, high energy physics and high performance computing. In this talk, we will introduce one such platform; Paradigm4's SciDB, the first DBMS designed from the ground up to combine the kinds of quality-of-service guarantees made by SQL DBMS platforms—high level data model, query languages, extensibility, transactions—with the kinds of functionality familiar to scientific users—arrays as structural building blocks, integrated linear algebra, and client language interfaces that minimize the learning curve. We will review how SciDB is used to manage and analyze earth science data by several teams of scientific users.

  2. Vibrational spectroscopy: a tool being developed for the noninvasive monitoring of wound healing

    Science.gov (United States)

    Crane, Nicole J.; Elster, Eric A.

    2012-01-01

    Wound care and management accounted for over 1.8 million hospital discharges in 2009. The complex nature of wound physiology involves hundreds of overlapping processes that we have only begun to understand over the past three decades. The management of wounds remains a significant challenge for inexperienced clinicians. The ensuing inflammatory response ultimately dictates the pace of wound healing and tissue regeneration. Consequently, the eventual timing of wound closure or definitive coverage is often subjective. Some wounds fail to close, or dehisce, despite the use and application of novel wound-specific treatment modalities. An understanding of the molecular environment of acute and chronic wounds throughout the wound-healing process can provide valuable insight into the mechanisms associated with the patient's outcome. Pathologic alterations of wounds are accompanied by fundamental changes in the molecular environment that can be analyzed by vibrational spectroscopy. Vibrational spectroscopy, specifically Raman and Fourier transform infrared spectroscopy, offers the capability to accurately detect and identify the various molecules that compose the extracellular matrix during wound healing in their native state. The identified changes might provide the objective markers of wound healing, which can then be integrated with clinical characteristics to guide the management of wounds.

  3. Formulation of Novel Layered Sodium Carboxymethylcellulose Film Wound Dressings with Ibuprofen for Alleviating Wound Pain

    Directory of Open Access Journals (Sweden)

    Lenka Vinklárková

    2015-01-01

    Full Text Available Effective assessment and management of wound pain can facilitate both improvements in healing rates and overall quality of life. From a pharmacological perspective, topical application of nonsteroidal anti-inflammatory drugs in the form of film wound dressings may be a good choice. Thus, the aim of this work was to develop novel layered film wound dressings containing ibuprofen based on partially substituted fibrous sodium carboxymethylcellulose (nonwoven textile Hcel NaT. To this end, an innovative solvent casting method using a sequential coating technique has been applied. The concentration of ibuprofen which was incorporated as an acetone solution or as a suspension in a sodium carboxymethylcellulose dispersion was 0.5 mg/cm2 and 1.0 mg/cm2 of film. Results showed that developed films had adequate mechanical and swelling properties and an advantageous acidic surface pH for wound application. An in vitro drug release study implied that layered films retained the drug for a longer period of time and thus could minimize the frequency of changing the dressing. Films with suspended ibuprofen demonstrated higher drug content uniformity and superior in vitro drug release characteristics in comparison with ibuprofen incorporation as an acetone solution. Prepared films could be potential wound dressings for the effective treatment of wound pain in low exuding wounds.

  4. AN ADVANCED TOOL FOR APPLIED INTEGRATED SAFETY MANAGEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Potts, T. Todd; Hylko, James M.; Douglas, Terence A.

    2003-02-27

    WESKEM, LLC's Environmental, Safety and Health (ES&H) Department had previously assessed that a lack of consistency, poor communication and using antiquated communication tools could result in varying operating practices, as well as a failure to capture and disseminate appropriate Integrated Safety Management (ISM) information. To address these issues, the ES&H Department established an Activity Hazard Review (AHR)/Activity Hazard Analysis (AHA) process for systematically identifying, assessing, and controlling hazards associated with project work activities during work planning and execution. Depending on the scope of a project, information from field walkdowns and table-top meetings are collected on an AHR form. The AHA then documents the potential failure and consequence scenarios for a particular hazard. Also, the AHA recommends whether the type of mitigation appears appropriate or whether additional controls should be implemented. Since the application is web based, the information is captured into a single system and organized according to the >200 work activities already recorded in the database. Using the streamlined AHA method improved cycle time from over four hours to an average of one hour, allowing more time to analyze unique hazards and develop appropriate controls. Also, the enhanced configuration control created a readily available AHA library to research and utilize along with standardizing hazard analysis and control selection across four separate work sites located in Kentucky and Tennessee. The AHR/AHA system provides an applied example of how the ISM concept evolved into a standardized field-deployed tool yielding considerable efficiency gains in project planning and resource utilization. Employee safety is preserved through detailed planning that now requires only a portion of the time previously necessary. The available resources can then be applied to implementing appropriate engineering, administrative and personal protective equipment

  5. Highly Automated Module Production Incorporating Advanced Light Management

    Energy Technology Data Exchange (ETDEWEB)

    Perelli-Minetti, Michael [SolarWorld Americas Inc., Hillsboro, OR (United States); Roof, Kyle [SolarWorld Americas Inc., Hillsboro, OR (United States)

    2015-08-11

    The objective was to enable a high volume, cost effective solution for increasing the amount of light captured by PV modules through utilization of an advanced Light Re-directing Film and to follow a phased approach to develop and implement this new technology in order to achieve an expected power gain of up to 12 watts per module. Full size PV modules were manufactured using a new Light Redirecting Film (LRF) material applied to two different areas of PV modules in order to increase the amount of light captured by the modules. One configuration involved applying thin strips of LRF film over the tabbing ribbon on the cells in order to redirect the light that is normally absorbed by the tabbing ribbon to the active areas of the cells. A second configuration involved applying thin strips of LRF film over the white spaces between cells within a module in order to capture some of the light that is normally reflected from the white areas back through the front glass of the modules. Significant power increases of 1.4% (3.9 watts) and 1.0% (3.2 watts), respectively, compared to standard PV modules were measured under standard test conditions. The performance of PV modules with LRF applied to the tabbing ribbon was modeled. The results showed that the power increase provided by LRF depended greatly on the angle of incident light with the optimum performance only occurring when the light was within a narrow range of being perpendicular to the solar module. The modeling showed that most of the performance gain would be lost when the angle of incident light was greater than 28 degrees off axis. This effect made the orientation of modules with LRF applied to tabbing ribbons very important as modules mounted in “portrait” mode were predicted to provide little to no power gain from LRF under real world conditions. Based on these results, modules with LRF on tabbing ribbons would have to be mounted in “landscape” mode to realize a performance advantage. In addition

  6. Career advancement in Public Employment in Colombia, a look at the Colombian State Management System

    Directory of Open Access Journals (Sweden)

    Mónica Lilly Serrato Moreno

    2014-12-01

    Full Text Available In Colombia, a public employee doesn’t seem to have rights to career advancement based on merit and experience. The current public hiring system seems to ignore experience, interest and effort made by an employee, at the time of considering a potential advancement to an upper-level position, which would assign new tasks and greater responsibilities. That is why there is a need for the implementation of different mechanisms, to increase employees’ career advancement possibilities based on merits accredited with tasks such as academic papers, institutional project management and public policy management, academic degrees, as well as experience, research and time of service. This paper, developed with a critical perspective of the problem, proposes alternatives to overcome this challenge.

  7. Overview of advances in water management in agricultural production:Sensor based irrigation management

    Science.gov (United States)

    Technological advances in irrigated agriculture are crucial to meeting the challenge of increasing demand for agricultural products given limited quality and quantity of water resources for irrigation, impacts of climate variability, and the need to reduce environmental impacts. Multidisciplinary ap...

  8. Etiology of contaminated wounds

    International Nuclear Information System (INIS)

    The US Department of Energy reports of events that occurred in the chemical processing 200 Areas of the Hanford Site during the period from 1972 through 1986 were reviewed to identify the causes of contaminated wounds. Contaminated wounds were reported in 19 events involving 20 workers. The causal agents (high risk operations) and the root causes were characterized. Emergency actions taken and their efficacy were noted. The 19 wound events were compared with 17 events with the potential for inhalation. It was found that the wound events involve a single worker and frequently result in an internal contamination and its resulting dose. Inhalation events involve groups of workers and rarely resulted in detectable internal contamination. The difference is attributed to anticipation of an inhalation event and use of respiratory protection and continuous air monitors to mitigate its effects

  9. Gunshot wounds - aftercare

    Science.gov (United States)

    ... notice other symptoms as well, such as: Anxiety Nightmares or trouble sleeping Thinking about the event over ... wounds to the extremities in a level 1 trauma center: our experience and recommendations. Isr Med Assoc ...

  10. Biofilms in wounds

    DEFF Research Database (Denmark)

    Cooper, R A; Bjarnsholt, Thomas; Alhede, M

    2014-01-01

    Following confirmation of the presence of biofilms in chronic wounds, the term biofilm became a buzzword within the wound healing community. For more than a century pathogens have been successfully isolated and identified from wound specimens using techniques that were devised in the nineteenth...... century by Louis Pasteur and Robert Koch. Although this approach still provides valuable information with which to help diagnose acute infections and to select appropriate antibiotic therapies, it is evident that those organisms isolated from clinical specimens with the conditions normally used in...... extracellular polymeric substances (EPS). Cells within such aggregations (or biofilms) display varying physiological and metabolic properties that are distinct from those of planktonic cells, and which contribute to their persistence. There are many factors that influence healing in wounds and the discovery of...

  11. Vita 6.2: Advanced visual tool for information management

    International Nuclear Information System (INIS)

    We have developed a knowledge management tool to search and organize disparate and large text corpora and display them in a manner for ease of interpretation. One application would be to uncover and determine the extent of clandestine nuclear supply networks. VITA, a 'Visual Interface for Text Analysis', is a tool used to direct computer-based document searches. It allows a user, via mouse and keyboard action, visually to find, organize, summarize, and present documents of potential interest. It has control features that allow visual clustering of like documents, thus enabling quick refinement of the search process. The visual features of VITA-6.2 support the observation and investigation of the [often unexpected] relationships among documents. Further, it acts to isolate and call attention to otherwise unsuspected documents of importance, in ways that other search tools cannot. The VITA series was developed first as a research testbed to identify better methods to visualize relevant document clusters and identifying their relationships. It has now stabilized into a pre-competitive design, through the interest of users in IAEA and the Government of Canada. VITA sits between the user and an extended set of search engines directed at external [Web] and internal private files The user is easily able to search and then see a conceptual map of documents, arrayed in relationships suggested by the query. The impact for knowledge discovery, summary and presentation can be surprising. The VITA output 1 arises from a nuclear proliferation query to an intelligence related website showed an unexpected outlier. On investigation, it was a highly relevant item [shown on the right] not expected, that would not have stood out nor been described among the search engine's returns in the standard lists. New in the current release VITA-x, the current version, is robust and fast, built on a Cno. platform that requires normal computing equipment and OS. Eight popular search engines are

  12. Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions-key messages

    DEFF Research Database (Denmark)

    Gottrup, Finn; Apelqvist, Jan; Bjarnsholt, Thomas;

    2014-01-01

    This article constitutes an extraction of key messages originally presented in the Document: Antimicrobials and Non-Healing Wounds. Evidence, controversies and suggestions written by the European Wound Management Association (EWMA), and originally published by the Journal of Wound Care in 2013. A...

  13. Arginine metabolism in wounds

    International Nuclear Information System (INIS)

    Arginine metabolism in wounds was investigated in the rat in 1) lambda-carrageenan-wounded skeletal muscle, 2) Schilling chambers, and 3) subcutaneous polyvinyl alcohol sponges. All showed decreased arginine and elevated ornithine contents and high arginase activity. Arginase could be brought to the wound by macrophages, which were found to contain arginase activity. However, arginase was expressed by macrophages only after cell lysis and no arginase was released by viable macrophages in vitro. Thus the extracellular arginase of wounds may derive from dead macrophages within the injured tissue. Wound and peritoneal macrophages exhibited arginase deiminase activity as demonstrated by the conversion of [guanido-14C]arginine to radiolabeled citrulline during culture, the inhibition of this reaction by formamidinium acetate, and the lack of prokaryotic contamination of the cultures. These findings and the known metabolic fates of the products of arginase and arginine deiminase in the cellular populations of the wound suggest the possibility of cooperativity among cells for the production of substrates for collagen synthesis

  14. A New Advanced Logistics Supply Chain for Food Management Based on Green Logistics Theory

    Directory of Open Access Journals (Sweden)

    Lanqing Liu

    2013-10-01

    Full Text Available The study aims to investigate the advanced logistics supply chain for food management using green logistics. To protect the food logistics environment and prevent the environmental pollution, it is crucial to establish powerful modern supply chains to support the food management in transportation. The construction speed of the food companies is very fast; however, the food supply lags behind the food companies. As a result, the environmental pollution caused in the food logistics becomes severe. To improve this situation, a new logistics supply chain for food management using the environmental logistics theory is proposed in this study. The design and analysis of the proposed food supply chain system has been introduced. By the use of advanced environmental logistics theory, the food supply can be operated in an effective and green manner. Hence, the proposed new logistics supply chain can reduce the environmental pollution of the food logistics and improve the food market environment.

  15. Use of negative pressure wound therapy in burn patients.

    Science.gov (United States)

    Teng, Shou-Cheng

    2016-09-01

    According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients. We propose an enhanced segmental compartment-covered technique, which uses NPWT adjunctively as first-line wound treatment to help manage postoperative infection. Moreover, NPWT promotes granulation tissue formation to prepare the wound bed for subsequent skin graft and may be used as a bolster over the graft, which helps to attain skin graft viability. PMID:27547959

  16. Establishment and operation of skin care management system for wound, ostomy, and incontinence%造口伤口失禁皮肤护理管理系统的建立与运行

    Institute of Scientific and Technical Information of China (English)

    徐旭娟; 袁宝芳

    2011-01-01

    Objective To establish a skin care management system for wound, ostomy, and incontinence (WOI) , and to explore the effectiveness after implement of the system. Methods We set up a skin care team of WOI, confirmed tertiary management model, clarified responsibilities for all levels, established regulations and processes, trained relevant staff, implemented nursing consulta-tion system, paid important attention to stoma complications, and used network technology for monitoring skin care in whole hos-pital. Results The scores of assessment, documentation, and management of WOI, and nurses proficiency of wound-related knowledge showed significant differences before and after 1 year implement of the system (P<0. 01 for all). Conclusion Skin care management system for WOI is a practical and efficient management model, which improves management of wound and ostomy in members of skin care team.%目的 探讨伤口造口失禁皮肤护理管理系统建立与运行后皮肤护理管理的效果.方法 成立造口伤口失禁皮肤护理小组,确定三级管理体制的运行模式,明确各级人员职责,制定工作制度和流程,对相关人员进行培训,实行护理会诊制度,高度重视造口并发症预防工作,利用网络技术对全院皮肤护理情况进行及时监控.结果 系统建立前后护理人员对造口伤口失禁评估记录处理得分及伤口相关知识掌握情况比较,差异有统计学意义(均P<0.01).结论 系统的建立与运行显著提升了小组成员正确处理造口伤口的能力,是可行、有效的临床专科护理及管理系统.

  17. Enzymatic Debriding Agents Are Safe in Wounds With High Bacterial Bioburdens and Stimulate Healing

    OpenAIRE

    Payne, Wyatt G.; Salas, R. Emerick; Ko, Francis; Naidu, Deepak K.; Donate, Guillermo; Wright, Terry E.; Robson, Martin C.

    2008-01-01

    Background: Debridement is essential for successful wound management. Enzymatic debridement is commonly utilized in wound care but has been reported to be unsafe in wounds with significant bacterial bioburden, unless used in conjunction with topical antimicrobials. We examine this hypothesis with 2 commercially available, commonly used preparations of enzymatic debriding agents. Materials and Methods: Using a standard rodent model of a chronically infected granulating wound with bacterial lev...

  18. Effects of irrigation with different solution on Incidence of Wound Infection

    OpenAIRE

    Majid Zamani; Fatemeh Sadeghi Panah; Mehrdad Esmailian; Reza Azizkhani; Zahra Yoosefian; Mojtaba soltani

    2015-01-01

    Introduction: Management of acute and chronic wounds has significantly altered in the last decade but little attention has been paid to the solution used for cleansing the wounds. Therefore, the present study aimed to compare the effects of tap water, distilled water, and normal saline for wound cleansing in emergency department. Methods: This is a double-blind randomized clinical trial with a 10-day follow up. Patients who had superficial wounds were randomly divided into 3 treatment groups:...

  19. Wound pH depends on actual wound size

    CERN Document Server

    Sirkka, T; Apell, S P

    2016-01-01

    Wound healing is an intricate process that involves many types of cells, reaction pathways as well as chemical, physical and electrical cues. Since biochemical reactions and physiological events are pH-dependent we study here pH as an important major characteristic of the wound healing process in the presence of endogenous and exogenous electric fields. Our model gives the spatial pH distribution in a wound. In particular we isolate a number of dimensionless quantities which sets the length, energy and time scales governing the wound healing process and which can be experimentally tested. Most interesting finding is that wound pH depends on actual wound size.

  20. 干细胞治疗糖尿病难愈创面研究进展%Advances in the research of treating refractory diabetic wounds with stem cells

    Institute of Scientific and Technical Information of China (English)

    弓家弘; 陆树良

    2014-01-01

    With the growth of aging society,China has become the country of population with the highest incidence of diabetes in the world.Diabetes leads to pathological changes in vascular and nervous system,rendering the diabetic skin fragile and hard to heal if wounded; in the end most diabetic wounds tend to become chronic skin ulcers.The refractory diabetic wound is the result of various endogenous and exogenous factors.It is a quite complicated pathophysiologic event which lacks an effective and specific therapeutic method in clinic.The use of stem cells could be a new approach of treating diabetic chronic wounds since they have a potential ability of self-renovation and multi-directional differentiation which will promote angiogenesis and wound healing process,thus be beneficial in the care of ischemia diseases of the lower limb.This article reviews basic theory of treating diabetic wound and the changes in microenvironment,and prompts many successful cases in curing refractory diabetic wounds.

  1. Correction of MFG-E8 Resolves Inflammation and Promotes Cutaneous Wound Healing in Diabetes.

    Science.gov (United States)

    Das, Amitava; Ghatak, Subhadip; Sinha, Mithun; Chaffee, Scott; Ahmed, Noha S; Parinandi, Narasimham L; Wohleb, Eric S; Sheridan, John F; Sen, Chandan K; Roy, Sashwati

    2016-06-15

    Milk fat globule epidermal growth factor-factor 8 (MFG-E8) is a peripheral glycoprotein that acts as a bridging molecule between the macrophage and apoptotic cells, thus executing a pivotal role in the scavenging of apoptotic cells from affected tissue. We have previously reported that apoptotic cell clearance activity or efferocytosis is compromised in diabetic wound macrophages. In this work, we test the hypothesis that MFG-E8 helps resolve inflammation, supports angiogenesis, and accelerates wound closure. MFG-E8(-/-) mice displayed impaired efferocytosis associated with exaggerated inflammatory response, poor angiogenesis, and wound closure. Wound macrophage-derived MFG-E8 was recognized as a critical driver of wound angiogenesis. Transplantation of MFG-E8(-/-) bone marrow to MFG-E8(+/+) mice resulted in impaired wound closure and compromised wound vascularization. In contrast, MFG-E8(-/-) mice that received wild-type bone marrow showed improved wound closure and improved wound vascularization. Hyperglycemia and exposure to advanced glycated end products inactivated MFG-E8, recognizing a key mechanism that complicates diabetic wound healing. Diabetic db/db mice suffered from impaired efferocytosis accompanied with persistent inflammation and slow wound closure. Topical recombinant MFG-E8 induced resolution of wound inflammation, improvements in angiogenesis, and acceleration of closure, upholding the potential of MFG-E8-directed therapeutics in diabetic wound care. PMID:27194784

  2. Pre-hospital advanced airway management by anaesthesiologists: Is there still room for improvement?

    Directory of Open Access Journals (Sweden)

    Søreide Eldar

    2008-07-01

    Full Text Available Abstract Background Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Method Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Results Of the 17 available respondents, most (88% felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. Conclusion The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

  3. Verification of advanced methods in TARMS boiling water reactor core management system

    International Nuclear Information System (INIS)

    The TARMS (Toshiba Advanced Reactor Management System) software package was developed as an effective on-line, on-site Boiling Water Reactor (BWR) core operation management system. It covers almost all the functional requirements to the current process computer to increase on-site core management capability, capacity factors, thermal margins, fuel reliability, and so on, by supporting application functions for monitoring the present core power distribution, and for aiding site engineers in making the core operation plans, by predicting future core performance. It is based on a three dimensional, 1.5 energy group, coarse mesh nodal diffusion theory code ''LOGOS02'', and includes advanced methods to increase the accuracy of core power distribution calculations as well as a local peaking factor calculation method by which the effect of neighboring nodes on intra-nodal power distribution can be considered. TARMS has been installed in eight BWR plants and was verified to be an effective BWR core operation management tool. This paper describes its advanced methods and the results of verifications with actual plant data. (author). 3 refs, 6 figs

  4. The role of business information management in advanced integrated environmental management systems

    DEFF Research Database (Denmark)

    Ulhøi, John Parm

    2000-01-01

    investments in the individual company. Secondly, based on the above, to calculate and assess some typical quantifiable savings, e.g. on energy and raw materials, over a period of four years (after the implementation of the integrated environmental management system). In line with other similar investigations......, the study shows that the implementation of systematic and integrated environmental management systems results in significant savings. This supports the general, albeit rarely tested, hypothesis that it pays to be an environmentally responsible enterprise....

  5. IPAD 2: Advances in Distributed Data Base Management for CAD/CAM

    Science.gov (United States)

    Bostic, S. W. (Compiler)

    1984-01-01

    The Integrated Programs for Aerospace-Vehicle Design (IPAD) Project objective is to improve engineering productivity through better use of computer-aided design and manufacturing (CAD/CAM) technology. The focus is on development of technology and associated software for integrated company-wide management of engineering information. The objectives of this conference are as follows: to provide a greater awareness of the critical need by U.S. industry for advancements in distributed CAD/CAM data management capability; to present industry experiences and current and planned research in distributed data base management; and to summarize IPAD data management contributions and their impact on U.S. industry and computer hardware and software vendors.

  6. Deep sternal wound infection after cardiac surgery: Evidences and controversies.

    Science.gov (United States)

    Cotogni, Paolo; Barbero, Cristina; Rinaldi, Mauro

    2015-11-01

    Despite many advances in prevention and perioperative care, deep sternal wound infection (DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid- and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at high-risk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylactic antibiotic therapy is one of the most important tools in the prevention of DSWI. However, the choice of antibiotic, the dose, the duration, the adequate levels in serum and tissue, and the timing of antimicrobial prophylaxis are still controversial. The treatment of DSWI ranges from surgical revision with primary closure to surgical revision with open dressings or closed irrigation, from reconstruction with soft tissue flaps to negative pressure wound therapy (NPWT). However, to date, there have been no accepted recommendations regarding the best management of DSWI. Emerging evidence in the literature has validated the efficacy and safety of NPWT either as a single-line therapy, or as a "bridge" prior to final surgical closure. In conclusion, the careful control of patient and surgical risk factors - when possible, the proper antimicrobial prophylaxis, and the choice of validated techniques of treatment could contribute to keep DSWIs at a minimal rate. PMID:26557476

  7. Advances in Agronomic Management of Indian Mustard (Brassica juncea (L. Czernj. Cosson: An Overview

    Directory of Open Access Journals (Sweden)

    Kapila Shekhawat

    2012-01-01

    Full Text Available India is the fourth largest oilseed economy in the world. Among the seven edible oilseeds cultivated in India, rapeseed-mustard contributes 28.6% in the total oilseeds production and ranks second after groundnut sharing 27.8% in the India’s oilseed economy. The mustard growing areas in India are experiencing the vast diversity in the agro climatic conditions and different species of rapeseed-mustard are grown in some or other part of the country. Under marginal resource situation, cultivation of rapeseed-mustard becomes less remunerative to the farmers. This results in a big gap between requirement and production of mustard in India. Therefore site-specific nutrient management through soil-test recommendation based should be adopted to improve upon the existing yield levels obtained at farmers field. Effective management of natural resources, integrated approach to plant-water, nutrient and pest management and extension of rapeseed-mustard cultivation to newer areas under different cropping systems will play a key role in further increasing and stabilizing the productivity and production of rapeseed-mustard. The paper reviews the advances in proper land and seedbed preparation, optimum seed and sowing, planting technique, crop geometry, plant canopy, appropriate cropping system, integrated nutrient management and so forth to meet the ever growing demand of oil in the country and to realize the goal of production of 24 million tonnes of oilseed by 2020 AD through these advanced management techniques.

  8. Sternal wound infection revisited

    International Nuclear Information System (INIS)

    Sternal wound infections (SWIs) can be subdivided into two types, superficial or deep, that require different treatments. The clinical diagnosis of superficial SWI is normally easy to perform, whereas the involvement of deep tissues is frequently difficult to detect. Therefore, there is a need for an imaging study that permits the assessment of SWIs and is able to distinguish between superficial and deep SWI. The present work was a prospective study aiming to evaluate the role of technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) labelled leucocyte scan in SWI management. Twenty-eight patients with suspected SWIs were included in the study. On the basis of clinical examination they were subdivided into three groups: patients with signs of superficial SWI (group 1), patients with signs of superficial SWI and suspected deep infection (group 2) and patients with suspected deep SWI without superficial involvement (group 3). Ten patients previously submitted to median sternotomy, but without suspected SWI, were also included in the study as a control group (group 4). All patients with suspected SWI had bacteriological examinations of wound secretion, if present. In addition 99mTc-HMPAO labelled leucocyte scan was performed in all patients. The patients of groups 1, 2 and 3 were treated on the basis of the clinical signs and microbiological findings, independently of the scintigraphic results. The patients of group 4 did not receive treatment. The final assessment of infection was based on histological and microbiological findings or on long-term clinical follow-up. Sensitivity, specificity, accuracy and positive and negative predictive values for scintigraphic and non-scintigraphic results were calculated. In the diagnosis of superficial and deep SWI, clinical and microbiological examination (combined) yielded, respectively, a sensitivity of 68.7% and 100%, a specificity of 77.3% and 80.8%, an accuracy of 73.7% and 86.8%, a positive predictive value of 68

  9. Resource management in radio access and IP-based core networks for IMT Advanced and Beyond

    Institute of Scientific and Technical Information of China (English)

    SU Gang; HIDELL Markus; ABRAHAMSSON Henrik; AHLGREN Bengt; LI Dan; SJDIN Peter; TANYINGYONG Voravit; XU Ke

    2013-01-01

    The increased capacity needs, primarily driven by content distribution, and the vision of Internet-of-Things with billions of connected devices pose radically new demands on future wireless and mobile systems. In general the increased diversity and scale result in complex resource management and optimization problems in both radio access networks and the wired core network infrastructure. We summarize results in this area from a collaborative Sino-Swedish project within IMT Advanced and Beyond, covering adaptive radio resource management, energy-aware routing, OpenFlow-based network virtualization, data center networking, and access network caching for TV on demand.

  10. Advanced Power Converter for Universal and Flexible Power Management in Future Electricity Network

    DEFF Research Database (Denmark)

    Iov, Florin; Blaabjerg, Frede; Bassett, R.;

    2007-01-01

    More "green" power provided by Distributed Generation will enter into the European electricity network in the near future. In order to control the power flow and to ensure proper and secure operation of this future grid, with an increased level of the renewable power, new power electronic...... converters for grid connection of renewable sources will be needed. These power converters must be able to provide intelligent power management as well as ancillary services. This paper presents the overall structure and the control aspects of an advanced power converter for universal and flexible power...... management in the future European electricity network....

  11. Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections.

    Science.gov (United States)

    Ng, Shiow-Fern; Leow, Hon-Lunn

    2015-01-01

    It has been established that microbial biofilms are largely responsible for the recalcitrance of many wound infections to conventional antibiotics. It was proposed that the efficacy of antibiotics could be optimized via the inhibition of bacterial biofilm growth in wounds. The combination of antibiofilm agent and antibiotics into a wound dressing may be a plausible strategy in wound infection management. Xylitol is an antibiofilm agent that has been shown to inhibit the biofilm formation. The purpose of this study was to develop an alginate film containing xylitol and gentamicin for the treatment of wound infection. Three films, i.e. blank alginate film (SA), alginate film with xylitol (F5) and alginate film with xylitol and gentamicin (AG), were prepared. The films were studied for their physical properties, swelling ratio, moisture absorption, moisture vapor transmission rate (MVTR), mechanical and rheology properties, drug content uniformity as well as in vitro drug release properties. Antimicrobial and antibiofilm in vitro studies on Staphylococcus aureus and Pseudomonas aeruginosa were also performed. The results showed that AG demonstrates superior mechanical properties, rheological properties and a higher MVTR compared with SA and F5. The drug flux of AG was higher than that of commercial gentamicin cream. Furthermore, antimicrobial studies showed that AG is effective against both S. aureus and P. aeruginosa, and the antibiofilm assays demonstrated that the combination was effective against biofilm bacteria. In summary, alginate films containing xylitol and gentamicin may potentially be used as new dressings for the treatment of wound infection. PMID:25758412

  12. MAXILLOFACIAL TRAUMA MANAGEMENT IN POLYTRAUMATIZED PATIENTS – THE USE OF ADVANCED TRAUMA LIFE SUPPORT (ATLS PRINCIPLES.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-03-01

    Full Text Available Management of the multiply injured patient requires a co-ordinated multi-disciplinary approach in order to optimise patients’ outcome. A working knowledge of the sort of problems these patients encounter is therefore vital to ensure that life-threatening injuries are recognised and treated in a timely pattern and that more minor associated injuries are not omitted. This article outlines the management of polytraumatized patients using the Advanced Trauma Life Support (ATLS principles and highlights the areas of specific involvement of the engaged medical team. Advanced Trauma Life Support is generally regarded as the gold standard and is founded on a number of well known principles, but strict adherence to protocols may have its drawbacks when facial trauma co-exists. These can arise in the presence of either major or minor facial injuries, and oral and maxillofacial surgeons need to be aware of the potential problems.

  13. Surgical Management of a Locally Advanced Symptomatic Recurrence of Penile Sarcoma Secondary to Prostate Brachytherapy

    Directory of Open Access Journals (Sweden)

    Tariq S. Hakky

    2013-04-01

    Full Text Available Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. Results The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. Conclusion As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient is informed of the

  14. A conservation approach to pharyngeal carcinoma with advanced neck disease: optimizing neck management

    OpenAIRE

    Allal, Abdelkarim Said; Dulguerov, Pavel; Bieri, Sabine; Lehmann, Willy; Kurtz, John

    1999-01-01

    Surgical management of advanced neck disease remains controversial when a conservative approach based on radiotherapy is retained for primary tumors. The objective of this study was to evaluate retrospectively treatment results in pharyngeal cancers presenting with N2-N3 neck disease, using neck dissection followed by radical locoregional radiotherapy (RT) and to compare these results with those obtained in patients treated by radical RT alone.

  15. Managing Risk on a Technology Development Project/Advanced Mirror System Demonstrator

    Science.gov (United States)

    Byberg, Alicia; Russell, J. Kevin; Stahl, Phil (Technical Monitor)

    2002-01-01

    The risk management study applied to the Advanced Mirror System Demonstrator (AMSD), a precursor mirror technology development for the Next Generation Space Telescope (NGST) is documented. The AMSD will be developed as a segment of a lightweight primary mirror system that can be produced at a low cost and with a short manufacturing schedule. The technology gained from the program will support the risk mitigation strategy for the NGST, as well as other government agency space mirror programs.

  16. Advanced transport operating system software upgrade: Flight management/flight controls software description

    Science.gov (United States)

    Clinedinst, Winston C.; Debure, Kelly R.; Dickson, Richard W.; Heaphy, William J.; Parks, Mark A.; Slominski, Christopher J.; Wolverton, David A.

    1988-01-01

    The Flight Management/Flight Controls (FM/FC) software for the Norden 2 (PDP-11/70M) computer installed on the NASA 737 aircraft is described. The software computes the navigation position estimates, guidance commands, those commands to be issued to the control surfaces to direct the aircraft in flight based on the modes selected on the Advanced Guidance Control System (AGSC) mode panel, and the flight path selected via the Navigation Control/Display Unit (NCDU).

  17. Human-system safety methods for development of advanced air traffic management systems

    International Nuclear Information System (INIS)

    The Idaho National Engineering and Environmental Laboratory (INEEL) is supporting the National Aeronautics and Space Administration in the development of advanced air traffic management (ATM) systems as part of the Advanced Air Transportation Technologies program. As part of this program INEEL conducted a survey of human-system safety methods that have been applied to complex technical systems, to identify lessons learned from these applications and provide recommendations for the development of advanced ATM systems. The domains that were surveyed included offshore oil and gas, commercial nuclear power, commercial aviation, and military. The survey showed that widely different approaches are used in these industries, and that the methods used range from very high-level, qualitative approaches to very detailed quantitative methods such as human reliability analysis (HRA) and probabilistic safety assessment (PSA). In addition, the industries varied widely in how effectively they incorporate human-system safety assessment in the design, development, and testing of complex technical systems. In spite of the lack of uniformity in the approaches and methods used, it was found that methods are available that can be combined and adapted to support the development of advanced air traffic management systems (author) (ml)

  18. Wound Coverage Technologies in Burn Care: Established Techniques

    Science.gov (United States)

    Jeschke, Marc G.; Shahrokhi, Shahriar; Finnerty, Celeste C.; Branski, Ludwik K.; Dibildox, Manuel

    2013-01-01

    Major advances in burn care have reduced post-burn morbidity and mortality. The development and incorporation of new wound healing modalities into the clinical arena have contributed to this improvement by allowing standard-of-care regimens to be established. These regimens range from early excision to the use of cultured epithelial autograft. Here, we review the wound care options that are now well established and used by many burn surgeons. PMID:24165670

  19. Design manual for management of solid by-products from advanced coal technologies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-10-01

    Developing coal conversion technologies face major obstacles in byproduct management. This project has developed several management strategies based on field trials of small-scale landfills in an earlier phase of the project, as well as on published/unpublished sources detailing regulatory issues, current industry practice, and reuse opportunities. Field testing, which forms the basis for several of the disposal alternatives presented in this design manual, was limited to byproducts from Ca-based dry SO{sub 2} control technologies, circulating fluidized bed combustion ash, and bubbling bed fluidized bed combustion ash. Data on byproducts from other advanced coal technologies and on reuse opportunities are drawn from other sources (citations following Chapter 3). Field results from the 5 test cases examined under this project, together with results from other ongoing research, provide a basis for predictive modeling of long-term performance of some advanced coal byproducts on exposure to ambient environment. This manual is intended to provide a reference database and development plan for designing, permitting, and operating facilities where advanced coal technology byproducts are managed.

  20. Traditional Therapies for Skin Wound Healing

    OpenAIRE

    Pereira, Rúben F.; Bártolo, Paulo J

    2016-01-01

    Significance: The regeneration of healthy and functional skin remains a huge challenge due to its multilayer structure and the presence of different cell types within the extracellular matrix in an organized way. Despite recent advances in wound care products, traditional therapies based on natural origin compounds, such as plant extracts, honey, and larvae, are interesting alternatives. These therapies offer new possibilities for the treatment of skin diseases, enhancing the access to the he...

  1. Wound biofilms: lessons learned from oral biofilms

    OpenAIRE

    Mancl, Kimberly A.; Kirsner, Robert S.; Ajdic, Dragana

    2013-01-01

    Biofilms play an important role in the development and pathogenesis of many chronic infections. Oral biofilms, more commonly known as dental plaque,are a primary cause of oral diseases including caries, gingivitis and periodontitis. Oral biofilms are commonly studied as model biofilm systems as they are easily accessible, thus biofilm research in oral diseases is advanced with details of biofilm formation and bacterial interactions being well-elucidated. In contrast, wound research has relati...

  2. Roles of Antioxidative Enzymes in Wound Healing

    OpenAIRE

    Toshihiro Kurahashi; Junichi Fujii

    2015-01-01

    Since skin is the first barrier separating the body from the external environment, impaired wound healing can be life threatening to living organisms. Delayed healing processes are observed in animals under certain circumstances, such as advanced age, diabetes, and immunosuppression, but the underlying mechanisms of the abnormality remain elusive. Redox homeostasis is defined as the balance between the levels of reactive oxygen species (ROS) and antioxidants in which antioxidative enzymes pla...

  3. Intraperitoneal wound in abdominal surgery

    OpenAIRE

    Kahokehr, Arman Adam

    2013-01-01

    The intraperitoneal wound is often forgotten after transperitoneal surgery. This review is a on the peritoneum and the implications of peritoneal injury after surgery. This review will focus on the intraperitoneal wound response after surgical injury.

  4. [Dressing and wound care pain].

    Science.gov (United States)

    Chin, Yen-Fan

    2006-12-01

    Wound care is an important step for promoting wound healing. Nevertheless it is also a major source of pain for patients with wounds. The results of a survey showed that not only burn patients but also non-burn ones suffered from wound care pain which occurred in inpatients and outpatients. One of the significant factors causing wound care pain was that the dressing adhered to the wound bed. Although some agencies claimed that particular dressings with low adhesion can result in painless removal, the actual effects needed to be verified. Results of clinical trials revealed that for relieving wound care pain of certain kinds of wound, it was recommended to use particular dressings, such as banana leaf dressing, boiled potato peel bandage, Acticoat, Mepital or Mefix. PMID:17160873

  5. Treating infected diabetic wounds with superoxidized water as anti-septic agent: a preliminary experience

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of superoxidized water (MicrocynTM) in diabetic patients with different wounds. One hundred known diabetic patients were enrolled. Half were randomized to the intervention group (those whose wounds were managed with superoxidized water) and half to the control group (whose wounds were treated with normal saline) using a table of random numbers. The two groups were matched for age, gender, duration of diabetes and category of wound. All patients received appropriate surgical treatment for their wounds as required. Local wound treatment was carried out daily using superoxidized water soaked gauzes on twice daily basis in the intervention group and normal saline in the control group. The treatment was continued until wound healing. The main outcome measures were duration of hospital stay, downgrading of the wound category, wound healing time and need for interventions such as amputation. Statistically significant differences were found in favour of the superoxidized water group with respect to duration of hospital stay, downgrading of the wound category and wound healing time. Although the initial results of employing superoxidized water for the management of infected diabetic wounds are encouraging, further multicentre clinical trials are warranted before this antiseptic is recommended for general use. It may offer an economical alternative to other expensive antiseptics with positive impact on the prevailing infection rates, patient outcomes and patient satisfaction. (author)

  6. Wound Care in Primary Health Care

    OpenAIRE

    Nail Ersoz; Ismail Hakki Ozerhan; Fatih Zor

    2008-01-01

    Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000): 71-74

  7. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull. 2008; 7(1: 71-74

  8. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000: 71-74

  9. Wound Care in Burn Patients

    OpenAIRE

    Orhan Çizmeci; Samet Vasfi Kuvat

    2011-01-01

    Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are generea...

  10. Wound Drainage Culture (For Parents)

    Science.gov (United States)

    ... Melon Smoothie Pregnant? Your Baby's Growth Wound Drainage Culture KidsHealth > For Parents > Wound Drainage Culture Print A A A Text Size What's in ... de heridas What It Is A wound drainage culture is a test to detect germs such as ...

  11. Wound Healing Devices Brief Vignettes

    OpenAIRE

    Anderson, Caesar A.; Hare, Marc A.; Perdrizet, George A.

    2016-01-01

    Significance: The demand for wound care therapies is increasing. New wound care products and devices are marketed at a dizzying rate. Practitioners must make informed decisions about the use of medical devices for wound healing therapy. This paper provides updated evidence and recommendations based on a review of recent publications.

  12. Trends in Surgical Wound Healing

    DEFF Research Database (Denmark)

    Gottrup, F.

    2008-01-01

    The understanding of acute and chronic wound pathophysiology has progressed considerably over the past decades. Unfortunately, improvement in clinical practice has not followed suit, although new trends and developments have improved the outcome of wound treatment in many ways. This review focuses...... on promising clinical development in major wound problems in general and on postoperative infections in particular Udgivelsesdato: 2008...

  13. Wound dressings in the therapy concept of chronic wounds

    Directory of Open Access Journals (Sweden)

    Eming, Sabine A.

    2006-08-01

    Full Text Available The essential requirement for enduring success in the treatment of chronic wounds is the recognition and correction of the underlying disease, be it through surgery in cases of arterial or venous ulcers, internistic resolution of a diabetogenic ulcer, or correct compression of primary/secondary varicosis. The fundamental systemic diseases also lead to an altered local wound environment, which ultimately manifests in disturbed wound healing. Thus, local therapy - expertly administered - is also of crucial importance and, as clinical experience has shown, can significantly improve the wound-healing process. This seems to be particularly important in those wounds which, despite elimination of the underlying disease, fail to heal completely.

  14. Detection of Biofilm in Wounds as an Early Indicator for Risk for Tissue Infection and Wound Chronicity.

    Science.gov (United States)

    Vyas, Krishna S; Wong, Lesley K

    2016-01-01

    Wounds are dynamic environments in which dead tissue, exudate, and the bacterial bioburden interact in a complex manner among themselves and with the tissue of the host. Bacteria organize into biofilms, reducing their susceptibility to elimination by the host immune response and antimicrobials. Early detection of biofilms in wounds is crucial to successful chronic wound management; and although many techniques have developed to identify planktonic counterparts in viable wounds, few have been able to quickly and accurately identify bacterial biofilms. Future studies are needed to find means of identifying and monitoring biofilm colonization at the bedside to permit timely initiation of treatment. In this review, we examine some promising new technologies that hope to identify and quantify the process of biofilm formation in chronic wounds. PMID:25774966

  15. Fungal Wound Infection

    Centers for Disease Control (CDC) Podcasts

    2016-01-28

    Dr. David Tribble, acting director of the infectious disease clinical research program at Uniformed Services University of the Health Sciences, discusses fungal wound infections after combat trauma.  Created: 1/28/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/28/2016.

  16. Phytochemicals in Wound Healing

    OpenAIRE

    Thangapazham, Rajesh L.; Sharad, Shashwat; Radha K. Maheshwari

    2016-01-01

    Significance: Traditional therapies, including the use of dietary components for wound healing and skin regeneration, are very common in Asian countries such as China and India. The increasing evidence of health-protective benefits of phytochemicals, components derived from plants is generating a lot of interest, warranting further scientific evaluation and mechanistic studies.

  17. The Wounded Spirit.

    Science.gov (United States)

    Peretti, Frank

    2001-01-01

    This article offers a glimpse into the life of Frank Peretti, who as a child suffered abuse because of his physical disfigurement. He was bullied and physically assaulted by peers and sometimes adults. Now well known for his novels, Peretti suggests that people who cause others to suffer also suffer from a wounded spirit. (Author)

  18. Advances in software development for intelligent interfaces for alarm and emergency management consoles

    International Nuclear Information System (INIS)

    Recent advances in technology allow features like voice synthesis, voice and speech recognition, image understanding, and intelligent data base management to be incorporated in computer driven alarm and emergency management information systems. New software development environments make it possible to do rapid prototyping of custom applications. Three examples using these technologies are discussed. 1) Maximum use is made of high-speed graphics and voice synthesis to implement a state-of-the-art alarm processing and display system with features that make the operator-machine interface efficient and accurate. 2) An application generator which has the capability of ''building'' a specific alarm processing and display application in a matter of a few hours, using the site definition developed in the security planning phase to produce the custom application. 3) A software tool, is described which permits rapid prototyping of human-machine interfaces for a variety of applications including emergency management, alarm display and process information display

  19. Diabetes medications: Impact on inflammation and wound healing.

    Science.gov (United States)

    Salazar, Jay J; Ennis, William J; Koh, Timothy J

    2016-01-01

    Chronic wounds are a common complication in patients with diabetes that often lead to amputation. These non-healing wounds are described as being stuck in a persistent inflammatory state characterized by accumulation of pro-inflammatory macrophages, cytokines and proteases. Some medications approved for management of type 2 diabetes have demonstrated anti-inflammatory properties independent of their marketed insulinotropic effects and thus have underappreciated potential to promote wound healing. In this review, the potential for insulin, metformin, specific sulfonylureas, thiazolidinediones, and dipeptidyl peptidase-4 inhibitors to promote healing is evaluated by reviewing human and animal studies on inflammation and wound healing. The available evidence indicates that diabetic medications have potential to prevent wounds from becoming arrested in the inflammatory stage of healing and to promote wound healing by downregulating pro-inflammatory cytokines, upregulating growth factors, lowering matrix metalloproteinases, stimulating angiogenesis, and increasing epithelization. However, no clinical recommendations currently exist on the potential for specific diabetic medications to impact healing of chronic wounds. Thus, we encourage further research that may guide physicians on providing personalized diabetes treatments that achieve glycemic goals while promoting healing in patients with chronic wounds. PMID:26796432

  20. Gunshot Wound Contamination with Squirrel Tissue: Wound Care Considerations

    Directory of Open Access Journals (Sweden)

    Porter W. Maerz

    2014-01-01

    Full Text Available While report of animal bites contaminating wounds is reported commonly, direct wound contamination with squirrel flesh has never been reported in the literature. The patient suffered an accidental self-inflicted gunshot wound that drove squirrel flesh and buck shot deep within his right buttock. This case outlines his hospital course and wound treatment. The patient was treated with ten days of broad spectrum antibiotics, extensive debridement of the wound in the operating room, and further treatment of the wound with a vacuum dressing system. While squirrel tissue and buckshot had to be removed from the wound on day six of the hospital stay, the patient remained afebrile without signs or symptoms of systemic illness.

  1. Complex wounds Feridas complexas

    Directory of Open Access Journals (Sweden)

    Marcus Castro Ferreira

    2006-01-01

    Full Text Available Complex wound is the term used more recently to group those well-known difficult wounds, either chronic or acute, that challenge medical and nursing teams. They defy cure using conventional and simple "dressings" therapy and currently have a major socioeconomic impact. The purpose of this review is to bring these wounds to the attention of the health-care community, suggesting that they should be treated by multidisciplinary teams in specialized hospital centers. In most cases, surgical treatment is unavoidable, because the extent of skin and subcutaneous tissue loss requires reconstruction with grafts and flaps. New technologies, such as the negative pressure device, should be introduced. A brief review is provided of the major groups of complex wounds-diabetic wounds, pressure sores, chronic venous ulcers, post-infection soft-tissue gangrenes, and ulcers resulting from vasculitis.Ferida complexa é uma nova definição para identificar aquelas feridas crônicas e algumas agudas já bem conhecidas e que desafiam equipes médicas e de enfermagem. São difíceis de serem resolvidas usando tratamentos convencionais e simples curativos. Têm atualmente grande impacto sócio-econômico. Esta revisão procura atrair atenção da comunidade de profissionais de saúde para estas feridas, sugerindo que devam ser tratadas por equipe multidisciplinar em centro hospitalar especializado. Na maioria dos casos o tratamento cirúrgico deve ser indicado, uma vez que a perda de pele e tecido subcutâneo é extensa, necessitando de reconstrução com enxertos e retalhos. Nova tecnologia, como uso da terapia por pressão negativa foi introduzido. Breves comentários sobre os principais grupos de feridas complexas: pé diabético, úlceras por pressão, úlceras venosas, síndrome de Fournier e vasculites.

  2. Comparison of negative pressure wound therapy (NPWT) &conventional wound dressings in the open fracture wounds

    OpenAIRE

    Arti, Hamidreza; Khorami, Mohsen; Ebrahimi-Nejad, Vahid

    2016-01-01

    Objective: Successful closure is a primary step of treatment in open fracture wounds. Delayed healing or complications can lead to increased treatment duration, costs and disability rates. The aim of this study was to compare Negative Pressure Wound Therapy (NPWT) and conventional wound dressings in patients with open fracture wounds. Methods: In a prospective randomized clinical trial study, 90 patients with open fractures that were referred for treatment were enrolled between February 2013 ...

  3. Development of advanced techniques for life management and inspection of advanced heavy water reactor (AWHR) coolant channel components

    International Nuclear Information System (INIS)

    Operating life of pressure tubes of Pressurized Heavy Water Reactor (PHWR) is limited due to the presence of various issues associated with the material like hydrogen pick up, delayed hydride cracking, axial elongation and increase in diameter due to irradiation creep and growth. Periodic monitoring of the health of the pressure tube under in-situ conditions is essential to ensure the safe operation of the reactor. New designs of reactor call for innovative design philosophy, modification in fabrication route of pressure tube, development of reactor specific tools, both analytical and hardware for assessing the fitness for service of the pressure tube. Feedback from existing reactors has enhanced the understanding about life limiting parameters. This paper gives an insight into the life limiting issues associated with pressure tube and the efforts pursued for development of life management techniques for coolant channel of Advanced Heavy Water Reactor (AHWR) designed in India. The tools and techniques for in-situ property/hydrogen measurement, pulsed eddy current technique for zirconium alloy in-homogeneity characterization, horizontal shear wave EMAT system for dissimilar metal weld inspection, sliver sampling of vertical channel etc. are elaborated in the paper. (author)

  4. Advanced practice nursing for enduring health needs management: a global perspective.

    Science.gov (United States)

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. PMID:21839552

  5. Quo Vadis Radiotherapy? Technological Advances and the Rising Problems in Cancer Management

    Directory of Open Access Journals (Sweden)

    Barry J. Allen

    2013-01-01

    Full Text Available Purpose. Despite the latest technological advances in radiotherapy, cancer control is still challenging for several tumour sites. The survival rates for the most deadly cancers, such as ovarian and pancreatic, have not changed over the last decades. The solution to the problem lies in the change of focus: from local treatment to systemic therapy. The aim of this paper is to present the current status as well as the gaps in radiotherapy and, at the same time, to look into potential solutions to improve cancer control and survival. Methods. The currently available advanced radiotherapy treatment techniques have been analysed and their cost-effectiveness discussed. The problem of systemic disease management was specifically targeted. Results. Clinical studies show limited benefit in cancer control from hadron therapy. However, targeted therapies together with molecular imaging could improve treatment outcome for several tumour sites while controlling the systemic disease. Conclusion. The advances in photon therapy continue to be competitive with the much more expensive hadron therapy. To justify the cost effectiveness of proton/heavy ion therapy, there is a need for phase III randomised clinical trials. Furthermore, the success of systemic disease management lies in the fusion between radiation oncology technology and microbiology.

  6. Multidisciplinary management of the locally advanced unresectable non-small cell lung cancer

    International Nuclear Information System (INIS)

    locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report

  7. Moist wound care using advanced dressings

    OpenAIRE

    Cegnar, Mateja; Baumgartner, Saša; Kristl, Julijana

    2015-01-01

    Pomemben dosezek na podroèju celjenja ran predstavlja koncept vlazne oskrbe. Uporabo vatirancev in gaz zamenjujejo novi naravni in sintezni biomateriali, ki so glede na fizikalno, kemijsko in tehnolosko obdelavo sposobni vzdrzevati ustrezno vlaznost na rani, vpijati presezen izloèek iz nje ali hidratirati zasuseno nekrozo. Poleg oblog s sposobnostjo vzdrzevanja vlaznosti razvijajo tudi obloge, s katerimi lahko aktivno posegajo v biokemiène procese na rani, kar pomaga pri celjenju. Z oblogami ...

  8. Common questions about wound care.

    Science.gov (United States)

    Worster, Brooke; Zawora, Michelle Q; Hsieh, Christine

    2015-01-15

    Lacerations, abrasions, burns, and puncture wounds are common in the outpatient setting. Because wounds can quickly become infected, the most important aspect of treating a minor wound is irrigation and cleaning. There is no evidence that antiseptic irrigation is superior to sterile saline or tap water. Occlusion of the wound is key to preventing contamination. Suturing, if required, can be completed up to 24 hours after the trauma occurs, depending on the wound site. Tissue adhesives are equally effective for low-tension wounds with linear edges that can be evenly approximated. Although patients are often instructed to keep their wounds covered and dry after suturing, they can get wet within the first 24 to 48 hours without increasing the risk of infection. There is no evidence that prophylactic antibiotics improve outcomes for most simple wounds. Tetanus toxoid should be administered as soon as possible to patients who have not received a booster in the past 10 years. Superficial mild wound infections can be treated with topical agents, whereas deeper mild and moderate infections should be treated with oral antibiotics. Most severe infections, and moderate infections in high-risk patients, require initial parenteral antibiotics. Severe burns and wounds that cover large areas of the body or involve the face, joints, bone, tendons, or nerves should generally be referred to wound care specialists. PMID:25591209

  9. Management of contaminated and dirty surgical wounds with different local treatment modalities Manejo de heridas quirúrgicas contaminadas y sucias con cuatro modalidades de tratamiento local

    Directory of Open Access Journals (Sweden)

    Luis E. Rolong

    1990-01-01

    Full Text Available

    Between March and November 1986 we studled 216 men with potentially infected surgical wounds (either contaminated or diny. For the purpose of local treatment they were allocated to one of 4 groups, namely: 1 pressure irrigation with saline solution; 2 lodo-povidone solution; 3 application of panela (unrefined brown sugar; 4 no local treatment. infection indexes were 18% and 25% in patients with contaminated and diny wounds respectively; no differences attributable to the local treatment procedure were found. infection index was significantly lower In the following circumstances: a In patients that received antibiotics both before and after the operation; b In those with culture results that were either negative or lower than 105 bacteria per gram of tissue.

     

    Frequency of positive wound cultures was significantly lower in patients with saline pressure irrigation as compared to those treated with panela or left without treatment. However, the frequency of clinical evidences of infection was similar In the 4 groups. In patients with negative cultures late primary closure was achieved in 95% of the cases; the corresponding figure for those with positive results (but under 105 bacteria per gram was 56%. We conclude that pressure Irr1gatlon of the wound with saline solution is advantageous in relation to the other methods employed in this study.

    En el período comprendido entre marzo y noviembre de 1986 se estudiaron en el Servicio de Cirugía General del Hospital Universitario San Vicente de Paúl (HUSVP de Medellín, 216 pacientes de sexo masculino, con heridas quirúrgicas potencialmente Infectadas, clasificadas como sucias o contaminadas

  10. Dermal Fenestration With Negative Pressure Wound Therapy: A Technique for Managing Soft Tissue Injuries Associated With High-Energy Complex Foot Fractures.

    Science.gov (United States)

    Poon, Henrietta; Le Cocq, Heather; Mountain, Alistair J; Sargeant, Ian D

    2016-01-01

    Military casualties can sustain complex foot fractures from blast incidents. This frequently involves the calcaneum and is commonly associated with mid-foot fracture dislocations. The foot is at risk of both compartment syndrome and the development of fracture blisters after such injuries. The amount of energy transfer and the environment in which the injury was sustained also predispose patients to potential skin necrosis and deep infection. Decompression of the compartments is a part of accepted practice in civilian trauma to reduce the risk of complications associated with significant soft tissue swelling. The traditional methods of foot fasciotomy, however, are not without significant complications. We report a simple technique of dermal fenestration combined with the use of negative pressure wound therapy, which aims to preserve the skin integrity of the foot without resorting to formal fasciotomy. PMID:26443232

  11. Contact dermatitis presenting as non-healing wound: case report

    OpenAIRE

    Leelavathi M; Le YY; Tohid H; Hasliza AH

    2011-01-01

    Abstract Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-def...

  12. Burn Wound Cleansing - A Myth or a Scientific Practice

    OpenAIRE

    Hayek, S; El Khatib, A.; Atiyeh, B.

    2010-01-01

    Burn wound cleansing is an integral step in every wound management protocol. Yet a lot of this practice is based on myth rather than real scientific basis. The literature is poor in scientific papers comparing the outcome of patients who underwent wound cleansing to those who did not. A survey form was designed by the Mediterranean Council for Burns and Fire Disasters - MBC and sent by e-mail to its members as well as members of the European Burn Association and other burn specialists, and 76...

  13. Advances in the management of MS symptoms: recently proposed clinical management algorithms.

    Science.gov (United States)

    Vermersch, Patrick

    2015-01-01

    Guidelines from both the German and Spanish Neurology Societies for managing patients with multiple sclerosis (MS) spasticity emphasize the importance of setting clear objectives and use evidence levels and grades to support their recommendations. Swedish guidelines for MS spasticity also reflect the need to establish treatment aims and recommend use of validated scales to measure symptom changes. Treatment of generalized MS spasticity, beyond physiotherapy, tends to begin with baclofen, tizanidine and/or diazepam, adding Sativex (THC:CBD) oromucosal spray for moderate-to-severe cases. The European Federation of Neurological Societies/European Academy of Neurology Taskforce on Spasticity in Multiple Sclerosis is currently reviewing the literature supporting the pharmacological treatment of MS spasticity and aims to publish recommendations in the near future to guide clinicians in their treatment choices. PMID:26611268

  14. Critical review of controversial issues in the management of advanced pediatric liver tumors.

    Science.gov (United States)

    Gupta, Abha A; Gerstle, J Ted; Ng, Vicky; Wong, Ansely; Fecteau, Annie; Malogolowkin, Marcio H; Meyers, Rebecka L; Grant, David; Grant, Ronald M

    2011-07-01

    Hepatocellular carcinoma (HCC) and hepatoblastoma (HB) are the most common primary tumors of liver in children. The management of patients with locally advanced, unresectable disease or those with extra-hepatic distant metastases provides substantial challenges to pediatric oncologists, hepatologists, and surgeons. Herein, we critically debate the two sides of three specific controversies: (1) the role of chemotherapy in the treatment of advanced pediatric HCC; (2) the indications for liver transplantation in children with HCC, specifically, the appropriateness of using adult Milan criteria; and (3) the role of liver trasplantation in children with unresectable HB that present with metastatic disease. Pediatr Blood Cancer 2011;56:1013-1018. © 2010 Wiley-Liss, Inc. PMID:21488153

  15. 10 CFR 830 Major Modification Determination for the Advanced Test Reactor Remote Monitoring and Management Capability

    Energy Technology Data Exchange (ETDEWEB)

    Bohachek, Randolph Charles [Idaho National Laboratory (INL), Idaho Falls, ID (United States)

    2015-09-01

    The Advanced Test Reactor (ATR; TRA-670), which is located in the ATR Complex at Idaho National Laboratory, was constructed in the 1960s for the purpose of irradiating reactor fuels and materials. Other irradiation services, such as radioisotope production, are also performed at ATR. While ATR is safely fulfilling current mission requirements, assessments are continuing. These assessments intend to identify areas to provide defense–in-depth and improve safety for ATR. One of the assessments performed by an independent group of nuclear industry experts recommended that a remote accident management capability be provided. The report stated that: “contemporary practice in commercial power reactors is to provide a remote shutdown station or stations to allow shutdown of the reactor and management of long-term cooling of the reactor (i.e., management of reactivity, inventory, and cooling) should the main control room be disabled (e.g., due to a fire in the control room or affecting the control room).” This project will install remote reactor monitoring and management capabilities for ATR. Remote capabilities will allow for post scram reactor management and monitoring in the event the main Reactor Control Room (RCR) must be evacuated.

  16. 10 CFR 830 Major Modification Determination for the Advanced Test Reactor Remote Monitoring and Management Capability

    International Nuclear Information System (INIS)

    The Advanced Test Reactor (ATR; TRA-670), which is located in the ATR Complex at Idaho National Laboratory, was constructed in the 1960s for the purpose of irradiating reactor fuels and materials. Other irradiation services, such as radioisotope production, are also performed at ATR. While ATR is safely fulfilling current mission requirements, assessments are continuing. These assessments intend to identify areas to provide defense–in-depth and improve safety for ATR. One of the assessments performed by an independent group of nuclear industry experts recommended that a remote accident management capability be provided. The report stated that: 'contemporary practice in commercial power reactors is to provide a remote shutdown station or stations to allow shutdown of the reactor and management of long-term cooling of the reactor (i.e., management of reactivity, inventory, and cooling) should the main control room be disabled (e.g., due to a fire in the control room or affecting the control room).' This project will install remote reactor monitoring and management capabilities for ATR. Remote capabilities will allow for post scram reactor management and monitoring in the event the main Reactor Control Room (RCR) must be evacuated.

  17. Diabetic cornea wounds produce significantly weaker electric signals that may contribute to impaired healing.

    Science.gov (United States)

    Shen, Yunyun; Pfluger, Trisha; Ferreira, Fernando; Liang, Jiebing; Navedo, Manuel F; Zeng, Qunli; Reid, Brian; Zhao, Min

    2016-01-01

    Wounds naturally produce electric signals which serve as powerful cues that stimulate and guide cell migration during wound healing. In diabetic patients, impaired wound healing is one of the most challenging complications in diabetes management. A fundamental gap in knowledge is whether diabetic wounds have abnormal electric signaling. Here we used a vibrating probe to demonstrate that diabetic corneas produced significantly weaker wound electric signals than the normal cornea. This was confirmed in three independent animal models of diabetes: db/db, streptozotocin-induced and mice fed a high-fat diet. Spatial measurements illustrated that diabetic cornea wound currents at the wound edge but not wound center were significantly weaker than normal. Time lapse measurements revealed that the electric currents at diabetic corneas lost the normal rising and plateau phases. The abnormal electric signals correlated significantly with impaired wound healing. Immunostaining suggested lower expression of chloride channel 2 and cystic fibrosis transmembrane regulator in diabetic corneal epithelium. Acute high glucose exposure significantly (albeit moderately) reduced electrotaxis of human corneal epithelial cells in vitro, but did not affect the electric currents at cornea wounds. These data suggest that weaker wound electric signals and impaired electrotaxis may contribute to the impaired wound healing in diabetes. PMID:27283241

  18. Activity of mesenchymal stem cells in therapies for chronic skin wound healing

    OpenAIRE

    Nuschke, Austin

    2013-01-01

    Chronic or non-healing skin wounds present an ongoing challenge in advanced wound care, particularly as the number of patients increases while technology aimed at stimulating wound healing in these cases remains inefficient. Mesenchymal stem cells (MSCs) have proved to be an attractive cell type for various cell therapies due to their ability to differentiate into various cell lineages, multiple donor tissue types, and relative resilience in ex-vivo expansion, as well as immunomodulatory effe...

  19. Shedding Light on a New Treatment for Diabetic Wound Healing: A Review on Phototherapy

    OpenAIRE

    Houreld, Nicolette N.

    2014-01-01

    Impaired wound healing is a common complication associated with diabetes with complex pathophysiological underlying mechanisms and often necessitates amputation. With the advancement in laser technology, irradiation of these wounds with low-intensity laser irradiation (LILI) or phototherapy, has shown a vast improvement in wound healing. At the correct laser parameters, LILI has shown to increase migration, viability, and proliferation of diabetic cells in vitro; there is a stimulatory effect...

  20. Establishment of team work system for advanced spent fuel management process

    International Nuclear Information System (INIS)

    The advanced spent fuel management process (ASFMP), which is being developed by KAERI, is now in the 2nd research phase. This phase has a goal to design the total system of active demonstration of ASFMP. It is composed of the core process, remote handling technologies, examination technologies and experimental facilities. For the collaboration of these research fields, a team work system has been established by proper hardware and software selections for use of about 50 project members. This system has been tested by adaptation to the ASFMP project and will be used during the remained project period