Im Gemeindegebiet von Holzwickede (Kreis Unna, Nordrhein-Westfalen) wachsen derzeit fünf verschiedene Orchideen-Sippen. Die bei weitem Häufigste ist die Breitblättrige Stendelwurz (Epipactis helleborine), von der mehr als 1300 Pflanzen gefunden wurden und die als typische Orchidee des Siedlungsraums bezeichnet werden kann. Das Fuchs' Knabenkraut (Dactylorhiza fuchsii) wächst heute nicht mehr in der Naturlandschaft, sondern nur noch an zwei Orten in Zierrasen in Privatgärten im Siedlungsraum. ...
Fernandez-Flores, Angel; Sanchez-Velicia, Laura; Manjon, Juan A; Alija, Antonio; Soto, Francisco
Unna and Miescher nevi show very different morphologic features. The main difference is that melanocytes involve mainly the papillary dermis in Unna nevi, whereas they widely penetrate the reticular dermis in Miescher nevi. The reason for this behavior is not totally understood, but anatomical location might play a role, since because Unna nevi are mainly found on the trunk, whereas Miescher nevi are mainly found on the face. We decided to test this hypothesis in relative easy way: dermis from the frontal, temporal, maxillary, and mandibullary regions derives from the neural crest, whereas the dermis of the parietal/occipital regions originates from the paraxial mesoderm (somites and somitomeres). Therefore, we studied the morphology of 137 acquired melanocytic nevi from the head and neck and classified their locations in 7 areas: occipital, temporal, parietal, frontal, face, high neck, and low neck. From such areas, we distinguished 4 groups: area A (parietal + occipital + low neck); area B (face + temporal + frontal + high neck); area 1 (parietal and occipital); and area 2 (temporal and frontal). In region A, 97.30% of the nevi were of Unna type. In region B, 89.00% were of Miescher type. Region A had 76.60% of Unna type nevi, whereas region B had 98.89% of Miescher nevi. In area 1, 100% of the nevi were of Miescher type. In area 2, 86.67% of the nevi were of Unna type. Region 1 had 86.67% of the cranial Unna nevi, whereas region 2 had 100% of the cranial Miescher nevi. Moreover, 90.9% of the nevi from the low neck were of Unna type. In the high neck, 20% of nevi were of Unna type. Finally, 90.90% of Unna nevi were in the low neck, whereas 80% of Miescher nevi were in the high neck. We concluded that these findings supported the hypothesis that the embryologic differences of these areas of head and neck might play a role in the morphology of Unna and Miescher nevi.
Baptista, Cleide Maria Caetano; Castilho, Valéria
Aims was to identify the social-demographic characteristics and the lesions of patients with venous ulcer (VU), as well as to estimate the total direct cost of materials and nursing personnel necessary for the procedure with unna boot, by the average total direct cost (ATDC) and the observed cost (OTDC). The theoretical referential adopted for cost calculation was the costing system by absorption of procedure or product. This study was conducted at the University Hospital of Sao Paulo Univers...
Salome, G M; de Brito, M J A; Ferreira, L M
To assess self-esteem in patients with venous leg ulcers treated with Unna's boot. • A descriptive, analytic, clinical study was conducted from June 2010 to May 2011 in an outpatient wound care clinic in São Paulo, Brazil. Patients of both sexes, aged ≥18 years, who had had a venous leg ulcer for more than one year and a Doppler ankle brachial index ranging from 0.8-1.0 were consecutively selected for inclusion. Patients were treated with wound dressings and Unna's boot. Self-esteem was assessed using the Brazilian version of the Rosenberg Self-Esteem Scale (RSE) at inclusion (baseline) and after 4, 8, and 12 months of compression therapy using Unna's boot. The scale is reverse-scored; thus lower scores indicate higher levels of self-esteem. • The patients showed a slight but significant improvement in self-esteem after 4 months of treatment (mean RSE score=17.12) compared with baseline (mean RSE score=24.90). However, a marked and significant improvement in self-esteem was observed after 8 months (mean RSE score=7.40) and 12 months (mean RSE score=2.10) of compression therapy using Unna's boot. • Patients with venous leg ulcers treated with Unna's boot for 12 months showed a significant improvement in self-esteem • All authors declare that no competing financial interests exist. There was no external funding for this study.
Cost survey of procedure with Unna boot in patients with venous ulcer Levantamento del costo del procedimiento com bota de Unna en pacientes com úlcera venosa (UV Levantamento do custo do procedimento com bota de Unna em pacientes com úlcera venosa
Cleide Maria Caetano Baptista
Full Text Available Aims was to identify the social-demographic characteristics and the lesions of patients with venous ulcer (VU, as well as to estimate the total direct cost of materials and nursing personnel necessary for the procedure with unna boot, by the average total direct cost (ATDC and the observed cost (OTDC. The theoretical referential adopted for cost calculation was the costing system by absorption of procedure or product. This study was conducted at the University Hospital of Sao Paulo University (HU Ambulatory. The sample was constituted by 65 procedures in nine patients with VU. The results show that the predominant age groups were 49 to 56 years (33,33% and 65 to 72 years (33,33%, in female patients (77,78%. Regarding associated diseases, there was a predominance of Systemic Arterial Hypertension (33,33% and Diabetes Mellitus (22,22%. The ATDC was R$ 107,99 and the OTDC was R$ 96,47.El objetivo fue identificar características sócio-demográficas y de las lesiones de los pacientes con úlcera venosa (UV, y calcular el costo total directo de los materiales y de personal de enfermería utilizados en del procedimiento con bota de unna, por el costo total directo medio (CTDM y por lo observado (CTDO. El referencial teórico adoptado para la medición de los costos fue el sistema de costeo por absorción por procedimiento o producto. El estudio fue realizado en el Consultorio Externo el Hospital Universitario de la Universidad de Sao Paulo (HUUSP. La muestra fue constituida por 65 procedimientos en nueve pacientes con UV. Los resultados muestran que la faja etária predominante fue 49 a 56 años (33,33% y de 65 a 72 años (33,33% y del sexo femenino (77,78%. Cuanto a la enfermedad asociada, hubo predominio de Hipertensión Arterial Sistemática (33,33% y Diabetes Mellitus (22,22%. El CTDM fue de R$ 107,99 y el CTDO fue de R$ 96,47.O objetivo foi identificar características sociodemográficas e das lesões dos pacientes com úlcera venosa (UV e
Full Text Available Marie-Unna hereditary hypotrichosis: case report and review of the literature. ... ...U2HR mutation in the family from the original 1925 report. ... JOURNAL ... J Am Acad Dermatol 64:e45-50 (2011) DOI:10.1016/j.jaad.2010.06.013
Ryan, T J
Both wound healing and lymphedema have fibrosis of the skin in common. They also share destruction of elastin by elastases from neutrophils as a significant feature. These are not new observations, and the writings of Unna and Kaposi are recalled. The contemporary observations on elastin by Gerli and his team are discussed in the light of these much earlier opinions.
Fargen, Kyle M; Mocco, J; Spiotta, Alejandro M; Rai, Ansaar; Hirsch, Joshua A
No studies have sought to provide a quantitative or qualitative critique of research in the field of neurointerventional surgery. To analyze recent publications from the Journal of Neurointerventional Surgery ( JNIS ) to test a new method for assessing research and collaboration. We reviewed all JNIS Online First publications from 25 February 2015 to 24 February 2016. All publications-human or non-human research, systematic reviews, meta-analyses, or literature reviews-were included; editorials and commentaries were excluded. For each publication, study design, number of patients, authors, contributing centers, and study subject were recorded. Level of evidence was defined using a new scale. A total of 206 articles met inclusion criteria. Only 4% were prospective studies. Twenty-eight per cent of scientific research featured patient series of nine or less. The majority of publications were categorized as low-level evidence (91%). Forty-seven per cent involved individuals from a single center, with 87% having collaboration from three or fewer centers. International collaboration was present in 19%. While 256 institutions from 31 countries were represented, 66% were represented in only one publication. We queried JNIS Online First articles from a 1-year period in a pilot study to test a new method of analyzing research quality and collaboration. The methodology appears to adequately quantify the studies into evidence tiers that emulate previously published, widely accepted scales. This may be useful for future comparison of peer-reviewed journals or for studying the quality of research being performed in different disease processes or medical specialties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Pereira,Bruno Emmanuel de Medeiros; Sousa,Alana Tamar Oliveira de; França,Jael Rúbia Figueiredo de Sá; Soares,Maria Júlia Guimarães Oliveira
Abstract: Evolution and cost of three types of compression therapy (single layer, multilayer and Unna boot) in patients with venous ulceration were compared. The evaluation lasted two months and used photographic records and instrument based on pressure ulcer scale for healing (PUSH). Treatment with monolayer compression therapy presented the lowest cost and more efficacy of the three types, with 82% savings compared with the multilayer therapy.
José Maria Pereira de Godoy
Full Text Available The aim of this study is to report the control of lymphorrhea in the intensive treatment of elephantiasis, using an Unna boot. The case of a 29-year-old female patient is reported. This young patient evolved with the more serious form of lymphedema, elephantiasis, after surgical treatment of an abdominal neoplasm and radiotherapy. Warty excrescences were present on both legs and genitalia where lymphorrhea was constant. The patient arrived at the Godoy's Clinic for treatment. She was weighed and perimetric evaluations were made at the start of treatment and thereafter every day during an intensive outpatient treatment of eight hours daily for three weeks. Treatment included manual lymph drainage, mechanical lymph drainage using the RA Godoy device, and the continuous use of compression stockings with adjustments made every three hours. An Unna boot was employed as compression at sites of dermal lesions (warty excrescences with overlapping use of individualized compression stockings that were individually adapted. The Unna boot was renewed every two days during the first week and every 3 days during the second and third weeks. By the end of this course of treatment, most of the warty excrescences had reduced in size or even disappeared and the lymphorrhea was controlled.
Kimura, Koji; Sawa, Akihiro; Akagi, Shinji; Kihira, Kenji
We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National Nosocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the current NNIS SSI rate, and the SSI rates and accumulated data can be exported electronically. Using this system, we monitored 798 patients in 24 operative procedure categories in the Digestive Organs Surgery Department of Mazda Hospital, Mazda Motor Corporation, from January 2004 through December 2005. The total number and rate of SSI were 47 and 5.89%, respectively. The SSI rates of 777 patients were calculated based on 15 operative procedure categories and Risk Index Categories (RIC). The highest SSI rate was observed in the rectum surgery of RIC 1 (30%), followed by the colon surgery of RIC3 (28.57%). About 30% of the isolated infecting bacteria were Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using quantification theory type 2, the American Society of Anesthesiology score (4.531), volume of hemorrhage under operation (3.075), wound classification (1.76), operation time (1.352), and history of diabetes (0.989) increased to higher ranks as factors for SSI. Therefore, we evaluated this system as a useful tool in safety control for operative procedures.
Before the era of microbiote, our ancestors patiently discovered, described and cultivated pathogens, including those responsible for dermatoses. The very well known ectoparasites were represented in the earliest books on cutaneous diseases at the end of XVIII(th) century and the first half of the XIX(th) century. Fungi were discovered in the 1840s, rapidly followed by numerous bacteria, including those causing tuberculosis and lepra. This article is illustrated by images that often showed for the first time parasites and bacteria in books dedicated to cutaneous diseases. Engravings and photographs from the books of Willan, Rayer and Hardy show accurate images of pathogens. Microscopic images can also be found in the textbooks of Simon, Leloir, Sabouraud, Unna and many others. Darier himself believed that "Darier's disease" was due to a parasite, which explains why he named his disease "Vegetant follicular psorospermosis". Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Alvaro Rodríguez Gama
Se encontrarán los lectores con una gran cantidad y calidad de biografías sobre investigaciones, médicos y científicos que han enfrentado el reto de tratar de entender y tratar el lupus, desde los médicos clásicos como Hipócrates, Galeno y Celso, los protodermatólogos Daniel Turner, Jean Astruc, Antoine Lorry y Josef von Plenk; el primer dematológo Robert Willam y médicos de los siglos XVIII y XIX como Thomas Bateman, Jean Lous Alibert, Theódore Biett, Olive Rayer, Pierre Cazenave, Antoine Bazin, Ferdinand von Hebra, Moriz Kaposi, Ernest Besnier, Alfred Fournier, Louis Brocq, Jean Darier, el clasificador Jonathan Hutchinson, Paul Unna, William Osler, Emanuel Libman, George Baehr y así decenas de colosos de la ciencia médica, cuyas historias son descritas minuciosamente por el Dr. Iglesias...
Tratamento de feridas: análise da produção científica publicada na Revista Brasileira de Enfermagem de 1970-2003 Tratamiento de heridas: análisis de la producción científica publicada en la Revista Brasileira de Enfermagem de 1970-2003 Wound treatment: scientific production analysis published in the Revista Brasileira de Enfermagem from 1970-2003
Ângela Lima Pereira
Full Text Available Esta revisão bibliográfica sistematizada teve como objetivo analisar a produção científica acerca da utilização de produtos no tratamento de feridas, publicada na REBEn de 1970 a 2003. Consultamos todos os números da revista publicados no período, identificando 41 artigos de interesse. Após leitura dos mesmos, incluímos na amostra 11 textos. Identificamos maior publicação na década de 1990, predominando autores da área assistencial, delineamento quase-experimental e de relato de experiência. Os produtos estudados foram papaína, própolis, açúcar, bota de Unna, carvão ativado, filme transparente, membrana amniótica, clara de ovo, colagenase, hidrocolóide, alginato de cálcio, pomadas antimicrobianas, ácidos graxos essenciais, fibras de viscose e poliéster. Os resultados encontrados denotam efeitos positivos da utilização dos produtos.Esta revisión bibliográfica sistematizada tuvo como objetivo analizar la producción científica respecto a la utilización de productos en el tratamiento de heridas, publicada en la REBEn de 1970 a 2003. Consultamos todos los números de la revista publicados en el periodo, identificando 41 artículos de interés. Después de la lectura de los mismos, incluimos en la nuestra 11 textos. Identificamos mayor publicación en la década del 1990, predominando autores del área asistencial, delineamiento casi-experimental y de relato de experiencia. Los productos estudiados fueron papaína, propolis, azúcar, bota de Unna, carbón activado, película transparente, membrana amniótica, albumina, colagenasa, hidrocolóide, alginato de calcio, ungüentos antimicrobianas, ácidos grasos esenciales, fibras de viscosa y poliéster. Los resultados encontrados denotan efectos positivos de la utilización de los productos.This systematic review aimed to analyze the scientific production concerning the use of products in the treatment of wounds, published by REBEn from 1970 to 2003. We consulted all
Full Text Available Venous ulcers of the lower limbs complicated by infection or chronicity represent a serious public health problem. The elevated number of those afflicted burdens the health services, interferes in quality of life and causes absenteeism. Although there are 2,500 items on the market, ranging from the simplest dressing up to the most complex types of dressing, treatment remains a challenge. Among the substances used, fibrin sealant is the one that promotes diminution of bacterial colonization and of edema, controls hemorrhaging, alters the pain threshold by protecting the nerve endings, hydrates the wound bed and forms granulation tissue that favors healing. Its disadvantages include higher cost and utilization of human fibrinogen that can transmit infectious diseases. The Center for the Study of Venoms and Venomous Animals (CEVAP at São Paulo State University (UNESP developed a new sealant made up of fibrinogen extracted from large animals and from an enzyme obtained from snake venom. The present study, developed in the Health Education Clinic (CEPS of Sacred Heart University (USC aimed to evaluate the effect of the new sealant on the healing process of venous ulcers in 24 adult patients, seven of whom were male and 17 female. Two study groups were formed as follows: Group 1 (G1 - control group of 11 patients treated with essential fatty acid (EFA and Unna's boot, and Group 2 (G2 - 13 patients treated with essential fatty acid (EFA, fibrin sealant and Unna's boot. The follow-up lasted eight weeks and the sealant was applied at only the first and fourth weeks. The results showed that Group 2 presented worse lesion conditions as to healing, but, when comparing the two groups, it was noteworthy that the the sealant was effective in healing venous ulcers. There is evidence that the new sealant is recommended for leg ulcers with the following advantages: ease of application, preparation of the wound bed, diminution of pain and a higher number of
Comparison Between a New, Two-component Compression System With Zinc Paste Bandages for Leg Ulcer Healing: A Prospective, Multicenter, Randomized, Controlled Trial Monitoring Sub-bandage Pressures.
Mosti, Giovanni; Crespi, Aldo; Mattaliano, Vincenzo
Compression therapy is standard treatment for venous leg ulcers. The authors prefer multi-layer, multi-component, stiff, high-pressure bandages to treat venous leg ulcers. The Unna boot (UB) is an example of this type of bandage. The aim of this study was to compare the effectiveness and tolerability of UB to a new, two-component bandage. One hundred (100) patients with venous ulcers were randomized into two groups: group A (n = 50) received UB and group B (n = 50) 3M™ Coban™ 2 Layer Compression System (C2L). All patients were followed weekly for 3 months and then monthly until complete healing was achieved. The primary outcomes were: ulcer healing or surface reduction; pain; and exudate control. The secondary outcomes were: ease of application and removal of the bandage, pressure exerted in the supine and standing position after application and before removal, and bandage comfort. C2L was associated with 100% ulcer healing; 47 out of 50 cases healed within the first 3 months after application of the bandage. Compared with the UB, there was no statistically significant difference. In both groups the effect of compression on pain and overall well being was excellent; pain decreased by 50% within 1-2 weeks and remained low throughout the duration of treatment and overall well being improved significantly. There was no significant difference between the two systems concerning level of comfort. C2L proved to be effective in treating venous ulcers due to its stiffness and pressure. Its effectiveness was similar to UB, which is often considered the gold-standard compression device for venous ulcers. This fact, in combination with high tolerability and ease of application and removal, make this new bandage particularly suitable for the treatment of venous leg ulcers. .
Lima, Leandro; Sinaimeri, Blerina; Sacomoto, Gustavo; Lopez-Maestre, Helene; Marchet, Camille; Miele, Vincent; Sagot, Marie-France; Lacroix, Vincent
compared to other transcriptome evaluation methods is that we use only the topology of the DBG, and not read nor coverage information. We show that our simple method gives better results than Rsem-Eval (Li et al. in Genome Biol 15(12):553, 4) and TransRate (Smith-Unna et al. in Genome Res 26(8):1134-1144, 5) on both real and simulated datasets for detecting chimeras, and therefore is able to capture assembly errors missed by these methods.
effekt på arealbruk, aktivitetsskifter, vaktsomhetsatferd, og rastløshetsatferd i form av løp, gange og ståing for tamrein i innhegning. I en 450 m lang innhegning på 8 hektar som var plassert tett opp til en vindmølle, ble fem forskjellig grupper av reinsdyr manipulert ved å slå vindmøllerotoren av og på. Reinsdyrene i innhegningen ved vindmøllen ble sammenlignet med reinsdyr i en kontrollinnhegning som var uten påvirkning fra vindmøller. Når reinsdyrene ble utsatt for vindmøllerotoren i bevegelse, viste to grupper av dyr et skifte i arealbruk til områder av innhegningen som var lenger unna møllen, to grupper av dyr viste ikke noe skifte i arealbruk, mens en gruppe dyr beveget seg nærmere vindmøllen. Sammenligning av atferden hos reinsdyrene i vindmølleinnhegningen og kontrollinnhegningen viste ingen systematisk forskjell som kunne indikere frykt eller stress som en effekt av vindmøllen eller rotorbevegelsen. Vi konkluderer med at tamrein i innhegning ikke viser negative atferdsresponser og viser lite eller ingen reduksjon i arealbruken tett opp til en vindmølle. Muligheten for at det skjer en rask tilvenning i en liten innhegning der dyrene er i kontinuerlig påvirkning av vindmøllen betyr at effekter på arealbruk bør studeres i et større arealperspektiv eller på frittgående rein.
Mousa, Albeir Y; Broce, Mike; Yacoub, Michael; AbuRahma, Ali F
Treatment of venous ulcers is demanding for patients, as well as clinicians, and the investigation of underlying venous hypertension is the cornerstone of therapy. We propose that occult iliac vein stenosis should be ruled out by iliac vein interrogation (IVI) in patients with advanced venous stasis. We conducted a systematic retrospective analysis of a consecutive series of patients who presented with CEAP (clinical, etiological, anatomical, and pathophysiological) 6 venous disease. All patients had great saphenous vein ablation, compressive treatment, wound care (including Unna boot compression), and perforator closure using ablation therapy. Iliac vein stenosis was defined as ≥50% stenosis in cross-sectional surface area on intravascular ultrasound. Primary outcomes include time of venous ulcer healing and/or measurable change in the Venous Clinical Severity Score. Twenty-two patients with CEAP 6 venous disease met the inclusion criteria (active ulcers >1.5 cm in diameter). The average age and body mass index were 62.2 ± 9.2 years and 41.7 ± 16.7, respectively. The majority were female (72.7%) with common comorbidities, such as hyperlipidemia (54.5%), hypertension (36.4%), and diabetes mellitus (27.3%). Twenty-nine ulcers with an average diameter of 3.4 ± 1.9 cm and a depth of 2.2 ± 0.5 mm were treated. The majority of the ulcers occurred on the left limb (n = 17, 58.6%). Average perforator venous reflux was 3.6 ± 0.8 sec, while common femoral reflux was 1.8 ± 1.6. The majority (n = 19, 64.5%) of the perforator veins were located at the base of the ulcer, while the remainder (n = 10, 34.5%) were within 2 cm from the base. Of the 13 patients who underwent IVI, 8 patients (61.5%) had stenosis >50% that was corrected with iliac vein angioplasty and stenting (IVAS). There was a strong trend toward shorter healing time in the IVI group (7.9 ± 9.5 weeks) than for patients in the no iliac vein interrogation (NIVI) group (20.2 ± 15
C. Magarinos Torres
Full Text Available Resulta das descripções e documentos examinados que as inclusões cytoplasmaticas da variola vera, no material humano examinado, apresentam caracteres geraes que poderão ser assim resumidos: 1. intensa coloração pela safranina nos preparados pelo methodo de Unna modificado (Fig. 42, mostrando a inclusão matiz semelhante ao dos nucleolos da mesma cellula. 2. reacção predominantemente acidophila nos preparados pela hematoxylina-eosina, traduzida pela tonalidade rosea ou vermelha de coloração (Figs. 27, 29, 30, 31 e 31. 3. frequente multiplicidade de inclusões de fórma e dimensões variadas na mesma cellula (Figs. 29 e 30, as maiores inclusões (Figs. 29 e 32, sendo menores que as grandes inclusões cytoplasmaticas solitarias do alastrim (Figs. 15, 16 e 18. É a regra, ainda, observar-se desapparecimento de qualquer estructura no cytoplasma das cellulas com inclusões em zona muito extensa, tornando-se difficil explicar tal aspecto unicamente pela retracção das inclusões no acto da fixação (Figs. 31 e 32. Quanto ás inclusões intranucleares, ellas se apresentam sob tres aspectos, dois dos quaes bem reconhecidos por Luger e Lauda (1926. Em um primeiro aspecto, o nucleo conserva, em parte, o reticulo de linina e encerra uma massa irregular (Fig. 35 ou, então, pequenas massas e granulos de dimensões variaveis (Figs. 33 e 34 constituidos por material acidophilo que ali não existe em condições normaes. A membrana nuclear tem espessura visinha do normal. Em um segundo aspecto, a inclusão occupa a totalidade do nucleoplasma (Fig. 3, apenas separado da membrana nuclear, em alguns casos (Fig. 38, por um estreito espaço claro (zona de retracção. Por vezes apresenta um aspecto homogeneo (Fig. 37; outras vezes a inclusão mostra pequenas areas chromophobas ( Fig. 38. A hyperchromatose da membrana nuclear é accentuada, tanto neste como no aspecto seguinte. No terceiro aspecto (aspecto corpuscular (Figs. 39, 40, 48 e 50, a inclus