WorldWideScience

Sample records for chronic non-specific ulcer

  1. Multiple chronic non-specific ulcer of small intestine characterized by anemia and hypoalbuminemia

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    A female patient with anemia and hypoalbuminemia was admitted to our hospital due to an over 20-year history of recurrent dizziness,fatigue and ankle edema.She was diagnosed as multiple chronic nonspecific ulcer of the small intestine characterized by non-specific histology and persistent gastrointestinal bleeding.

  2. Clinical and immunological features of chronic non-specific non-ulcerative colitis in infants.

    Directory of Open Access Journals (Sweden)

    Marushko RV

    2013-04-01

    Full Text Available Objective: To study the activity of cytokines for determination of their pathogenic role and effective action of the individual factors of the immune system in infants with chronic non&specific non&ulcerative colitis (CNNC. Patients and methods. It is studied 60 children in the age from 1 to 3 years with CNNC, who were under hospitalization. The control group consisted of 30 apparently healthy children of appropriate age. Immunological status of children was evaluated on the base of determination of cytokine concentration in the blood serum by the method of Enzyme-Immuno-Sorbent-Assay. Results. It is found that during the CNNC in infants and the concentration and ratio of the different groups of cytokines in the blood serum undergoes significant changes — increasing the concentration of pro&inflammatory cytokines (IL&1α, IL&6, IL&8, TNF-α and decreases the level of inflammatory cytokines (IL-4 is the IL-10, wherein the content growth factors is changing — by increased hepatocytes growth factor and reduced intestinal trefoil factor. Conclusions. Found changes of cytokines state can be regarded as a violation of the immunoregulatory mechanisms that is the basis of pathogenesis of the formation of a chronic inflammatory process in the infant's intestine.

  3. The radiographic appearances of non-specific small intestinal ulceration

    Energy Technology Data Exchange (ETDEWEB)

    Bryant, Thomas H.; Jackson, James E

    2002-02-01

    AIM: To determine the imaging characteristics of non-specific ulceration of the small intestine. MATERIALS AND METHODS: The radiographic investigations undertaken in three patients originally referred for visceral angiography in whom a histological diagnosis of non-specific ulceration of the small bowel was subsequently made were retrospectively reviewed. Two men and one woman aged from 17 to 24 years all presented with anaemia requiring blood transfusion. Visceral angiography was available for review in all three patients, abdominal computed tomography in two, and a small bowel enema and white cell scintigraphy in one. RESULTS: In all three patients an angiographic abnormality was present within the ileum consisting of irregularity of the vasa recta, an area of subtle increased vascularity and early venous return. A long, non-branching vessel interpreted as a persistent vitello-intestinal artery was seen in two of these patients. A CT abnormality was present in two individuals consisting of a focal area of thickened small bowel. The single small bowel enema demonstrated a focal stricture and the white cell scan showed localized accumulation of radioactivity within the pelvis. CONCLUSION: Non-specific small intestinal ulceration may produce abnormalities that are discernible on barium studies, computed tomography, radiolabelled white cell scanning and visceral angiography. Recognition of these findings may allow a pre-operative diagnosis of this condition. Bryant, T.H. and Jackson, J.E. (2001)

  4. Wenzhong Jianpi Method in Treating Chronic Peptic Ulcers and Chronic Non-specific Ulcerative Colitis%温中健脾法治疗慢性消化性溃疡及慢性非特异性溃疡性结肠炎临床研究

    Institute of Scientific and Technical Information of China (English)

    张乐乐; 耿雷

    2015-01-01

    目的:探讨温中健脾法治疗虚寒型慢性消化性溃疡及慢性非特异性溃疡的临床疗效。方法:将120例符合中医虚寒证的慢性消化性溃疡及慢性非特异性溃疡性结肠炎患者按1∶1随机分为治疗组60例和对照组60例。治疗组采用温中健脾饮治疗,慢性消化性溃疡采用雷尼替丁对照,慢性非特异性溃疡性结肠炎用柳氮磺吡啶肠溶片进行对照。疗程2个月。结果:中医证候总显效率为75.00%,总有效为83.33%,对照组分别为56.67%和75.00%。治疗组慢性非特异性溃疡性结肠炎疾病疗效评价的显效率为40%,总有效率73.33%,对照组分别为44.44%和80.95%,治疗组慢性消化性溃疡疗效总显效率为42.22%,总有效率73.33%,对照组分别为52.38%和80.95%,组间比较差异无统计学意义(P >0.05).结论:采用芪连片治疗慢性消化性溃疡及慢性非特异性溃疡疗效满意。%Objective:To discuss the clinical efficacy of the Wenzhong Jianpi (middle-warming,spleen-tonifying)method in chro-nic peptic ulcers and chronic non-specific ulcerative cases belonging to the pattern of Xuhan (deficiency-cold).Methods:We randomized 120 cases of Xuhan featured chronic peptic ulcers and chronic non-specific ulcerative colitis patients into a 1∶1 treat-ment group (60 cases)and a control group (60 cases).The treatment group used self-designed prescription Wenzhong Jianpi Yin,the control group adopted ranitidine or sulfasalazine (enteric coated tablets)respectively for a treatment course of two months.Results:For alleviating of TCMsyndrome symptoms,the treatment group had a total significant effective rate of 75.00%, and total effective rate of 83.33%;which were 56.67% and 75.00% of the control group.For treating chronic non-specific ulcer-ative colitis,the treatment group had a total significant effective rate of 40.00% and total effective rate of 73.33%;Control group was at 44.44% and

  5. Dr.Dong Demao's Experience in Treating Chronic Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    徐凌云

    2004-01-01

    @@ Chronic ulcerative colitis (chronic non-specific ulcerative colitis) is a kind of non-specific inflammation occurred in the colonic mucosa layers. As a lingering and troublesome condition that often attacks people aged 20-40, it is characterized by recurrent diarrhea, abdominal pain, pus- and mucus-stained stools in clinic.

  6. [Oral cavity microflora in patients with non-specific ulcerative colitis and Crohn's disease].

    Science.gov (United States)

    Kondrakova, O A; Muliar, E A; Voropaeva, E A; Babin, V N; Dubinin, A V; Briko, N I

    2009-01-01

    Results of study of microecological disorders in oral cavity of patients with non-specific ulcerative colitis (NSUC) and Crohn's disease (CD) and control subjects (patients with hypertension). Condition of mucosa was assessed on the basis of morphological data and electrophoretic mobility of cell nuclei, whereas structure of microbiocenosis and metabolic activity of microflora--on the basis of saliva bacterial culture and contents and profile of volatile fat acids in it. Detection rate of negative charge of the cell nuclei (decrease of functional activity of epithelium) was significantly higher in patients with NSUC and CD (66.6%) compared with controls (10%). This fact was directly related with hypercolonization of oral cavity by Gram-negative microflora. Lesions of mucosa which are characteristic of NSUC and CD and determined by pathologic immune mechanisms correlated with quantity of pathogenic microflora (Staphylococcus aureus and Candida). Marked differences of chromatograms' patterns were observed in patients with NSUC and CD indicating the suppression of anaerobic microflora in patients with CD and hypercolonization of oral cavity by anaerobic microflora in majority of patients with NSUC.

  7. Chronic non-specific low back pain; has cognitive behavioural therapy effect and

    OpenAIRE

    Hjermann, Mette Kristine

    2005-01-01

    Low back pain (LBP) presents a major public health problem. Half of the population will report acute LBP during the last year; approximately 80-90% is non-specific. Many will develop chronic / intermittent LBP and a part of these patients will become unable to maintain daily function and working life. Although non-specific chronic LBP is common, there is little knowledge of its cause and right treatment. In this paper the cognitive chronification process is seen together with newer neurobiolo...

  8. Epidemiological studies of the relationship between occupational exposures and chronic non-specific lung disease.

    NARCIS (Netherlands)

    Heederik, D.

    1990-01-01

    In this thesis the relationship between occupational exposures, lung function and Chronic Non-Specific Lung Disease is studied. The study comprises an epidemiological analysis of data from the British Pneumoconiosis Field Research among coal miners and an analysis of data gathered in the Zutphen

  9. The research of Proactive Coping Behavior of Patients with Chronic Non-Specific Lung Disease

    Directory of Open Access Journals (Sweden)

    Marija A. Yaroslavskaya

    2011-01-01

    Full Text Available The purpose of the research was to study the patterns of using proactive coping and adherences to it's different types in patients with chronic non-specifi c lung diseases. Participants of the study (N=180 were 30 to 60 years old. The Proactive Coping Inventory was used to assess the patients' psychological status. According to the results of the study patients with chronic non-specifi c lung diseases use dif-ferent types of proactive coping behavior while solving problematic and stressful situations. The research revealed that patients with bronchial asthma don't have the skills of independent decision making, definition of objectives, considering of options in solving conflicts or other inconvenient situations sufficiently developed. Patients with chronic obstructive pulmonary disease are less satisfied with the emotional support that they receive from their relatives and closest people, it's harder for them to reveal their feelings and emotions than for those who suffer from bronchial asthma and healthy ones. The results of the study may be useful in developing educational systems of proactive coping behavior skills for patients with chronic non-specific lung diseases for their health and well-being support.

  10. Acupuncture for Chronic Non-Specific Low Back Pain: A Case Series Study

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the efficacy of acupuncture in treating chronic non-specific low back pain. Methods: Ten patients with chronic low back pain were selected to receive 9 acupuncture treatments over a three-week period with point selection based on syndrome differentiation in Chinese medicine. The BROM Instrument for assessment of back range of motion; subjective evaluation with Visual Analog Scale of Pain (VASP) ratings, Oswestry Disability ratings, objective measurements including Algometry, and Flexion and Extension ratings to investigate the range of motion were used for comparing the large, medium and small effect sizes of baseline, treatment and follow-up phases. Results: Clinical significance of pain relief was shown in all parameters assessed. A large effect size was detected in VASP, Oswestry and Algometry. A small effect size was demonstrated in Flexion/Extension. Needling over short period time (3 weeks) could relieve the pain, but the muscular-skeletal function measured by BROM persists. To treat patients exclusively by needling for statistical purposes can not be justified, because by merely relieving pain, permanent improvement in function may not be achieved. Conclusion: Acupuncture offers an effective alternative for the clinical management of chronic low back pain, significant improvement in most of the parameters evaluated, but the functional improvement was not as satisfactory as pain relieving. Further study with larger sample size focuses on long-term efficacy and functional improvement for chronic low back pain is recommended.

  11. Bronchial hypersecretion, chronic airflow limitation, and peptic ulcer.

    Science.gov (United States)

    Kauffmann, F; Brille, D

    1981-11-01

    Men with and men without a history of peptic ulcers were compared using respiratory symptoms and spirographic measurements taken from data recorded in an epidemiologic study. Among the 1,049 men examined, 7% reported a history of peptic ulcer. A clear relationship appeared between bronchial hypersecretion and peptic ulcers. It persisted after adjustment for age, smoking habits, social class, and country of origin. Men with ulcers inhaled tobacco smoke more often. Ulcers, smoking, and chronic phlegm were independently related to a lower body build index. It seems that the relationship between smoking and ulcers was greater among men with chronic phlegm, and it is postulated that peptic ulcers and "chronic bronchitis" might be related to a "common secretory disorder." After adjustment for age, men with a history of peptic ulcers had, not a lower FEV1, but a higher vital capacity. A slightly lower FEV1/VC ratio cannot in such cases be considered as an index of chronic airflow limitation.

  12. A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain

    NARCIS (Netherlands)

    S.M. Rubinstein (Sidney); M. van Middelkoop (Marienke); T. Kuijpers (Ton); R.W.J.G. Ostelo (Raymond); A.P. Verhagen (Arianne); M.R. de Boer (Michiel Robert); B.W. Koes (Bart); M.W. van Tulder (Maurits)

    2010-01-01

    textabstractThe purpose of this systematic review was to assess the effects of spinal manipulative therapy (SMT), acupuncture and herbal medicine for chronic non-specific LBP. A comprehensive search was conducted by an experienced librarian from the Cochrane Back Review Group (CBRG) in multiple data

  13. Reduction of chronic non-specific low back pain: A randomised controlled clinical trial on acupuncture and baclofen

    Directory of Open Access Journals (Sweden)

    Rastqar Ali

    2010-04-01

    Full Text Available Abstract Background Chronic non-specific low back pain (LBP is a prevalent (80% and multi-dimensional illness. This study aims to test whether acupuncture, baclofen, or combined treatment with acupuncture and baclofen alleviates symptoms of non-specific chronic LBP in men. Methods Eight-four (84 men aged 50-60 years with non-specific chronic LBP were randomly assigned to four groups: the baclofen group received only baclofen (30 mg/day; the acupuncture group received only acupuncture at selected acupoints; the acupuncture + baclofen group received combined treatment with acupuncture and baclofen treatments; and the control group received no pain reduction treatment. After five weeks of treatment, visual analogue scale (VAS and self-reported pain disability with the Roland-Morris Disability Questionnaire (RDQ were conducted for outcome measures. Results After treatment, the baclofen, acupuncture and acupuncture + baclofen groups all had lower VAS and RDQ scores. Significantly higher reduction and improvement in VAS and RDQ scores were found in the acupuncture and acupuncture + baclofen groups compared to the baclofen group. Conclusion The present study indicates that the combined treatment of acupuncture and baclofen is more effective than baclofen treatment alone to reduce pain in patients with non-specific chronic LBP. Trial registration number ACTRN12609000698279

  14. Haemophilus ducreyi causing chronic skin ulceration in children visiting Samoa.

    Science.gov (United States)

    Ussher, James E; Wilson, Elizabeth; Campanella, Silvana; Taylor, Susan L; Roberts, Sally A

    2007-05-15

    Chancroid is a sexually transmitted infection associated with genital ulceration and lymphadenopathy caused by Haemophilus ducreyi. Localized skin infections, in the absence of genital lesions, have not been previously reported. We report 3 cases of lower limb ulceration in children caused by H. ducreyi and postulate that H. ducreyi may be a previously unrecognized cause of chronic skin ulceration.

  15. ANTIBODIES TO THE CYTOPLASM OF NEUTROPHILS: A MARKER OF UNFAVORABLE CLINICAL COURSE IN NON-SPECIFIC ULCERATIVE COLITIS

    Directory of Open Access Journals (Sweden)

    A. G. Kharitonov

    2010-01-01

    Full Text Available Antibodies to the cytoplasm of neutrophils (p-ANCA are detectable in 67% of patients with ulcerative colitis (UC. We have revealed typical clinical features of the patients with diagnostic p-ANCA titer, i.e., longer disease duration, prolonged fevers, and increased stool frequency. Moreover, thrombocytosis, leukocytosis and hypoalbuminemia are more common in this group. By endoscopic examination, mucosal ulcers of the colon are significantly more frequent in this group of patients. We have also noted higher rates of severe and relapsing cases among p-ANCA-positive patients. The data obtained allow us to suggest that the diagnostic titers of p-ANCA are predictive for unfavorable prognosis in UC.

  16. The effectiveness of isometric exercises as compared to general exercises in the management of chronic non-specific neck pain.

    Science.gov (United States)

    Khan, Muhammad; Soomro, Rabail Rani; Ali, Syed Shahzad

    2014-09-01

    To evaluate the effectiveness of isometric exercises as compared to general exercises in chronic non-specific neck pain. For this randomised controlled trial total 68 patients (34 each group) with chronic non-specific neck pain were recruited from Alain Poly Clinic and Institute of Physical Medicine & Rehabilitation Dow University of Health Sciences, Karachi between May, 2012 and August, 2012. Simple randomisation method was used to assign participants into isometric exercise group and general exercise groups. The isometric exercise group performed exercises for neck muscle groups with a rubber band and general exercises group performed active range of movement exercises for all neck movements. Patients in both groups received 3 supervised treatment sessions per week for 12 weeks. Visual Analogue Scale (VAS), North wick Park Neck Pain Questionnaire and goniometer were used to assess pain, disability and neck range of movements at baseline and after 12 weeks. Both interventions showed statistically significant improvements in pain, function and range of movement p = 0.001f or isometric exercise group, p = 0.04 for general exercises group and p = 0.001 for range of movement. However, mean improvements in post intervention VAS score and North wick Park Neck Pain Questionnaire score was better in isometric exercises group as compared to general exercise group. In conclusion, both interventions are effective in the treatment of chronic non-specific neck pain however; isometric exercises are clinically more effective than general exercises.

  17. Prognosis and course of work-participation in patients with chronic non-specific low back pain: A 12-month follow-up cohort study

    NARCIS (Netherlands)

    Verkerk, K.; Luijsterburg, P.A.J.; Pool-Goudzwaard, A.; Heymans, M.W.; Ronchetti, I.; Miedema, H.S.; Koes, B.W.

    2015-01-01

    OBJECTIVE: To investigate the clinical course of, and prognostic factors for, work-participation in patients with chronic non-specific low back pain. METHODS: A total of 1,608 patients with chronic non-specific low back pain received a multidisciplinary therapy and were evaluated at baseline an

  18. [C. pylori colonization of the mucosa in patients with chronic ulcerative and non-ulcerative gastropathies].

    Science.gov (United States)

    Loschiavo, F; Ventura-Spagnolo, T; Broccio, G

    1990-05-01

    C. pyloridis colonization was investigated in a selected group of 58 patients with upper gastrointestinal disorders submitted to endoscopy and biopsy. The following results were registered. C. pyloridis was isolated in 14 out of 18 cases of active chronic gastritis, in 15 out of 24 cases of non active chronic gastritis, and 7 out of 8 cases of antral ulceration. A negative finding was registered in 8 patients whose gastric mucosa was normal. Therefore, the Authors consider as valid the etiopathogenetic correlation between C. pyloridis and ulcerative or non-ulcerative chronic gastric diseases, suggested by others.

  19. Chronic cutaneous ulcers secondary to Haemophilus ducreyi infection.

    Science.gov (United States)

    Peel, Trisha N; Bhatti, Deepak; De Boer, Jim C; Stratov, Ivan; Spelman, Denis W

    2010-03-15

    Haemophilus ducreyi is a well recognised causative agent of genital ulcers and chancroid. We report two unusual cases of non-sexually transmitted H. ducreyi infection leading to chronic lower limb ulcers. Both patients were Australian expatriates visiting Australia from the Pacific Islands--one from Papua New Guinea and the other from Vanuatu.

  20. THE EFFECT OF KINESIO TAPING IN CHRONIC NON-SPECIFIC LOW BACK PAIN

    OpenAIRE

    Makeeva, Anna

    2016-01-01

    The purpose of this thesis is to find out the effect of Kinesio taping on patients with low back pain (LBP). LBP is the most common musculoskeletal disease affecting all human beings. It effects on activities of daily living (ADL). The aim of this thesis is to determine the effect of Kinesio taping on pain and ADL. The research subject will be adults from the “Satakunnan Selkäyhdistys” Back Pain Association with chronic LBP. All participants will be interviewed during the first meeting. Th...

  1. EFFICACY OF POST ISOMETRIC RELAXATION VERSUS STATIC STRECHING IN SUBJECTS WITH CHRONIC NON SPECIFIC NECK PAIN

    Directory of Open Access Journals (Sweden)

    P.Haritha

    2015-12-01

    Full Text Available Background: Neck pain is a common problem within our society. Upper trapezius sternocleidomastoid and the levator scapulae are the most common postural muscles that tends to get shorten leading to restricted neck mobility. There is lack of evidence to allow conclusions to be drawn about the effectiveness of post isometric relaxation when compared with static stretching exercises. The aim is to find out the effectiveness of Post isometric relaxation Versus Static stretching in the subjects with chronic nonspecific neck pain. To evaluate the effectiveness of post isometric relaxation technique on pain by using Visual analoge scale, range of motion by using Universal Goniometry, and functional disability by using Neck Disability Index in chronic nonspecific neck pain. Methods: A convenient sample of thirty seven subjects was diagnosed with nonspecific neck pain was randomly allocated to one of the two treatment groups on the basis of the inclusion criteria. The experimental group (n=15 received three sessions of post isometric relaxation technique for trapezius, sternocleidomastoid and the levator scapulae and control group (n=15 received the three sessions of static stretching for trapezius, sternocliedomastiod and levator scapulae for four weeks. Results: Non parametric tests demonstrated a statistically significant difference with experimental group showing greater improvement in ROM, VAS, and NDI than the control group and significant difference within the group also. Conclusion: This study concluded and the results reflected that post isometric relaxation technique group had better improvement in reduction of pain, improvement in the range of motion, and increased neck functional activities than the static stretching group.

  2. Sensory and sympathetic disorders in chronic non-specific neck pain.

    Science.gov (United States)

    Zaproudina, Nina; Ming, Zhiyong; Närhi, Matti

    2015-01-01

    The signs of sympathetic and sensory nerve-related disorders are not widely investigated in chronic nonspecific neck pain (NNP) patients. Thus, we performed skin temperature (Tsk), evaporation and touch threshold (TT) measurements to reveal possible dysfunctions at the fingertips of NNP patients (n=60) compared with healthy controls (n=11). Neck pain intensity was the main modifier of Tsk, and age the main modifier of TT in a multivariate model. On comparisons of the subgroups of NNP patients with unilateral (n=26) and bilateral (n=34) symptoms and controls, TT differed and Tsk tended to differ, the unilateral pain patients being found to demonstrate higher TT values on both sides. Interrelations between the measured parameters were found in the controls, but not in the patients. The NNP patients exhibited signs of functional impairment of innervation reflected in changes in tactile sensitivity and vasoactive sympathetic function. These changes may be based on both central and peripheral mechanisms, which possibly differ in patients with unilateral and bilateral symptoms.

  3. Tactile thresholds are preserved yet complex sensory function is impaired over the lumbar spine of chronic non-specific low back pain patients. A preliminary investigation

    OpenAIRE

    Wand, BM; Di Pietro, FS; George, PJ; O'Connell, NE

    2010-01-01

    Objectives: To investigate impairments in sensory function in chronic non-specific low back pain patients and the relationship between any impairment and the clinical features of the condition. Design: A cross-sectional case-control study. Setting: Laboratory based study. Participants: Nineteen chronic non-specific low back pain patients and nineteen healthy controls. Main Outcome measures: Tactile threshold, two point discrimination distance and accuracy at a task involving recognizing lett...

  4. Is chronic ulcerative stomatitis a variant of lichen planus, or a distinct disease?

    Science.gov (United States)

    Feller, Liviu; Khammissa, Razia A G; Lemmer, Johan

    2017-02-10

    Chronic ulcerative stomatitis is an immune-mediated mucocutaneous disorder characterized clinically by erosions or ulcers. Most cases are limited to the mouth. The histopathological features are non-specific or mimic those of oral lichen planus, and studies by immunoflorescent microscopy are essential for definitive diagnosis. The defining immunopathogenic mechanism is the binding of IgG to the nuclear protein deltaNp63alpha of keratinocytes in the basal and parabasal cell layers of the oral stratified epithelium. DeltaNp63alpha functions as a regulator of epithelial stem cell activity and as an anti-apoptotic agent, and regulates the expression of cell-to-cell and cell-to-basement membrane adhesion molecules. The autoimmune IgG-deltaNp63alpha interaction is thought to result in damage to the structural attachment of keratinocytes to one another and to the epithelial basement membrane zone, and in dysregulation of the cell cycle and apoptosis of basal keratinocytes with the development of erosions or ulcers. The aims of treatment are to suppress the pathogenic immuno-inflammatory responses, to prevent local infection and to promote healing. The purpose of this article is to provide a succinct review of the diagnostic, clinical and aetiopathogenic features of, and treatment guidelines for chronic ulcerative stomatitis, and to argue that this disease should be regarded as a variant of oral lichen planus, rather than as a distinct entity. This article is protected by copyright. All rights reserved.

  5. EFFECT OF HIP MOBILIZATION WITH EXERCISES FOR SUBJECTS WITH CHRONIC NON SPECIFIC LOW BACK PAIN ASSOCIATED WITH HIP IMPAIRMENT

    Directory of Open Access Journals (Sweden)

    Chintan Patel

    2015-02-01

    Full Text Available Background:There is a basic assumption from the studies on hip–LBP relationship that suboptimal function of the hip might result in an alteration of the mechanics of the lumbopelvic region. Evidence is mounting to support the possibility that low back pain may be result of hip rotation deficits. The excessive or limited hip rotation range of motion could be a predisposing factor for low back dysfunction. Exercises and hip joint mobilization, individually found to be effective in chronic nonspecific low back pain with hip impairment. Hence, the purpose is to find the effect of hip joint mobilization with stretching exercises on intensity of pain and functional disability for subjects with chronic nonspecific low back pain associated with hip impairment. Method: An experimental study design selected 30 subjects with chronic low back pain associated with Hip impairment randomized 15 subjects each into Study and Control group. Control group received stretching exercises while Study group received hip joint mobilization with stretching exercises thrice a week for 3 weeks. Pain intensity was measured using Visual Analogue Scale and Functional disability was measured by Modified Oswestry Disability Index for LBP before and after 2 weeks of treatment. Results: There is statistically significant difference in improvement in means of VAS and Modified ODI when analyzed within the group. When the post-intervention means were compared between Study and Control group there is a statistically significant difference in means after 2 weeks of treatment. Conclusion: The present study concluded that the two weeks duration of combined hip joint mobilization with stretching exercises significantly effective on improving pain and functional disability than only stretching exercise regimen for chronic non-specific low back pain associated with Hip impairment.

  6. A novel method for neck coordination exercise – a pilot study on persons with chronic non-specific neck pain

    Directory of Open Access Journals (Sweden)

    Björklund Martin

    2008-12-01

    Full Text Available Abstract Background Chronic neck pain is a common problem and is often associated with changes in sensorimotor functions, such as reduced proprioceptive acuity of the neck, altered coordination of the cervical muscles, and increased postural sway. In line with these findings there are studies supporting the efficacy of exercises targeting different aspects of sensorimotor function, for example training aimed at improving proprioception and muscle coordination. To further develop this type of exercises we have designed a novel device and method for neck coordination training. The aim of the study was to investigate the clinical applicability of the method and to obtain indications of preliminary effects on sensorimotor functions, symptoms and self-rated characteristics in non-specific chronic neck pain Methods The study was designed as an uncontrolled clinical trial including fourteen subjects with chronic non-specific neck pain. A new device was designed to allow for an open skills task with adjustable difficulty. With visual feedback, subjects had to control the movement of a metal ball on a flat surface with a rim strapped on the subjects' head. Eight training sessions were performed over a four week period. Skill acquisition was measured throughout the intervention period. After intervention subjects were interviewed about their experience of the exercise and pain and sensorimotor functions, including the fast and slow components of postural sway and jerkiness-, range-, position sense-, movement time- and velocity of cervical rotation, were measured. At six-month follow up, self-rated pain, health and functioning was collected. Results The subjects improved their skill to perform the exercise and were overall positive to the method. No residual negative side-effects due to the exercise were reported. After intervention the fast component of postural sway (p = 0.019 and jerkiness of cervical rotation (p = 0.032 were reduced. The follow up

  7. Kinesio Taping® is not better than placebo in reducing pain and disability in patients with chronic non-specific low back pain: a randomized controlled trial

    OpenAIRE

    Luz Júnior,Maurício A.; Manoel V. Sousa; Neves, Luciana A. F. S.; Aline A. C. Cezar; Costa, Leonardo O. P.

    2015-01-01

    Background: Kinesio Taping® has been widely used in clinical practice. However, it is unknown whether this type of tape is more effective than placebo taping in patients with chronic lower back pain. Objective: To compare the effectiveness of Kinesio Taping® in patients with chronic non-specific low back pain against a placebo tape and a control group. Method: This is a 3-arm, randomized controlled trial with a blinded assessor. Sixty patients with chronic non-specific low back pain were r...

  8. Perceptions of sitting posture among members of the community, both with and without non-specific chronic low back pain.

    Science.gov (United States)

    O'Sullivan, Kieran; O'Keeffe, Mary; O'Sullivan, Leonard; O'Sullivan, Peter; Dankaerts, Wim

    2013-12-01

    Physiotherapists perceive upright, lordotic sitting postures to be important in the management of non-specific chronic low back pain (NSCLBP). Little is known about the perceptions of the wider community about seated posture, despite this being an important consideration before attempting to change seated posture. This study investigated perceptions of the best and worst sitting postures among members of the community, both with (n = 120) and without (n = 235) NSCLBP. Participants with NSCLBP perceived posture to be more important (p neck and shoulders in good alignment were preferred. However, what people considered "straight" varied considerably. 78% selected a slumped sitting posture as their worst posture, which was more frequent than any other posture (p pain, disability or back pain beliefs. Interestingly, a very upright sitting posture was the second most popular selection as both the best (19%) and worst (15%) posture. Overall, lordotic lumbar postures were strongly favoured among members of the community, which is broadly in line with the previously reported perceptions of physiotherapists.

  9. Clinical characteristics of foot ulceration in people with chronic gout.

    Science.gov (United States)

    Rome, Keith; Erikson, Kathryn; Otene, Cynthia; Sahid, Hazra; Sangster, Karyn; Gow, Peter

    2016-04-01

    Gout is the most common form of inflammatory arthritis and it has an affliction to the foot. Foot involvement in gout has been linked to foot pain, impairment and disability. There has been limited research on the effect of ulceration on foot pain, impairment, disability and health-related quality of life in patients already living with gout. The aim of the study was to describe the wound characteristics and the effect on foot pain, disability and health-related quality of life in patients with foot ulceration associated with gout. Participants were recruited from rheumatology clinics in Auckland, New Zealand. All the current foot ulceration sites and wound characteristics were recorded using the TIME wound assessment tool. The outcome measures included general pain, patient global assessment scale, foot pain, disability and impairment. Participants completed the Cardiff Wound Impact Schedule to assess the effect of ulcers on health-related quality of life. Sensory loss, vibrational thresholds and ankle brachial pressure index were collated to assess for lower limb arterial disease. Six participants were predominantly older men with a long duration of gout, high rates of obesity and co-morbidities such as hypertension, hyperlipidaemia, diabetes and cardiovascular disease. The mean (SD) duration of the foot ulcers was 4 (2) months. The majority of foot ulcers observed were 0·5 cm(2) or smaller superficial thickness with surrounding callus. Partial thickness and full-thickness ulcers were also observed. Two patients presented with ulcers on multiple sites. There was only one case of infection. Gouty tophi were evident in most of the wounds. The dorsal aspect of the third toe was found to ulcerate in most cases. Moderate scores of foot pain, disability, impairment and health-related quality of life were observed. Most participants wore shoes deemed as poor. Foot ulceration in gout is chronic and multiple ulcers can occur with the potential of leading to delayed

  10. A STUDY TO ANALYSE THE EFFICACY OF MODIFIED PILATES BASED EXERCISES AND THERAPEUTIC EXERCISES IN INDIVIDUALS WITH CHRONIC NON SPECIFIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRAIL

    Directory of Open Access Journals (Sweden)

    U.Albert Anand,

    2014-06-01

    Full Text Available Background: Chronic low back pain is an expensive and difficult condition to treat. Low back pain is the most common musculoskeletal symptoms seen in 85 % of individuals in their life time. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain (CNLBP is exercise therapy based upon the Pilates principles. Objective: The purpose of the study was to find out the effect of Modified Pilates based exercises for patients with Chronic Non Specific Low Back Pain. Design: A randomized controlled trial, pre test-post test design Setting: The study was conducted in Out Patient Department of physiotherapy, K.G Hospital, Coimbatore, India. Patients: Fifty– two physically active subjects between 18 – 60 years old with Chronic Non specific Low Specific Pain of more than 12 weeks’ duration were randomly assigned into 2 groups. Interventions: Group A subjects underwent a Modified specific Pilates based exercises with Flexibility Exercises & Group B Subjects underwent a Therapeutic Exercises with Flexibility Exercises were conducted over of 8 weeks. Measurements: Back specific Functional Status outcome were measured with the Oswestry Disability Index and pain intensity were measured with Visual analogue scale. Conclusion: The study concluded that the Modified specific Pilates based exercises helps in reducing the pain, improve the back specific function, improve general health, personal Care, Social Life and flexibility in individuals with non specific chronic low back pain than the therapeutic exercise group.

  11. [When to worry about before a vascular chronic leg ulcer?].

    Science.gov (United States)

    Lazareth, I

    2016-09-01

    Leg ulcers are a chronic condition. Healing can be long for venous ulcers and the risk of complications is significant. Infection is the most severe complication and can occur in the form of easily diagnosed acute bacterial dermohypodermitis that generally responds well to antibiotic treatment if given at an appropriate dose or in the form of localized infection that is more difficult to diagnosis. Indeed, no consensus has been reached in the literature on the clinical criteria to retain for the diagnosis of localized infection. Similarly, the most appropriate treatment remains to be established. Local care would be a logical starting point, followed by systemic antibiotics if this approach is unsuccessful. Individual conditions also should be taken into consideration (immunodepression, severe arteriopathy warranting more rapid use of systemic antibiotics). The second most frequent complication is an allergic reaction to a topical agent used for wound care. The rate of sensitivization in patients with leg ulcers is high (60 %), although the rate is declining with modern dressings. No product can be considered perfectly safe for these polysensitized patients. Dermocorticoid therapy can be very effective. Allergology tests are needed. Certain leg ulcers require special care from diagnosis. An arterial origin must be suspected for deep, or necrotic ulcers. Arterial supply must be explored rapidly, followed by a revascularization procedure when necessary. Highly painful superficial extensive necrotic ulcers due to necrotic angiodermitis require hospital care for skin grafts that will control the antiodermitis and provide pain. Carcinoma should be suspected in cases of leg ulcers with an atypical localization exhibiting excessive budding. A biopsy is mandatory for leg ulcers with an unusual course (absence of healing despite well-conducted care).

  12. Heart Coherence Training Combined with Back School in Patients with Chronic Non-specific Low Back Pain : First Pragmatic Clinical Results

    NARCIS (Netherlands)

    Soer, Remko; Vos, Dafne; Hofstra, Bert; Reneman, Michiel F.

    2014-01-01

    The aim of this study was to explore on which variables a stress reduction program based on heart coherence can enhance the effects of a back school (BS) in patients with chronic non-specific low back pain and to explore possible moderators for treatment success. A retrospective explorative design w

  13. Compression therapies for chronic venous leg ulcers: interventions and adherence

    Directory of Open Access Journals (Sweden)

    Latz CA

    2015-01-01

    Full Text Available Christopher A Latz,1 Kellie R Brown,2 Ruth L Bush11Texas A&M Health Science Center College of Medicine, Bryan, TX, USA; 2Medical College of Wisconsin, Milwaukee, WI, USAAbstract: Compression therapy has been the mainstay for the treatment of lower extremity edema, venous insufficiency, and particularly, venous ulcerative disease. Though modern surgical treatments exist, none are completely effective without good compressive options to allow for decreased swelling and better oxygenation of damaged tissues. This review article will describe the pathophysiology and presentation of lower extremity venous ulcerations, as well as current options for compression therapy. The benefits, along with the major pitfall of nonadherence, will also be discussed.Keywords: venous disease, chronic venous insufficiency, venous ulceration

  14. Chronic Ulcerative Herpes Simplex Virus Infection of the Vulva

    Directory of Open Access Journals (Sweden)

    Kelly Griffith-Bauer

    2012-09-01

    Full Text Available Herpes simplex virus infections in HIV-infected individuals can be clinically unusual and difficult to treat due to underlying problems with cell-mediated immunity and the occurrence of antiviral resistance. Additionally, partial or incomplete restoration of immune function may result in chronic ulcerations that require rotational treatments. In this report, we describe the case of a 38-year-old HIV-positive woman who developed the ulcerative form of chronic herpes simplex infection despite highly active antiretroviral therapy and valacyclovir prophylaxis. Repeated intravenous courses of foscarnet and topical cidofovir finally controlled her erosions as her cell-mediated immunity was slowly restored. This case highlights the challenges that still exist in diagnosing and managing this rare presentation of herpes simplex virus

  15. Point Injection for 43 Cases of Chronic Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    ZHU Yue-ping

    2003-01-01

    Pishu ( BL 20), Dachangshu ( BL 25), Zusanli (ST 36), and Shangjuxu (ST 37) were selected to treat chronic ulcerative colonitis in 43 cases by point injection with placental tissue fluid and the curative effect was compared with that of west medicine plus enema in 22 cases (control group). It showed that there was a significant difference in short-term total effective rate between the two groups. It suggested that point therapy was effective.

  16. Allergic contact dermatitis to Plectranthus amboinicus masquerading as chronic leg ulcer.

    Science.gov (United States)

    Chang, Shyue-Luen; Chang, Ya-Ching; Yang, Chin-Hsun; Hong, Hong-Shang

    2005-12-01

    This report discusses a case of a 69-year-old woman who developed chronic non-healing leg ulcers after long-term topical use of Plectranthus amboinicus. The ulcer was proven to be allergic contact dermatitis to P. amboinicus by a patch test. The ulcer healed after discontinuation of P. amboinicus. To the best of our knowledge, this is the first reported case of allergic contact dermatitis to P. amboinicus masquerading as chronic leg ulcer.

  17. Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers

    Directory of Open Access Journals (Sweden)

    Shwetha Suryanarayan

    2014-09-01

    Full Text Available Aim: The aim was to evaluate the efficacy of platelet-rich plasma (PRP in the treatment of chronic nonhealing ulcers. Methods: A nonrandomized, uncontrolled study was performed on 24 patients with 33 nonhealing ulcers of various etiologies. All patients were treated with PRP at weekly intervals for a maximum of 6 treatments. At the end of the 6-week period, reduction in size of the ulcers (area and volume was assessed. Results: The mean age of the patients was 42.5 years (standard deviation [SD] 12.48. Of 33 ulcers, there were 19 venous ulcers, 7 traumatic ulcers, 2 ulcers secondary to pyoderma gangrenosum, 2 diabetic ulcers, 2 trophic ulcers, and 1 vasculitic ulcer. The mean duration of healing of the ulcers was 5.6 weeks (SD 3.23. The mean percentage of reduction in area and volume of the ulcers was 91.7% (SD 18.4% and 95% (SD 14%, respectively. About 100% resolution in the area was seen in 25 (76% of the ulcers and 100% reduction in volume was seen in 24 (73% of the ulcers at the end of the 6th treatment. Conclusion: Conventional therapies do not provide satisfactory healing for chronic nonhealing ulcers as they are not able to provide the necessary growth factors (GFs (platelet-derived GF, epidermal GF, vascular endothelial GF, etc. which are essential for the healing process. PRP is a safe, affordable, biocompatible, and simple office-based procedure for the treatment of nonhealing ulcers.

  18. Chronic ulcers: MATRIDERM® system in smoker, cardiopathic, and diabetic patients

    Directory of Open Access Journals (Sweden)

    Barbara De Angelis

    2013-08-01

    Full Text Available Diabetic ulcers and pressure ulcers represent a more frequent cause of chronic wounds in aging populations. It is estimated that approximately 15% of the diabetic population will develop diabetic ulcers during their life and over half of these patients develop an infection, often osteomyelitis, with 20% requiring amputation. The authors report a case of a 65-year-old woman affected by a post-traumatic loss of substance due to road accidents with soft tissue exposure (comprising muscle tendon of the left knee combined with the fracture of the right fibula previously subjected to surgery and reconstruction of muscle tendon. The patient was affected by diabetes type II, hypertension, and ischemic heart disease. In 2008, she underwent a double bypass surgery and coronary angioplasty. Initially, the patient was treated with cycles of advanced dressings, with fibrinolytic ointments, hydrocolloid, and subsequently, when the bottom began granulated with fibrinolytic and idrocellulosa, Hydrofibra-Ag, and Ag-alginate, three times a week for 30 days. In the second step, the authors decided to treat the ulcer with the MATRIDERM system and auto skin graft. Following the first treatment, 7 days after the procedure, the authors found the reduction of the loss of substance until its complete closure. The wound’s infection was evaluated by a buffer negative confirmation performed every 2 weeks four times. We obtained decrease of limb edema and full functional rehabilitation. The skin appeared renovated, with volume restoration and an improvement of the texture.

  19. A Real World, Observational Registry of Chronic Wounds and Ulcers

    Science.gov (United States)

    2016-05-18

    Diabetic Foot; Varicose Ulcer; Pressure Ulcer; Surgical Wound Dehiscence; Vasculitis; Skin Ulcer; Leg Ulcer; Wounds and Injuries; Pyoderma; Peripheral Arterial Disease; Diabetic Neuropathies; Lymphedema; Venous Insufficiency; Diabetes Complications; Amputation Stump

  20. The effectiveness of acupuncture in treating chronic non-specific low back pain: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Hutchinson Amanda J P

    2012-10-01

    Full Text Available Abstract Background Low back pain is a common musculoskeletal disorder defined as pain and soreness, muscle tension, or stiffness in the lumbosacral area of the spine which does not have a specific cause. Low back pain results in high health costs and incapacity to work causing an economic burden to society. The optimal management of non-specific low back pain appears to be undecided. Recently published guidelines support the use of acupuncture for treating non-specific low back pain and it has become a popular alternative treatment modality for patients with low back pain. Methods A comprehensive systematic literature search was conducted through Medline using Ovid and Medical Subject Headings for randomized controlled trials published in the last 10 years. The outcomes scored were subjective pain scores and functional outcome scores. Results Eighty two randomized studies were identified, of which 7 met our inclusion criteria. Three studies found a significant difference in pain scores when comparing acupuncture, or sham acupuncture, with conventional therapy or no care. Two studies demonstrated a significant difference between acupuncture treatment and no treatment or routine care at 8 weeks and 3 months. Three studies demonstrated no significant difference between acupuncture and minimal/sham acupuncture with no difference in pain relief or function over 6 to 12 months. Conclusions This review provides some evidence to support acupuncture as more effective than no treatment, but no conclusions can be drawn about its effectiveness over other treatment modalities as the evidence is conflicting.

  1. Course and prognosis of recovery for chronic non-specific low back pain: design, therapy program and baseline data of a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Verkerk Karin

    2011-11-01

    Full Text Available Abstract Background There has been increasing focus on factors predicting the development of chronic musculoskeletal disorders. For patients already experiencing chronic non-specific low back pain it is also relevant to investigate which prognostic factors predict recovery. We present the design of a cohort study that aims to determine the course and prognostic factors for recovery in patients with chronic non-specific low back pain. Methods/Design All participating patients were recruited (Jan 2003-Dec 2008 from the same rehabilitation centre and were evaluated by means of (postal questionnaires and physical examinations at baseline, during the 2-month therapy program, and at 5 and 12 months after start of therapy. The therapy protocol at the rehabilitation centre used a bio-psychosocial approach to stimulate patients to adopt adequate (movement behaviour aimed at physical and functional recovery. The program is part of regular care and consists of 16 sessions of 3 hours each, over an 8-week period (in total 48 hours, followed by a 3-month self-management program. The primary outcomes are low back pain intensity, disability, quality of life, patient's global perceived effect of recovery, and participation in work. Baseline characteristics include information on socio-demographics, low back pain, employment status, and additional clinical items status such as fatigue, duration of activities, and fear of kinesiophobia. Prognostic variables are determined for recovery at short-term (5 months and long-term (12 months follow-up after start of therapy. Discussion In a routine clinical setting it is important to provide patients suffering from chronic non-specific low back pain with adequate information about the prognosis of their complaint.

  2. Results of a non-specific immunomodulation therapy on chronic heart failure (ACCLAIM trial): a placebo-controlled randomised trial

    DEFF Research Database (Denmark)

    Torre-Amione, G.; Anker, S.D.; Bourge, R.C.;

    2008-01-01

    Background Evidence suggests that inflammatory mediators contribute to development and progression of chronic heart failure. We therefore tested the hypothesis that immunomodulation might counteract this pathophysiological mechanism in patients. Methods We did a double-blind, placebo-controlled s...

  3. Exostectomy for chronic midfoot plantar ulcer in Charcot deformity

    DEFF Research Database (Denmark)

    Laurinaviciene, R.; Kirketerp-Moeller, K.; Holstein, Per Evald

    2008-01-01

    Charcot midfoot ulcers are rare and very difficult to heal, with surgery being an option. This retrospective study assessed healing rates, complications, and the incidence of re-ulceration and other foot ulcer problems following exostectomies Udgivelsesdato: 2008/2......Charcot midfoot ulcers are rare and very difficult to heal, with surgery being an option. This retrospective study assessed healing rates, complications, and the incidence of re-ulceration and other foot ulcer problems following exostectomies Udgivelsesdato: 2008/2...

  4. 77 FR 24718 - Scientific Information Request on Chronic Venous Ulcers Treatments

    Science.gov (United States)

    2012-04-25

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on Chronic... for Scientific Information Submissions. SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from manufacturers of chronic venous ulcer...

  5. A rare cause of chronic rectal bleeding in children; solitary rectal ulcer: case report.

    Science.gov (United States)

    Temiz, Abdulkerim; Tander, Burak; Temiz, Muhyittin; Barış, Sancar; Arıtürk, Ender

    2011-03-01

    Solitary rectal ulcer causing lower gastrointestinal bleeding is extremely rare in children. Rare presentation, non-specific symptoms, insufficient experience, and characteristics mimicking other rectal diseases may cause misdiagnosis or delay of diagnosis in some pediatric patients. Here, we report a 10-year-old boy with solitary rectal ulcer diagnosed two years after onset of the symptoms who responded well to the conservative therapy, including high-fiber diet, laxatives, defecation training, and sucralfate enema.

  6. The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain.

    Science.gov (United States)

    Mohseni-Bandpei, Mohammad A; Rahmani, Nahid; Behtash, Hamid; Karimloo, Masoud

    2011-01-01

    Dysfunction of spinal stability seems to be one of the causes of low back pain (LBP). It is thought that a large number of muscles have a role in spinal stability including the pelvic floor muscle (PFM). The purpose of this study was to investigate the effect of PFM exercise in the treatment of chronic LBP. After ethical approval, a randomized controlled clinical trial was carried out on 20 women with chronic LBP. Patients were randomly allocated into two groups: an experimental and a control group. The control group was given routine treatment including electrotherapy and general exercises; and the experimental group received routine treatment and additional PFM exercise. Pain intensity, functional disability and PFM strength and endurance were measured before, immediately after intervention and at 3 months follow-up. In both groups pain and functional disability were significantly reduced following treatment (p0.05). All measurements were improved in both groups (p<0.01) although patients in the experimental group showed greater improvement in PFM strength and endurance (p<0.01). It seems that the PFM exercise combined with routine treatment was not superior to routine treatment alone in patients with chronic LBP.

  7. Improvements in tissue blood flow and lumbopelvic stability after lumbopelvic core stabilization training in patients with chronic non-specific low back pain.

    Science.gov (United States)

    Paungmali, Aatit; Henry, Leonard Joseph; Sitilertpisan, Patraporn; Pirunsan, Ubon; Uthaikhup, Sureeporn

    2016-01-01

    [Purpose] This study investigated the effects of lumbopelvic stabilization training on tissue blood flow changes in the lumbopelvic region and lumbopelvic stability compared to placebo treatment and controlled intervention among patients with chronic non-specific low back pain. [Subjects and Methods] A total of 25 participants (7 males, 18 females; mean age, 33.3 ± 14.4 years) participated in this within-subject, repeated-measures, double-blind, placebo-controlled comparison trial. The participants randomly underwent three types of interventions that included lumbopelvic stabilization training, placebo treatment, and controlled intervention with 48 hours between sessions. Lumbopelvic stability and tissue blood flow were measured using a pressure biofeedback device and a laser Doppler flow meter before and after the interventions. [Results] The repeated-measures analysis of variance results demonstrated a significant increase in tissue blood flow over the lumbopelvic region tissues for post- versus pre-lumbopelvic stabilization training and compared to placebo and control interventions. A significant increase in lumbopelvic stability before and after lumbopelvic stabilization training was noted, as well as upon comparison to placebo and control interventions. [Conclusion] The current study supports an increase in tissue blood flow in the lumbopelvic region and improved lumbopelvic stability after core training among patients with chronic non-specific low back pain.

  8. Effectiveness of mat Pilates or equipment-based Pilates in patients with chronic non-specific low back pain: a protocol of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    da Luz Maurício Antônio

    2013-01-01

    Full Text Available Abstract Background Chronic low back pain is an expensive and difficult condition to treat. One of the interventions widely used by physiotherapists in the treatment of chronic non-specific low back pain is exercise therapy based upon the Pilates principles. Pilates exercises can be performed with or without specific equipment. These two types of Pilates exercises have never been compared on a high-quality randomised controlled trial. Methods/design This randomised controlled trial with a blinded assessor will evaluate eighty six patients of both genders with chronic low back pain, aged between 18 and 60 years, from one Brazilian private physiotherapy clinic. The patients will be randomly allocated into two groups: Mat Group will perform the exercises on the ground while the Equipment-based Group will perform the Pilates method exercises on the following equipment: Cadillac, Reformer, Ladder Barrel, and Step Chair. The general and specific disability of the patient, kinesiophobia, pain intensity and global perceived effect will be evaluated by a blinded assessor before randomisation and at six weeks and six months after randomisation. In addition, the expectation of the participants and their confidence with the treatment will be evaluated before randomisation and after the first treatment session, respectively. Discussion This will be the first study aiming to compare the effectiveness of Mat and Equipment-based Pilates exercises in patients with chronic non-specific low back pain. The results may help health-care professionals in clinical decision-making and could potentially reduce the treatment costs of this condition. Trial registration Brazilian Registry of Clinical Trials RBR-7tyg5j

  9. Kinesio Taping® is not better than placebo in reducing pain and disability in patients with chronic non-specific low back pain: a randomized controlled trial

    Science.gov (United States)

    Luz, Maurício A.; Sousa, Manoel V.; Neves, Luciana A. F. S.; Cezar, Aline A. C.; Costa, Leonardo O. P.

    2015-01-01

    Background: Kinesio Taping ® has been widely used in clinical practice. However, it is unknown whether this type of tape is more effective than placebo taping in patients with chronic lower back pain. Objective: To compare the effectiveness of Kinesio Taping ® in patients with chronic non-specific low back pain against a placebo tape and a control group. Method: This is a 3-arm, randomized controlled trial with a blinded assessor. Sixty patients with chronic non-specific low back pain were randomized into one of the three groups: Kinesio Taping ® group (n=20), Micropore® (placebo) group (n=20) and control group (n=20). Patients allocated to both the Kinesio Taping ® group and the placebo group used the different types of tape for a period of 48 hours. The control group did not receive any intervention. The outcomes measured were pain intensity (measured by an 11-point numerical rating scale) and disability (measured by the 24-item Roland Morris Disability Questionnaire). A blinded assessor measured the outcomes at baseline, 48 hours and 7 days after randomization. Results: After 48 hours, there was a statistically significant difference between the Kinesio Taping ® group versus the control group (mean between-group difference = -3.1 points, 95% CI=-5.2 to -1.1, p=0.003), but no difference when compared to the placebo group (mean between-group difference= 1.9 points, 95% CI=-0.2 to 3.9, p=0.08). For the other outcomes no differences were observed. Conclusions: The Kinesio Taping ® is not better than placebo (Micropore®) in patients with chronic low back pain. PMID:26647750

  10. Kinesio Taping® is not better than placebo in reducing pain and disability in patients with chronic non-specific low back pain: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Maurício A. Luz Júnior

    2015-12-01

    Full Text Available Background: Kinesio Taping® has been widely used in clinical practice. However, it is unknown whether this type of tape is more effective than placebo taping in patients with chronic lower back pain. Objective: To compare the effectiveness of Kinesio Taping® in patients with chronic non-specific low back pain against a placebo tape and a control group. Method: This is a 3-arm, randomized controlled trial with a blinded assessor. Sixty patients with chronic non-specific low back pain were randomized into one of the three groups: Kinesio Taping® group (n=20, Micropore® (placebo group (n=20 and control group (n=20. Patients allocated to both the Kinesio Taping® group and the placebo group used the different types of tape for a period of 48 hours. The control group did not receive any intervention. The outcomes measured were pain intensity (measured by an 11-point numerical rating scale and disability (measured by the 24-item Roland Morris Disability Questionnaire. A blinded assessor measured the outcomes at baseline, 48 hours and 7 days after randomization. Results: After 48 hours, there was a statistically significant difference between the Kinesio Taping® group versus the control group (mean between-group difference = -3.1 points, 95% CI=-5.2 to -1.1, p=0.003, but no difference when compared to the placebo group (mean between-group difference= 1.9 points, 95% CI=-0.2 to 3.9, p=0.08. For the other outcomes no differences were observed. Conclusions: The Kinesio Taping® is not better than placebo (Micropore® in patients with chronic low back pain.

  11. Nursing diagnoses in patients with chronic venous ulcer: observational study

    Directory of Open Access Journals (Sweden)

    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  12. An Unusual Association between Chronic Pancreatitis and Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Surya Prakash Bhatt

    2008-01-01

    Full Text Available Episodes of acute pancreatitis have been described during the course of ulcerative colitis and most of them are due to cholelithiasis or drugs. Idiopathic pancreatitis has rarely been associated with inflammatory bowel disease (IBD. We describe one such case. A 35-year-old male presented in 2001 with a ten year history of recurrent episodes of diarrhea without blood and mucus in the stools. Four years ago, he developed an episode of mild acute pancreatitis. At that time, the serum amylase level was three times the upper normal limit. He was treated conservatively. A month later, he was found to be diabetic and was put on insulin. He was non-alcoholic and there was no history of any chronic drug use. There was no similar family history.

  13. Eye Movement Desensitization and Reprocessing (EMDR Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Andreas Gerhardt

    2016-12-01

    Full Text Available Objective: Eye-Movement-Desensitization and Reprocessing (EMDR – an evidence-based approach to eliminate emotional distress from traumatic experiences – was recently suggested for the treatment of chronic pain. Aim of this study was to estimate preliminary efficacy of a pain-focused EMDR intervention for the treatment of non-specific chronic back pain.Design: Randomized controlled pilot study.Methods: Forty non-specific chronic back pain patients reporting previous experiences of psychological trauma were consecutively recruited from outpatient tertiary-care pain centers. After baseline assessment, patients were randomized to intervention or control group (1:1. The intervention group received ten sessions standardized pain-focused EMDR in addition to treatment-as-usual. The control group received treatment-as-usual alone.The primary outcome was preliminary efficacy, measured by pain intensity, disability, and treatment satisfaction from the patients' perspective. Clinical relevance of changes was determined according to established recommendations. Assessments were conducted at the baseline, post-treatment, and at a 6-month follow-up. Intention-to-treat-analysis with last-observation-carried-forward method was used. Registered with ClinicalTrials.gov (NCT01850875.Results: Estimated effect sizes (between-group, pooled standard deviation for pain intensity and disability were d=0.79 (CI95%: 0.13, 1.42 and d=0.39 (CI95%: -0.24, 1.01 post-treatment, and d=0.50 (CI95%: 0.14, 1.12 and d=0.14 (CI95%: -0.48, 0.76 at 6-month follow-up. Evaluation on individual patient basis showed that about 50% of the patients in the intervention group improved clinically relevant and also rated their situation as clinically satisfactory improved, compared to zero patients in the control group.Conclusions: There is preliminary evidence that pain-focused EMDR might be useful for non-specific chronic back pain patients with previous experiences of psychological trauma

  14. Genetic alterations in benign lesions: Chronic gastritis and gastric ulcer

    Institute of Scientific and Technical Information of China (English)

    Ana Cristina Gobbo César; Marília de Freitas Calmon; Patrícia Maluf Cury; Alaor Caetano; Aldenis Albaneze Borim; Ana Elizabete Silva

    2006-01-01

    AIM: To investigate the occurrence of chromosome 3, 7,8, 9, and 17 aneuploidies, TP53 gene deletion and p53 protein expression in chronic gastritis, atrophic gastritis and gastric ulcer, and their association with H pylori infection.METHODS: Gastric biopsies from normal mucosa (NM,n = 10), chronic gastritis (CG,n =38), atrophic gastritis (CAG, n=13) and gastric ulcer (GU, n = 21) were studied using fluorescence in situ hybridization (FISH) and immunohistochemical assay. A modified Giemsa staining technique and PCR were used to detect H pylori. An association of the gastric pathologies and aneuploidies with H pylori infection was assessed.RESULTS: Aneuploidies were increasingly found from CG (21%) to CAG (31%) and to GU (62%), involving mainly monosomy and trisomy 7, trisomies 7 and 8, and trisornies 7, 8 and 17, respectively. A significant association was found between H pylori infection and aneuploidies in CAG (P= 0.0143) and GU (P= 0.0498). No TP53 deletion was found in these gastric lesions, but p53-positive immunoreactivity was detected in 45% (5/11) and 12% (2/17) of CG and GU cases, respectively. However, there was no significant association between p53 expression and H pylori infection.CONCLUSION: The occurrence of aneuploidies in benign lesions evidences chromosomal instability in early stages of gastric carcinogenesis associated with H pylori infection, which may confer proliferative advantage. The increase of p53 protein expression in CG and GU may be due to overproduction of the wild-type protein related to an inflammatory response in mucosa.

  15. EP4 agonist alleviates indomethacin-induced gastric lesions and promotes chronic gastric ulcer healing

    Institute of Scientific and Technical Information of China (English)

    Guang-Liang Jiang; Wha Bin Im; Yariv Donde; Larry A Wheeler

    2009-01-01

    AIM: To investigate EP4-selective agonist effect on indomethacin-induced gastric lesions and on the spontaneous healing of chronic gastric ulcers. METHODS: In a mouse model of gastric bleeding with high dose of indomethacin (20 mg/kg), an EP4-selective agonist was administered orally. Stomach lesions and gastric mucous regeneration were monitored. In a mouse model of chronic gastric ulcer induced by acetic acid, EP4 agonist effect on the healing of chronic gastric ulcer was evaluated in the presence or absence of low dose indomethacin (3 mg/kg). In cultured human gastric mucous cells, EP4 agonist effect on indomethacininduced apoptosis was assessed by flow cytometry. RESULTS: The EP4-selective agonist reduced high dose indomethacin-induced acute hemorrhagic damage and promoted mucous epithelial regeneration. Low-dose indomethacin aggravated ulcer bleeding and inflammation, and delayed the healing of the established chronic gastric ulcer. The EP4 agonist, when applied locally, not only offset indomethacin-induced gastric bleeding and inflammation, but also accelerated ulcer healing. In the absence of indomethacin, the EP4 agonist even accelerated chronic gastric ulcer healing and suppressed inflammatory cell infiltration in the granulation tissue. In vitro , the EP4 agonist protected human gastric mucous cells from indomethacin-induced apoptosis. CONCLUSION: EP4-selective agonist may prevent indomethacin-induced gastric lesions and promote healing of existing and indomethacin-aggravated gastric ulcers, via promoting proliferation and survival of mucous epithelial cells.

  16. Are There Abnormalities in Peripheral and Central Components of Somatosensory Evoked Potentials in Non-Specific Chronic Low Back Pain?

    Science.gov (United States)

    Puta, Christian; Franz, Marcel; Blume, Kathrin R.; Gabriel, Holger H. W.; Miltner, Wolfgang H. R.; Weiss, Thomas

    2016-01-01

    Chronic low back pain (CLBP) was shown to be associated with longer reflex response latencies of trunk muscles during external upper limb perturbations. One theoretical, but rarely investigated possibility for longer reflex latencies might be related to modulated somatosensory information processing. Therefore, the present study investigated somatosensory evoked potentials (SEPs) to median nerve stimulation in CLBP patients and healthy controls (HC). Latencies of the peripheral N9 SEP component were used as the primary outcome. In addition, latencies and amplitudes of the central N20 SEP component, sensory thresholds, motor thresholds and nerve conduction velocity were also analyzed in CLBP patients and HC. There is a trend for the CLBP patients to exhibit longer N9 latencies at the ipsilateral Erb’s point compared to HC. This trend is substantiated by significantly longer N9 latencies in CLBP patients compared to normative data. None of the other parameters showed any significant difference between CLBP patients and HC. Overall, our data indicate small differences of the peripheral N9 SEP component; however, these differences cannot explain the reflex delay observed in CLBP patients. While it was important to rule out the contribution of early somatosensory processing and to elucidate its contribution to the delayed reflex responses in CLBP patients, further research is needed to find the primary source(s) of time-delayed reflexes in CLBP. PMID:27799904

  17. Treatment of chronic venous leg ulcers by platelet gel.

    Science.gov (United States)

    Ficarelli, Elena; Bernuzzi, Gino; Tognetti, Elena; Bussolati, Ovidio; Zucchi, Alfredo; Adorni, Daniela; De Panfilis, Giuseppe

    2008-07-01

    Chronic venous leg ulcers (CVLU) are chronic wounds, associated with long-standing venous hypertension, which have a poor prognosis for healing. In the process of wound healing the first step is represented by platelet aggregation and subsequent release of growth factors and other mediators, which play a key role in the repair response. Platelet gel (PG), a hemocomponent obtained by mixing platelets, thrombin, and calcium, is able, when applied topically, to release platelet mediators that likely favor CVLU healing. However, unstandardized protocols have been described in studies utilizing PG for the regeneration of a number of tissues, including CVLU; the relative clinical outcomes were hence highly variable. In our experience the topical use of PG, together with the strict adherence to the principles of good wound care, quickly promoted increased granulation tissue, followed by a complete CVLU epithelization. Although further studies and trials are needed to establish the major outcome affecting rules for optimal indications, preparation, and use of PG for CVLU treatment, PG can be undoubtedly considered a useful tool, able to improve the management of CVLU.

  18. Glucose metabolism in chronic diabetic foot ulcers measured in vivo using microdialysis

    DEFF Research Database (Denmark)

    Simonsen, L; Holstein, P; Larsen, K;

    1998-01-01

    Ten subjects with diabetes mellitus and unilateral chronic foot ulcer were investigated. Local tissue concentrations of glucose and lactate were measured using the microdialysis method at a distance of 0.5-1 cm from the edge of the ulcer and in normal skin in the contralateral foot. Subcutaneous ...

  19. Glucose metabolism in chronic diabetic foot ulcers measured in vivo using microdialysis

    DEFF Research Database (Denmark)

    Simonsen, L; Holstein, P; Larsen, K

    1998-01-01

    Ten subjects with diabetes mellitus and unilateral chronic foot ulcer were investigated. Local tissue concentrations of glucose and lactate were measured using the microdialysis method at a distance of 0.5-1 cm from the edge of the ulcer and in normal skin in the contralateral foot. Subcutaneous...

  20. Effect of exercise therapy on displacement of the center of rotation of lumbar vertebrae in patients with non-specific chronic low back pain

    Directory of Open Access Journals (Sweden)

    Y. Javadian

    2015-06-01

    Full Text Available Background: The center of rotation (COR of the lumbar vertebrae is one of the important characteristics in evaluation of lumbar spine kinematics. Objective: The aim of this study was to investigate the effect of exercise therapy on displacement of the COR of lumbar vertebrae in patients with non-specific chronic low back pain. Methods: This interventional study was conducted in 30 patients with non-specific chronic low back pain referred to Shahid Beheshti hospital in Babol, 2012. The patients were randomly assigned to two equal groups. For 8 weeks, the patients in the intervention group performed routine plus stabilization exercises while the patients in the control group performed only routine exercises. Radiographic examination was performed in flexion, extension, and neutral views before and after the treatment and the followings were compared: the COR of each lumbar vertebra in global state (rotation of each vertebra relative to the sacrum and relative state (rotation of each vertebra relative to the lower vertebra and in full flexion-extension, flexion, and extension arcs. Data were analyzed using paired T-test and independent sample T-test. Findings: After treatment, the mean difference of the COR of the lumbar vertebrae was only significantly different between the two groups for relative measurement in L3 on y-axis in full flexion-extension arc. In flexion arc, the mean difference of the displacement of the COR was significantly different between the two groups for global measurement in L3 and L5 on y-axis and for relative measurement in L5 on y-axis. In extension arc, the mean difference of the COR of the lumbar vertebrae was not significantly different between the two groups for both global and relative measurements. Conclusion: With regards to the results, it is suggested to consider the displacement of the COR as an objective index in order to evaluate the effect of stabilization exercises.

  1. Chronic venous leg ulcers – role of topical zinc

    Directory of Open Access Journals (Sweden)

    Maher SF

    2015-06-01

    Full Text Available Sara F Maher Physical Therapy Program, Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA Abstract: Topical zinc has been used in the treatment of wounds for over 3,000 years, and is reported to have antiseptic, astringent, anti-inflammatory, antimicrobial, and wound healing properties. Fourteen studies were identified and reviewed, to assess the efficacy of this treatment modality as either a bandage or skin protectant in the treatment of venous ulcers. The authors of three studies reported improved healing time or success rate in wounds treated with zinc-based products. However, the authors of one study attributed the faster healing rate mainly to the extra compression (that improved venous blood return, delivered by the non-elastic paste bandage, and not by the zinc oxide alone. The quality of evidence is fair, as 50% of the studies were conducted prior to 2000 and 50% of the studies utilized fewer than 45 patients randomized to two or more groups. Other treatments have been reported to be more cost-effective than zinc, including hydrocolloids, four-layer compression systems, and CircAid Thera-boots. Finally, zinc was reported to be less comfortable, less easy to use, and caused increased pain, in comparison to other products on the market. This literature review, therefore, demonstrated that current evidence is insufficient to determine the effectiveness of zinc-based products in the treatment of venous wounds. Future research is needed focusing on larger, high-quality trials with an emphasis on quality of life issues and cost-effectiveness of treatment. Keywords: chronic wounds, leg ulcers, venous insufficiency, topical zinc

  2. Colite ulcerativa inespecífica em crianças e adolescentes: análise de casuística Non-specific ulcerative colitis in children and adolescents: casuistic analysis

    Directory of Open Access Journals (Sweden)

    Adelma A. de Figueirêdo

    2004-09-01

    Full Text Available OBJETIVOS: descrever uma série de casos de colite ulcerativa inespecífica, com ênfase nas manifestações iniciais, propedêutica e intervalo entre os primeiros sintomas e o diagnóstico. MÉTODOS: análise retrospectiva de casos de colite ulcerativa inespecífica, cujos sintomas iniciaram antes de 20 anos de idade. Os pacientes foram selecionados nos Serviços de Gastroenterologia Pediátrica do Hospital das Clínicas da Universidade Federal de Minas Gerais e do Instituto Materno Infantil de Pernambuco. RESULTADOS: foram encontrados 29 pacientes com diagnóstico de colite ulcerativa inespecífica, sendo 15 (51,7% pacientes do sexo masculino. A idade ao início dos sintomas variou entre 0,3 a 15,8 anos. Os sintomas mais freqüentes ao diagnóstico foram diarréia (89,7% e dor abdominal (82,8%. A manifestação extra-intestinal mais comum foi artralgia/artrite (41,4%. A relação peso para a idade estava abaixo do percentil 3 em 13,8% dos pacientes. O intervalo de tempo entre o início dos sintomas e o diagnóstico variou entre 0,1 e 10,9 anos. CONCLUSÕES: o intervalo entre os sintomas iniciais e o diagnóstico ainda continua elevado na nossa Região devido ao somatório de vários fatores.OBJECTIVES: to describe a series of non-specific ulcerative colitis with focus on the initial manifestation of the disease, propedeutics and interval between the first symptoms and diagnosis. METHODS: retrospective analysis of non-specific ulcerative colitis with symptoms appearing before 20 years old. Patients were selected in the Pediatrics Gastroenterology Services of the Hospital das Clínicas da Universidade Federal de Minas Gerais and of the Instituto Materno Infantil de Pernambuco. RESULTS: 29 patients with the diagnosis of non-specific ulcerative colitis were identified with fifteen patients (51.7% of the male sex. The age of the beginning of the symptoms varied between 0.3 to 15.8. The most frequent symptoms of the diagnosis were diarrhea (89

  3. [Clinical-immunological and microbiological parallels in chronic generalized parodontitis and peptic ulcer of the stomach].

    Science.gov (United States)

    Orekhova, L Iu; Neĭzberg, D M; Stiuf, I Iu

    2006-01-01

    Clinical, immunological and DNA diagnostic examinations of 101 patients with chronic generalized parodontitis and peptic ulcer have revealed similar features of immunological disorders of gastric and oral mucosa and the role of Helicobacter pylori.

  4. Expression of apoptosis related proteins during malignant progression in chronic ulcerative colitis

    NARCIS (Netherlands)

    C.J. van der Woude (Janneke); H. Moshage; M. Homan; J.H. Kleibeuker (Jan); P.L.M. Jansen (Peter); H. van Dekken (Herman)

    2005-01-01

    textabstractBACKGROUND: Chronic ulcerative colitis (CUC) is associated with increased risk of developing colon cancer through a dysplasia (intraepithelial neoplasia)-carcinoma sequence. AIMS: To investigate the expression of apoptosis and inflammatory related proteins in CUC. METHO

  5. Maxillary osteomyelitis in two Scottish terrier dogs with chronic ulcerative paradental stomatitis.

    Science.gov (United States)

    Boutoille, Florian; Hennet, Philippe

    2011-01-01

    Two Scottish terrier dogs were presented for recurrent oral problems. They were diagnosed with refractory chronic ulcerative paradental stomatitis and necrosis of the incisive and maxillary bones. Both dogs were treated with a combination of bilateral rostral maxillectomy and tooth extractions. The ostectomy was performed with a specific cutting device using piezoelectric bone surgery technology. These two cases show that a precise evaluation of dogs is essential for the diagnose of chronic ulcerative paradental stomatitis and its differentiation from mucocutaneous autoimmune diseases.

  6. Topical Administration of Pirfenidone Increases Healing of Chronic Diabetic Foot Ulcers: A Randomized Crossover Study

    Directory of Open Access Journals (Sweden)

    Marcela Janka-Zires

    2016-01-01

    Full Text Available Only 30 percent of chronic diabetic foot ulcers heal after 20 weeks of standard treatment. Pirfenidone is a drug with biological, anti-inflammatory, and antifibrotic effects. The aim of this study was to evaluate the effect of topical pirfenidone added to conventional treatment in noninfected chronic diabetic foot ulcers. This was a randomized crossover study. Group 1 received topical pirfenidone plus conventional treatment for 8 weeks; after this period, they were switched to receive conventional treatment only for 8 more weeks. In group 2, the order of the treatments was the opposite. The end points were complete ulcer healing and size reduction. Final data were obtained from 35 ulcers in 24 patients. Fifty-two percent of ulcers treated with pirfenidone healed before 8 weeks versus 14.3% treated with conventional treatment only (P=0.025. Between 8 and 16 weeks, 30.8% ulcers that received pirfenidone healed versus 0% with conventional treatment (P=0.081. By week 8, the reduction in ulcer size was 100% [73–100] with pirfenidone versus 57.5% with conventional treatment [28.9–74] (P=0.011. By week 16, the reduction was 93% [42.7–100] with pirfenidone and 21.8% [8–77.5] with conventional treatment (P=0.050. The addition of topical pirfenidone to conventional treatment significantly improves the healing of chronic diabetic noninfected foot ulcers.

  7. Topical Administration of Pirfenidone Increases Healing of Chronic Diabetic Foot Ulcers: A Randomized Crossover Study

    Science.gov (United States)

    Janka-Zires, Marcela; Uribe-Wiechers, Ana Cecilia; Juárez-Comboni, Sonia Citlali; López-Gutiérrez, Joel; Escobar-Jiménez, Jarod Jazek; Gómez-Pérez, Francisco J.

    2016-01-01

    Only 30 percent of chronic diabetic foot ulcers heal after 20 weeks of standard treatment. Pirfenidone is a drug with biological, anti-inflammatory, and antifibrotic effects. The aim of this study was to evaluate the effect of topical pirfenidone added to conventional treatment in noninfected chronic diabetic foot ulcers. This was a randomized crossover study. Group 1 received topical pirfenidone plus conventional treatment for 8 weeks; after this period, they were switched to receive conventional treatment only for 8 more weeks. In group 2, the order of the treatments was the opposite. The end points were complete ulcer healing and size reduction. Final data were obtained from 35 ulcers in 24 patients. Fifty-two percent of ulcers treated with pirfenidone healed before 8 weeks versus 14.3% treated with conventional treatment only (P = 0.025). Between 8 and 16 weeks, 30.8% ulcers that received pirfenidone healed versus 0% with conventional treatment (P = 0.081). By week 8, the reduction in ulcer size was 100% [73–100] with pirfenidone versus 57.5% with conventional treatment [28.9–74] (P = 0.011). By week 16, the reduction was 93% [42.7–100] with pirfenidone and 21.8% [8–77.5] with conventional treatment (P = 0.050). The addition of topical pirfenidone to conventional treatment significantly improves the healing of chronic diabetic noninfected foot ulcers. PMID:27478849

  8. [Tumoral proliferations in chronic plantar ulcers: how to treat?].

    Science.gov (United States)

    Grauwin, M Y; Mane, I; Cartel, J L

    1996-01-01

    Between 1983 and 1994, 66 Senegalese leprosy patients were seen for cauliflower growths developed in chronic plantar ulcer (CPU), (2 patients had each 2 tumors). 68 biopsies for pathological examination were taken: the diagnosis of squamous cell carcinoma was effectively made in 39 cases (38 patients) and that of pseudo-epitheliomatous hyperplasia in the remaining 29 cases (28 patients). The mean annual frequency of cauliflower growths was 0.45 per 100 CPU. Among these tumors, the percentage of carcinoma was 57%. Of the 38 patients with a carcinoma, 5 refused amputation and all of them died. The 33 others were amputated and of these 8 died as a direct result of their carcinoma (24%). In the case of the 28 patients with hyperplasia, amputation was carried out on 18 patients and local excision on 10. In the months following the operation 8 recurrences were observed in 10 of the patients on whom excision had been carried out. These recurrences were treated by amputation. This gives a total of 93% of amputations in the cases of hyperplasia. These facts lead as to conclude that at least in countries where pathological examination is not available below knee amputation is the most reasonable action to take in the proliferative tumors developed on a CPU.

  9. [Characterization of chronic plantar ulcers in former leprosy patients].

    Science.gov (United States)

    Grauwin, M Y; Gentile, B; Chevallard, A; Cartel, J L

    1994-01-01

    Between 1988 and 1992, 21 biopsies for pathological examination were taken from 20 Senegalese leprosy patients suffering from chronic plantar ulcers (CPU) suspected of malignant transformation. The diagnosis of squamous cell carcinoma was effectively made in 13 cases and that of pseudoepitheliomatous hyperplasia in the remaining 8 cases. The mean period of time between the onset of CPU and that of malignant transformation was 10 years (range: 1 to 15 years); the mean annual frequency of the malignant transformation was 2 per 1,000 CPU. In countries where pathological examination is not available, below knee amputation could be considered whenever main clinical signs of malignant transformation are present. In countries where pathological examination is available, the therapeutic decision may differ according to the diagnosis: below knee amputation supplemented with block dissection of inguinal lymph nodes whenever possible in cases of carcinoma; below knee amputation depending on the function status of the foot and on the volume of tumor in case of pseudo-epitheliomatous hyperplasia.

  10. Ulcers

    Science.gov (United States)

    ... someone's risk of getting an ulcer because the nicotine in cigarettes causes the stomach to produce more ... endoscopy is given anesthesia and will have no memory of the procedure. For an endoscopy, the doctor ...

  11. Role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain.

    Science.gov (United States)

    Akhter, Saeed; Khan, Muhammad; Ali, Syed Shahzad; Soomro, Rabial Rani

    2014-11-01

    To evaluate the role of manual therapy with exercise regime versus exercise regime alone in the management of non-specific chronic neck pain. In this 62 subjects randomized controlled trial 31 subjects in group A received manual therapy (manipulation) with supervised exercise regime whilst 31 subjects in group B performed only supervised exercise regime for the period of 3 weeks. Both groups had a home exercise program consisted of strengthening exercises for neck/scapuluar stability, stretching and general range of motion exercises for neck with advice regarding posture awareness and correction for 3 months. The results suggested significant reduction in pain intensity level in both groups; over 3 weeks and 12 weeks' time period in relation to baseline on visual analog scale (p=0.001). Similarly, statistically significant improvements noticed in Neck Disability Index (NDI) (p=0.0001) in both groups while looking at baseline data with reference to 12 weeks' time period. On closer inspection, the manual therapy (manipulation) with exercise regime appeared as a favorable treatment preference compared with exercise regime alone.

  12. Preliminary study of neck muscle size and strength measurements in females with chronic non-specific neck pain and healthy control subjects.

    Science.gov (United States)

    Rezasoltani, Asghar; Ali-Reza, Ahmadipor; Khosro, Khademi-Kalantari; Abbass, Rahimi

    2010-08-01

    Neck muscle weakness and atrophy are two common causes of pain and disability among office workers. The aim of this study was to compare the strength of the neck extensor and flexor muscles and the size of the semispinalis capitis muscle (SECM) in patients with chronic non-specific neck pain (CNNP) and healthy subjects. Twenty female office workers (10 patients with CNNP and 10 healthy subjects) participated in this study. The strength of the neck extensor and flexor muscles was measured by an isometric device and the SECM size was measured by ultrasonography. Neck muscle strength, size of the SECM and the ratios of neck strength to body weight, neck extensor strength to SECM size, SECM size to body weight and neck flexor to extensor strength were all significantly lower in patients compared to controls (P neck strength, the size of the SECM and the ratio of neck muscle strength to SECM size appear to be useful parameters in appraising patients with CNNP.

  13. Characteristics of chronic non-specific musculoskeletal pain in children and adolescents attending a rheumatology outpatients clinic: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Murray Kevin

    2011-01-01

    Full Text Available Abstract Background Chronic non-specific musculoskeletal pain (CNSMSP may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood. The purpose of the study was to build a biopsychosocial profile of children and adolescents with CNSMSP. Methods CNSMSP subjects (n = 30, 18 females, age 7-18 were compared with age matched pain free controls across a number of biopsychosocial domains. Results In the psychosocial domain CNSMSP subjects had increased levels of anxiety and depression, and had more somatic pain complaints. In the lifestyle domain CNSMSP subjects had lower physical activity levels, but no difference in television or computer use compared to pain free subjects. Physically, CNSMSP subjects tended to sit with a more slumped spinal posture, had reduced back muscle endurance, increased presence of joint hypermobility and poorer gross motor skills. Conclusion These findings support the notion that CNSMSP is a multidimensional biopsychosocial disorder. Further research is needed to increase understanding of how the psychosocial, lifestyle and physical factors develop and interact in CNSMSP.

  14. Subacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Strender Lars-Erik

    2008-12-01

    Full Text Available Abstract Background In the industrial world, non-specific back and neck pain (BNP is the largest diagnostic group underlying sick-listing. For patients with subacute and chronic (= full-time sick-listed for 43 – 84 and 85 – 730 days, respectively BNP, cognitive-behavioural rehabilitation was compared with primary care. The specific aim was to answer the question: within an 18-month follow-up, will the outcomes differ in respect of sick-listing and number of health-care visits? Methods After stratification by age (≤ 44/≥ 45 years and subacute/chronic BNP, 125 Swedish primary-care patients were randomly allocated to cognitive-behavioural rehabilitation (rehabilitation group or continued primary care (primary-care group. Outcome measures were Return-to-work share (percentage and Return-to-work chance (hazard ratios over 18 months, Net days (crude sick-listing days × degree, and the number of Visits (to physicians, physiotherapists etc. over 18 months and the three component six-month periods. Descriptive statistics, Cox regression and mixed-linear models were used. Results All patients: Return-to-work share and Return-to-work chance were equivalent between the groups. Net days and Visits were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods (p Return-to-work share was equivalent. Return-to-work chance was significantly greater for the rehabilitation group (hazard ratio 3.5 [95%CI1.001 – 12.2]. Net days were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods and there were 31 days fewer in the third period. Visits showed similar though non-significant differences and there were half as many in the third period. Chronic patients: Return-to-work share, Return-to-work chance and Net days were equivalent. Visits were equivalent over 18 months but tended to decrease more rapidly for the

  15. Extracorporeal shockwave therapy in the treatment of chronic diabetic foot ulcers

    DEFF Research Database (Denmark)

    Jeppesen, S M; Yderstraede, K B; Rasmussen, B S B

    2016-01-01

    OBJECTIVE: To investigate the efficacy of extracorporeal shockwave therapy (ESWT) on healing chronic diabetic foot ulcers (DFU). METHOD: Patients with chronic DFUs were randomised (1:1) to receive a series of six ESWT treatments over 3 weeks in combination with standard care or standard care alone...

  16. Effect of sialoadenectomy and synthetic human urogastrone on healing of chronic gastric ulcers in rats

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier; Nexø, Ebba

    1986-01-01

    The effect of extirpation of the submandibular glands, an exocrine organ for epidermal growth factor/urogastrone (EGF/URO), and the effect of oral administration of synthetic human (EGF/URO) on healing of chronic gastric ulcers in rats has been investigated. Removal of the submandibular glands...... delayed healing of chronic gastric ulcers when examined after 50, 100, and 200 days. Oral administration of synthetic human EGF/URO stimulated gastric ulcer healing when examined after 25 and 50 days of treatment. The effect of synthetic human EGF/URO was comparable with that of cimetidine. The combined...... administration of synthetic human EGF/URO and cimetidine further increased healing of gastric ulcers compared with administration of each substance. Neither synthetic human EGF/URO, nor removal of the submandibular glands had any influence on gastric acid secretion. This study showed that the submandibular...

  17. The bacteriology of chronic venous leg ulcer examined by culture-independent molecular methods

    DEFF Research Database (Denmark)

    Thomsen, Trine R; Aasholm, Martin S; Rudkjøbing, Vibeke B;

    2010-01-01

    , such as 16S rRNA gene sequencing, fingerprinting, quantitative polymerase chain reaction, and fluorescence in situ hybridization. Each wound contained an average of 5.4 species but the actual species varied between wounds. The diversity determined by culture-based methods and the molecular biological methods...... was different. All the wounds contained Staphylococcus aureus, whereas Pseudomonas aeruginosa was in six out of 14 wounds. Molecular methods detected anaerobic pathogens in four ulcers that were not detected with anaerobic culture methods. Quantitative polymerase chain reaction was used to compare the abundance......The bacterial microbiota plays an important role in the prolonged healing of chronic venous leg ulcers. The present study compared the bacterial diversity within ulcer material from 14 skin graft operations of chronic venous leg ulcers using culture-based methods and molecular biological methods...

  18. Citric acid treatment of chronic nonhealing ulcerated tophaceous gout with bursitis.

    Science.gov (United States)

    Nagoba, Basavaraj S; Punpale, Ajay; Poddar, Ashok; Suryawanshi, Namdev M; Swami, Ganesh A; Selkar, Sohan P

    2013-12-01

    The ulceration associated with gout tophi is very difficult to treat because of impaired and halted local inflammatory response resulting from the gout treatment regimen. We report chronic nonhealing tophaceous gout with bursitis in an 80-year-old male, not responding to conventional treatment modality for months together. This nonhealing ulcer was treated successfully with local application of 3% citric acid ointment for 22 days.

  19. The effect of continuous ultrasound on chronic non-specific low back pain: a single blind placebo-controlled randomized trial

    Directory of Open Access Journals (Sweden)

    Ebadi Safoora

    2012-10-01

    Full Text Available Abstract Background Non-specific chronic low back pain (NSCLBP is one of the most common musculoskeletal disorders around the world including Iran. One of the most widely used modalities in the field of physiotherapy is therapeutic ultrasound (US. Despite its common use, there is still inconclusive evidence to support its effectiveness in patients with NSCLBP. The objective of this study was to evaluate the effect of continuous US compared with placebo US additional to exercise therapy for patients with NSCLBP. Methods In this single blind placebo controlled study, 50 patients with NSCLBP were randomized into two treatment groups: 1 continuous US (1 MHz &1.5 W/cm2 plus exercise 2 placebo US plus exercise. Patients received treatments for 4 weeks, 10 treatment sessions, 3 times per week, every other day. Treatment effects were assessed in terms of primary outcome measures: 1 functional disability, measured by Functional Rating Index, and 2 global pain, measured by a visual analog scale. Secondary outcome measures were lumbar flexion and extension range of motion (ROM, endurance time and rate of decline in median frequency of electromyography spectrum during a Biering Sorensen test. All outcome variables were measured before, after treatment, and after one-month follow-up. An intention to treat analysis was performed. Main effects of Time and Group as well as their interaction effect on outcome measures were investigated using repeated measure ANOVA. Results Analysis showed that both groups had improved regarding function (FRI and global pain (VAS (P .05. Improvement in function and lumbar ROM as well as endurance time were significantly greater in the group receiving continuous US (P Conclusions The study showed that adding continuous US to a semi supervised exercise program significantly improved function, lumbar ROM and endurance time. Further studies including a third group of only exercise and no US can establish the possible effects of

  20. Crohn's disease but not chronic ulcerative colitis induces the expression of PAI-1 in enteric neurons

    DEFF Research Database (Denmark)

    Laerum, O.D.; Illemann, M.; Skarstein, A.

    2008-01-01

    OBJECTIVES: Chronic inflammation of the intestinal wall is the common characteristic of Crohn's disease and ulcerative colitis; disorders, which in some cases can be difficult to distinguish. The inflammation also affects the local neuronal plexuses of the enteric nervous system. It is known...... by immunohistochemical techniques. RESULTS: PAI-1 was found in a subset of neurons primarily located in the submucosal plexus of the small and large intestine in 24 of 28 cases (86%) with Crohn's disease, but in none of 17 cases with chronic ulcerative colitis and other severe inflammatory conditions in the intestinal....... CONCLUSIONS: PAI-1-positive neurons in inflammatory bowel disease are linked to chronic inflammation in Crohn's disease, implying PAI-1 as a potential parameter for the differential diagnosis between Crohn's disease and ulcerative colitis. The findings also suggest that PAI-1 in neurons is related to pain...

  1. Major ozonated autohemotherapy in chronic limb ischemia with ulcerations.

    Science.gov (United States)

    de Monte, Amato; van der Zee, Hoyte; Bocci, Velio

    2005-04-01

    This paper reports the beneficial effects of ozone autohemotherapy (OHT) in 2 patients afflicted with painful, intractable leg ulcers. One patient had diabetes mellitus type II (DM), the other had vasculitis. Both patients had seen multiple specialists, including a dermatologist, an internist, and a vascular surgeon, but their clinical course continued to worsen. When the pain became intolerable, the patients came to our pain clinic. Chemical lumbar sympathectomy as well as epidural blockade with bupivacaine and morphine were moderately effective in reducing their pain but had no effect on the ulcers. Only after OHT treatments were performed for several months was satisfactory healing observed.

  2. Chronic ulceration of the leg following extensive scarring due to a snake bite complicated by squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mello, L.F.B.; Barcelos, M.G.; Nogueira Neto, N.C. [Dept. of Radiology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Meohas, W. [Dept. of Surgery (Bone and Soft Tissue), National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Pinto, L.W. [Department of Surgical Pathology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Melo, P.A. [Pharmacology Lab. of Snake-related Toxins, Department of Basic and Clinical Pharmacology, Federal University of Rio de Janeiro - UFRJ, Rio de Janeiro, RJ (Brazil); Smith, J. [Dept. of Radiology, National Cancer Institute - INCA, Rio de Janeiro, RJ (Brazil); Rua Humberto de Campos 974/1301, Leblon 22430 - 190, Rio de Janeiro, RJ (Brazil)

    2000-05-01

    Chronic ulcers of the leg are common in Brazil, perhaps more common than in the developed world. We report a case of a chronic ulcer of the leg following extensive scarring due to a bite by a venomous snake, which eventually led to a squamous cell carcinoma. (orig.)

  3. Bidirectional crosstalk between stress-induced gastric ulcer and depression under chronic stress.

    Directory of Open Access Journals (Sweden)

    Shuang Zhang

    Full Text Available Stress contributes to a variety of diseases and disorders such as depression and peptic ulcer. The present study aimed to investigate the correlation between stress ulcer and depression in pathogenesis and treatment by using chronic stress depression (CSD, chronic psychological stress ulcer (CPSU and water immersion restrain stress models in rats. Our data showed that the ulcer index of the animals after CSD exposure was significantly higher than that of controls. Depression-like behaviors were observed in rat after CPSU exposure. Fluoxetine hydrochloride significantly reduced the ulcer index of rats exposed to CPSU stress, while ranitidine inhibited depression-like behavior of the animals in CSD group. The ulcer index of rats administered with mifepristone after CPSU stress was markedly reduced compared to CPSU group, although there was no significant difference in the depression-like behavior between mifepristone-treated CSD group and naive controls. We also found that the rats exposed to CPSU or CSD stress displayed a lower level of corticosterone than naive controls, however, the acute stress (AS group showed an opposite result. Additionally, in order to study the relevance of H(2 receptors and depression, we treated the CSD group with cimetidine and famotidine respectively. The data showed that cimetidine inhibited depression-like behavior in CSD rats, and famotidine had no impact on depression. Overall our data suggested that the hypothalamic-pituitary-adrenal (HPA axis dysfunction may be the key role in triggering depression and stress ulcer. Acid-suppressing drugs and antidepressants could be used for treatment of depression and stress ulcer respectively. The occurrence of depression might be inhibited by blocking the central H(2 receptors.

  4. Long-term effects of interprofessional biopsychosocial rehabilitation for adults with chronic non-specific low back pain: a multicentre, quasi-experimental study.

    Directory of Open Access Journals (Sweden)

    Jana Semrau

    Full Text Available Improvement of the long-term effectiveness of multidisciplinary ortho-paedic rehabilitation (MOR in the management of chronic non-specific low back pain (CLBP remains a central issue for health care in Germany. We developed an interprofessional and interdisciplinary, biopsychosocial rehabilitation concept named "PASTOR" to promote self-management in adults with CLBP and compared its effectiveness with the current model of MOR.A multicentre quasi-experimental study with three measurement time points was implemented. 680 adults aged 18 to 65 with CLBP were assed for eligibil-ity in three inpatient rehabilitation centres in Germany. At first the effects of the MOR, with a total extent of 48 hours (control group, were assessed. Thereafter, PASTOR was implemented and evaluated in the same centres (intervention group. It consisted of six interprofessional modules, which were provided on 12 days in fixed groups, with a total extent of 48 hours. Participants were assessed with self-report measures at baseline, discharge, and 12 months for functional ability (primary outcome using the Hannover Functional Ability Questionnaire (FFbH-R and vari-ous secondary outcomes (e.g. pain, health status, physical activity, pain coping, pain-related cognitions.In total 536 participants were consecutively assigned to PASTOR (n=266 or MOR (n=270. At 12 months, complete data of 368 participants was available. The adjusted between-group difference in the FFbH-R at 12 months was 6.58 (95% CI 3.38 to 9.78 using complete data and 3.56 (95% CI 0.45 to 6.67 using available da-ta, corresponding to significant small-to-medium effect sizes of d=0.42 (p<0.001 and d=0.10 (p=0.025 in favour of PASTOR. Further improvements in secondary out-comes were also observed in favour of PASTOR.The interprofessional and interdisciplinary, biopsychosocial rehabilita-tion program PASTOR shows some improvements of the long-term effectiveness of inpatient rehabilitation in the management of adults

  5. Oral administration of synthetic human urogastrone promotes healing of chronic duodenal ulcers in rats

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier; Nexø, Ebba

    1986-01-01

    The effect of oral administration of synthetic human epidermal growth factor/urogastrone (EGF/URO) on healing of chronic duodenal ulcers induced by cysteamine in rats was investigated and compared with that of cimetidine, a H2-receptor antagonist. After 25 and 50 days of treatment, synthetic human...... EGF/URO significantly increased healing of chronic duodenal ulcers to the same extent as cimetidine. Combined treatment with synthetic human EGF/URO and cimetidine for 25 days was more effective than synthetic human EGF/URO given alone, whereas combined treatment for 50 days was significantly more...... effective than cimetidine alone. These results show that a combination of an agent inhibiting gastric acid secretion and the cytoprotective and growth-stimulating peptide EGF/URO seems to be more effective with regard to duodenal ulcer healing than individual administration of the two substances. Synthetic...

  6. Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Marcelo Henrique da Silva

    2014-08-01

    Full Text Available Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions.

  7. Wound Chronicity, Inpatient Care, and Chronic Kidney Disease Predispose to MRSA Infection in Diabetic Foot Ulcers

    Science.gov (United States)

    Yates, Christopher; May, Kerry; Hale, Thomas; Allard, Bernard; Rowlings, Naomi; Freeman, Amy; Harrison, Jessica; McCann, Jane; Wraight, Paul

    2009-01-01

    OBJECTIVE To determine the microbiological profile of diabetes-related foot infections (DRFIs) and the impact of wound duration, inpatient treatment, and chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS Postdebridement microbiological samples were collected from individuals presenting with DRFIs from 1 January 2005 to 31 December 2007. RESULTS A total of 653 specimens were collected from 379 individuals with 36% identifying only one isolate. Of the total isolates, 77% were gram-positive bacteria (staphylococci 43%, streptococci 13%). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from 23%; risk factors for MRSA included prolonged wound duration (odds ratio 2.31), inpatient management (2.19), and CKD (OR 1.49). Gram-negative infections were more prevalent with inpatient management (P = 0.002) and prolonged wound duration (P < 0.001). Pseudomonal isolates were more common in chronic wounds (P < 0.001). CONCLUSIONS DRFIs are predominantly due to gram-positive aerobes but are usually polymicrobial and increase in complexity with inpatient care and ulcer duration. In the presence of prolonged duration, inpatient management, or CKD, empiric MRSA antibiotic cover should be considered. PMID:19587371

  8. Chronic Ulceration and Sinus Formation due to Foreign Body

    DEFF Research Database (Denmark)

    Hansen, Karin Birgitte; Gottrup, Finn

    2015-01-01

    Foreign bodies like residues of suture or mesh may lead to a foreign body reaction, cavity formation and continuous secretion and perhaps ulceration. We present a more than 9 years long medical record of a 49 year old man after a simple surgical procedure. The background was a sinus formation gen...... in these cases. The knowledge of the foreign body reaction in tissue continuously needs to be reestablished in the health care system especially in areas, where implantation of foreign material is used....

  9. Pattern of antimicrobials use in chronic leg ulcers at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Afreen Fatima

    2016-10-01

    Conclusions: Majority of the AMAs used in the treatment of chronic leg ulcers were injection. However prescriptions from Essential Medicine List and by generic name were less frequent. [Int J Basic Clin Pharmacol 2016; 5(5.000: 2021-2024

  10. Heme-Scavenging Role of alpha1-Microglobulin in Chronic Ulcers.

    OpenAIRE

    Allhorn, Maria; Lundqvist, Katarina; Schmidtchen, Artur; Åkerström, Bo

    2003-01-01

    Chronic venous ulcers are characterized by chronic inflammation. Heme and iron, originating from blood cell hemolysis as well as extravascular necrosis, have been implicated as important pathogenic factors due to their promotion of oxidative stress. It was recently reported that the plasma and tissue protein alpha1-microglobulin is involved in heme metabolism. The protein binds heme, and a carboxy-terminally processed form, truncated alpha1-microglobulin, also degrades heme. Here, we show the...

  11. Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers

    DEFF Research Database (Denmark)

    Karlsmark, T; Agerslev, R H; Bendz, S H

    2003-01-01

    OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD: The clini......OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD......'s effect on the peri-ulcer area. Blood samples were analysed for silver content. RESULTS: Twenty-three out of 25 patients completed the study. One ulcer healed and no wound infections occurred during the study period. A mean 56% reduction in ulcer area (from 15.6 to 6.9 cm2) was recorded during the four...... weeks, and there was a mean 25% reduction in granulation tissue from dull to healthy after one week. Wound odour reduced significantly after one week. Mean dressing wear time was 3.1 days, and there were only minimal incidences of leakage. Serum silver levels did not exceed reference values. CONCLUSION...

  12. Solcoseryl in prevention of stress-induced gastric lesions and healing of chronic ulcers.

    Science.gov (United States)

    Konturek, S J; Drozdowicz, D; Pytko-Polonczyk, J; Brzozowski, T; Bielański, W

    1991-03-01

    Solcoseryl, a deproteinized extract of calf blood, protects the gastric mucosa against various topical irritants and enhances the healing of chronic gastric ulcerations but the mechanisms of these effects have been little studied. This study was designed to elucidate the active principle in Solcoseryl and to determine the role of prostaglandins (PG) and polyamines in the antiulcer properties of this agent. Using both, the radioimmunoassay and radioreceptor assay, EGF-like material was detected in Solcoseryl preparation. Solcoseryl given s.c. prevented the formation of stress-induced gastric lesions and this was accompanied by an increase in the generation of PGE2 in the gastric mucosa. Similar effects were obtained with EGF. Pretreatment with indomethacin, to suppress mucosal generation of prostaglandins (PG), greatly augmented stress-induced gastric ulcerations and antagonized the protection exerted by both Solcoseryl and EGF. Solcoseryl, like EGF, enhanced the healing of chronic gastro-duodenal ulcerations. This effect was abolished by the pretreatment with difluoromethylornithine, an inhibitor of ornithine decarboxylase, the key enzyme in the biosynthesis of polyamines. The healing effects of Solcoseryl and EGF was also reduced by prednisolone which decreased the angiogenesis in the granulation tissue in the ulcer area. These results indicate that Solcoseryl 1. contains EGF-like material, 2. displays the protective and ulcer healing effects similar to those of EGF and involving both PG and polyamines and 3. acts via similar mechanism as does EGF.

  13. Extracellular matrix assessment of infected chronic venous leg ulcers: role of metalloproteinases and inflammatory cytokines.

    Science.gov (United States)

    Serra, Raffaele; Grande, Raffaele; Buffone, Gianluca; Molinari, Vincenzo; Perri, Paolo; Perri, Aldina; Amato, Bruno; Colosimo, Manuela; de Franciscis, Stefano

    2016-02-01

    Chronic venous ulcer (CVU) represents a dreaded complication of chronic venous disease (CVD). The onset of infection may further delay the already precarious healing process in such lesions. Some evidences have shown that matrix metalloproteinases (MMPs) are involved and play a central role in both CVUs and infectious diseases. Two groups of patients were enrolled to evaluate the expression of MMPs in infected ulcers and the levels of inflammatory cytokines as well as their prevalence. Group I comprised 63 patients (36 females and 27 males with a median age of 68·7 years) with infected CVUs, and group II (control group) comprised 66 patients (38 females and 28 males with a median age of 61·2 years) with non-infected venous ulcers. MMP evaluation and dosage of inflammatory cytokines in plasma and wound fluid was performed by means of enzyme-linked immunosorbent assay test; protein extraction and immunoblot analysis were performed on biopsied wounds. The first three most common agents involved in CVUs were Staphylococcus aureus (38·09%), Corynebacterium striatum (19·05%) and Pseudomonas aeruginosa (12·7%). In this study, we documented overall higher levels of MMP-1 and MMP-8 in patients with infected ulcers compared to those with uninfected ulcers that showed higher levels of MMP-2 and MMP-9. We also documented higher levels of interleukin (IL)-1, IL-6, IL-8, vascular endothelial growth factor and tumour necrosis factor-alpha in patients with infected ulcers with respect to those with uninfected ulcers, documenting a possible association between infection, MMP activation, cytokine secretions and symptoms. The present results could represent the basis for further studies on drug use that mimic the action of tissue inhibitors of metalloproteinases in order to make infected CVU more manageable.

  14. [A clinical constelation in disuse: vitiligo, mastocytosis of the bone marrow, circulating heparinoid, chronic leg ulcer, hypoalbuminemia, ulcerative colitis and hepatic fibrosis].

    Science.gov (United States)

    Goihman Yahr, M; Goldstein, C; González, Y; Aranzazu, N; Convit, J; Acevedo Gallegos, F; Grases, P

    1977-01-01

    We report an unusual case. Our patient had vitiligo, ulcerative colitis, hepatic fibrosis, hypoalbuminemia, bone marrow mastocytosis, a circulating heparinoid and chronic leg ulcers. The relationship between some of the components of this constellation seems logical. This is the case with bone marrow mastocytosis and circulating heparinoid. Also, between hypoalbuminemia and colitis and liver disfunction. On the other hand, the relationship between other features does not seem clear in the light of current knowledge.

  15. Chronic tongue ulceration resolved by sulpiride: a report of two cases.

    Science.gov (United States)

    Terai, H; Shimahara, M

    2009-07-01

    We report two patients with chronic tongue ulceration who were successfully treated using sulpiride. The clinical diagnosis was oral candidiasis related to long-term steroid treatment. The results of the culture test and cytological examination supported this diagnosis, but antifungal treatment was ineffective and the tongue pain in these patients became more severe. Furthermore, the pain could not be relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). We therefore prescribed sulpiride in addition to NSAIDs to reduce the tongue pain. A consequent improvement in both pain severity and ulceration was observed 2-3 weeks after sulpiride administration.

  16. Preventing Ischial Pressure Ulcers: III. Clinical Pilot Study of Chronic Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Hilton M. Kaplan

    2011-01-01

    Full Text Available Objective: BIONs™ (BIOnic Neurons are injectable, wireless microstimulators that make chronic BION Active Seating (BAS possible for pressure ulcer prevention (PUP. Neuromuscular electrical stimulation (NMES produces skeletal motion and activates trophic factors, counteracting three major etiological mechanisms leading to pressure ulcers (PUs: immobility, soft-tissue atrophy, and ischemia. Companion papers I and II reviewed prior experience with NMES for PUP, and analyzed the biomechanical considerations, respectively. This paper presents a treatment strategy derived from this analysis, and the clinical results of the first three cases.

  17. Chronic ulcers and myasis as ports of entry for Clostridium tetani

    Directory of Open Access Journals (Sweden)

    Greco Jiuseppe Benitivoglio

    2001-01-01

    Full Text Available Evaluating tetanus immune status is not yet the usual clinical practice regarding patients with chronic ulcers or myasis. However, of 858 tetanus patients at Hospital Couto Maia (Salvador, Bahia, Brazil aged 1 year or above, 2 had pressure ulcers and 17 had chronic ulceration of the lower limbs where these skin lesions were the ports of entry for Clostridium tetani. In these 19 cases, the following predisposing factors were described: venous insufficiency (n=6, sickle cell anemia (n=2, Hansen's disease (n=1, malnutrition (n=1, diabetes mellitus (n=1, trauma (n=1 and unknown factors (n=7. In 6 other cases, in addition to the Hansen's disease patient, the port of entry for tetanus was the site of extraction of Tunga penetrans larvae. In these 25 cases, the majority of patients (68% were over 40 years old (17/25 and all of these patients stated that they had either not followed a tetanus toxoid vaccination regimen (19/25, or had partially completed such a regimen, or did not give precise information (6/25. Among the same series studied, over half (52% of the patients died (13/25. We conclude that tetanus prevention must be included in the treatment of chronic skin ulcer patients, vaccination coverage should be increased among older people, and strategies aimed at improving coverage for all age groups must be reviewed.

  18. Chronic ulcers and myasis as ports of entry for Clostridium tetani.

    Science.gov (United States)

    Greco, J B; Sacramento, E; Tavares-Neto, J

    2001-12-01

    Evaluating tetanus immune status is not yet the usual clinical practice regarding patients with chronic ulcers or myasis. However, of 858 tetanus patients at Hospital Couto Maia (Salvador, Bahia, Brazil) aged 1 year or above, 2 had pressure ulcers and 17 had chronic ulceration of the lower limbs where these skin lesions were the ports of entry for Clostridium tetani. In these 19 cases, the following predisposing factors were described: venous insufficiency (n=6), sickle cell anemia (n=2), Hansen s disease (n=1), malnutrition (n=1), diabetes mellitus (n=1), trauma (n=1) and unknown factors (n=7). In 6 other cases, in addition to the Hansen s disease patient, the port of entry for tetanus was the site of extraction of Tunga penetrans larvae. In these 25 cases, the majority of patients (68%) were over 40 years old (17/25) and all of these patients stated that they had either not followed a tetanus toxoid vaccination regimen (19/25), or had partially completed such a regimen, or did not give precise information (6/25). Among the same series studied, over half (52%) of the patients died (13/25). We conclude that tetanus prevention must be included in the treatment of chronic skin ulcer patients, vaccination coverage should be increased among older people, and strategies aimed at improving coverage for all age groups must be reviewed.

  19. Morphologic features of chronic hepatitis associated with primary sclerosing cholangitis and chronic ulcerative colitis

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, J.; Barham, S.S.; LaRusso, N.F.; Elveback, L.R.; Wiesner, R.H.; McCall, J.T.

    Histologic, ultrastructural, chemical, and statistical methods were used to study liver biopsy and autopsy specimens from 43 patients who had primary sclerosing cholangitis (PSC), with or without chronic ulcerative colitis (CUC), and from 19 patients who had CUC without PSC. In all study groups, essentially the same abnormalities were found in the hepatic parenchyma outside the major bile ducts, although nondiagnostic tissue samples were observed also. Specimens from patients with extrahepatic PSC were indistinguishable from those patients with combined extra- and intrahepatic PSC. Common findings included periductal fibrosis and inflammation, portal edema and fibrosis, focal proliferation of bile ducts and ductules, focal bile duct obliteration and loss of bile ducts, copper deposition, and cholestasis. Proliferation of bile ducts in some portal tracts and obliteration or absence of bile duct in others were the most characteristic changes. In most specimens, inflammatory changes appeared mild, yet biliary cirrhosis had developed in 34% of the patients. Specimens from patients with PSC, with or without CUC, more often contained bile and strikingly increased stainable copper (Grades 2 and 3) than did specimens from patients with CUC without PSC. Hepatic copper contents, measured by atomic absorption spectrophotometry, also were higher in specimens from patients with PSC. Study of PCS specimens by transmission electron microscopy and by energy-dispersive X-ray microanalysis revealed that most copper was sequestered in lipolysosomes. The recognition of strikingly similar morphologic features in many liver specimens from patients with either PSC or CUC or both suggests that the causes of these conditions are closely related.

  20. [Extracorporeal shock wave therapy as a treatment of a non-healing chronic leg ulcer].

    Science.gov (United States)

    Stieger, M; Schmid, J-P; Bajrami, S; Hunziker, T

    2013-06-01

    Extracorporeal shock waves are defined as a sequence of sonic pulses characterized by high peak pressure over 100 MPa, fast pressure rise, and short lifecycle. In the 1980s extracorporeal shock wave lithotripsy (ESWL) was first used for the treatment of urolithiasis. Orthopedic surgeons use extracorporeal shock wave therapy (ESWT) to treat non-union fractures, tendinopathies and osteonecrosis. The first application of ESWT in dermatology was for recalcitrant skin ulcers. Several studies in the last 10 years have shown that ESWT promotes angiogenesis, increases perfusion in ischemic tissues, decreases inflammation, enhances cell differentiation and accelerates wound healing. We successfully treated a non-healing chronic venous leg ulcer with ESWT. Furthermore we observed an improvement of the lymphatic drainage after application of ESWT. We are confident that ESWT is a non-invasive, practical, safe and efficient physical treatment modality for recalcitrant leg ulcers.

  1. A randomized controlled trial of solcoseryl and duoderm in chronic sickle-cell ulcers.

    Science.gov (United States)

    La Grenade, L; Thomas, P W; Serjeant, G R

    1993-09-01

    A randomized controlled trial of Solcoseryl, DuoDerm and conventional conservative therapy with Eusol has been performed in 32 patients with homozygous sickle-cell (SS) disease. After 12 weeks' baseline observation, patients were randomized to one of three therapies and monitored for a further 12 weeks. Of 44 ulcerated legs, 20 received control treatment, 12 Solcoseryl and 12 DuoDerm. DuoDerm was generally unacceptable, and two-thirds of the patients defaulted from this treatment. Solcoseryl increased ulcer healing compared to the controls but the difference was not significant. Solcoseryl was well tolerated and may have a role in the treatment of chronic leg ulcers of sickle-cell disease.

  2. 温中健脾法治疗慢性消化性溃疡及慢性非特异性溃疡性结肠炎效果评价%Effect evaluation of chronic peptic ulcer and chronic nonspecific ulcerative colitis treated by warming inner and invigorating spleen therapy

    Institute of Scientific and Technical Information of China (English)

    吕瑾

    2015-01-01

    目的:探析在慢性消化性溃疡及慢性非特异性溃疡性结肠炎患者治疗过程中,温中健脾法治疗方法的应用效果。方法选择我院2014年3月至2015年4月收治的慢性消化性溃疡及慢性非特异性溃疡性结肠炎患者110例,随机均匀分成两组,对照组患者主要进行雷尼替丁药物治疗和柳氮磺砒啶肠溶片治疗,观察组患者主要进行温中健脾法治疗,研究比较两组患者临床治疗有效情况。结果经过两组患者临床治疗,在患者临床治疗有效情况、中医证候疗效以及中医证候积分情况上,观察组都明显优于对照组。结论温中健脾法治疗慢性消化性溃疡及慢性非特异性溃疡性结肠炎效果显著。%Objective to analyze application effect of warming inner and invigorating spleen method during treating patients with chronic peptic ulcer and chronic non specificity ulcer colitis. Method choose 110 cases patients with chronic peptic ulcer and chronic nonspecific ulcerative colitis received in our hospital during March 2014 and April 2015, and randomly divide them into two groups in average, control group was treated mainly by ranitidine therapy and sulfasalazine enteric coated tablets, and observation group mainly by warming inner and invigorating spleen therapy, and study and compare two groups patients with clinical effects﹒ Result after clinical treatment of two groups patients, observation group was significantly better than control group with clinical treatment effect, TCM syndrome effects and TCM syndrome scores. Conclusion warming inner and invigorating spleen therapy has remarkable effect to treat chronic peptic ulcer and chronic nonspecific ulcerative colitis.

  3. Ganoderma Lucidum Pharmacopuncture for Teating Ethanol-induced Chronic Gastric Ulcers in Rats

    Directory of Open Access Journals (Sweden)

    Jae-Heung Park

    2015-03-01

    Full Text Available Objectives: The stomach is a sensitive digestive organ that is susceptible to exogenous pathogens from the diet. In response to such pathogens, the stomach induces oxidative stress, which might be related to the development of both gastric organic disorders such as gastritis, gastric ulcers, and gastric cancer, and functional disorders such as functional dyspepsia. This study was accomplished to investigate the effect of Ganoderma lucidum pharmacopuncture (GLP on chronic gastric ulcers in rats. Methods: The rats were divided into 4 groups of 8 animals each: the normal, the control, the normal saline (NP and the GLP groups. In this study, the modified ethanol gastritis model was used. The rats were administrated 56% ethanol orally every other day. The dose of ethanol was 8 g/kg body weight. The normal group received the same amount of normal saline instead of ethanol. The NP and the GLP groups were treated with injection of saline and GLP respectively. The control group received no treatment. Two local acupoints CV12 (中脘 and ST36 (足三里 were used. All laboratory rats underwent treatment for 15 days. On last day, the rats were sacrificed and their stomachs were immediately excised. Results: Ulcers of the gastric mucosa appeared as elongated bands of hemorrhagic lesions parallel to the long axis of the stomach. In the NP and GLP groups, the injuries to the gastric mucosal injuries were not as severe as they were in the control group. Wound healings of the chronic gastric ulcers was promoted by using GLP and significant alterations of the indices in the gastric mucosa were observed. Such protection was demonstrated by gross appearance, histology and immunehistochemistry staining for Bcl-2-associated X (BAX, B-cell lymphoma 2 (Bcl-2 and Transforming growth factor-beta 1 (TGF-β1. Conclusion: These results suggest that GLP at CV12 and ST36 can provide significant protection to the gastric mucosa against an ethanol induced chronic gastric ulcer.

  4. Experimental chronic Pseudomonas aeruginosa lung infection in rats. Non-specific stimulation with LPS reduces lethality as efficiently as specific immunization

    DEFF Research Database (Denmark)

    Lange, K H; Hougen, H P; Høiby, N

    1995-01-01

    stimulation of the non-specific defence mechanisms by Escherichia coli lipopolysaccharide (LPS) or P. aeruginosa sonicate, or the acquired specific immune response by vaccination with the same bacterial antigens. One day prior to challenge with P. aeruginosa embedded in alginate beads, rats were stimulated...... to earlier recruitment of PMNs most likely mediated by either cytokines and other chemotactic factors (stimulated group) or the immune response in concert with the complement cascade (vaccinated group). The results of the present and previous vaccination studies show that it is possible to improve survival...

  5. Proliferation and mitogenic response to PDGF-BB of fibroblasts isolated from chronic venous leg ulcers is ulcer-age dependent

    DEFF Research Database (Denmark)

    Agren, M S; Steenfos, H H; Dabelsteen, S

    1999-01-01

    Several pathophysiologic mechanisms have been proposed to explain slow-healing leg ulcers, but little is known about the growth behavior of cells in these wounds. Platelet-derived growth factor-BB applied topically to chronic wounds has shown beneficial effects, although the effects have been les...... chronic wounds have approached or even reached the end of their lifespan (phase III). This might provide one explanation for the non-healing state and therapy resistance to topical platelet-derived growth factor-BB of some venous leg ulcers.......Several pathophysiologic mechanisms have been proposed to explain slow-healing leg ulcers, but little is known about the growth behavior of cells in these wounds. Platelet-derived growth factor-BB applied topically to chronic wounds has shown beneficial effects, although the effects have been less...... pronounced than would have been expected based on studies on acute wounds. The objective of this study was to compare fibroblasts in culture obtained from chronic wounds (non-healing chronic venous leg ulcers), acute wounds and normal dermis regarding growth, mitogenic response to platelet-derived growth...

  6. Peripheral ulcerative keratitis associated with chronic malabsorption syndrome and miliary tuberculosis in a child

    OpenAIRE

    Tarun Arora; Namrata Sharma; Adarsh Shashni; Titiyal, Jeewan S.

    2015-01-01

    A 16-year-old girl presented with pain, redness, watering, and blurring of vision in her right eye. Slit lamp examination revealed the presence of peripheral ulcerative keratitis (PUK) and nodular scleritis. On clinical examination, the patient had stunted growth, low body mass index, and enlarged axillary nodes. Giardia cysts were present in the stool sample and histopathology of axillary lymph nodes showed caseating necrosis suggestive of tuberculosis (TB). A diagnosis of PUK with chronic m...

  7. Cost-effective use of silver dressings for the treatment of hard-to-heal chronic venous leg ulcers

    DEFF Research Database (Denmark)

    Jemec, Gregor B E; Kerihuel, Jean Charles; Ousey, Karen

    2014-01-01

    AIM: To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). BACKGROUND: Chronic venous ulceration affects 1-3% of the adult population and typically has a protracted course of healing....... METHODS: A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: 'Healed ulcer', 'Healing ulcer' or 'No improvement' were developed, reflecting the relative reduction in ulcer...... area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. RESULTS: Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings...

  8. Neuromuscular adaptations predict functional disability independently of clinical pain and psychological factors in patients with chronic non-specific low back pain.

    Science.gov (United States)

    Dubois, Jean-Daniel; Abboud, Jacques; St-Pierre, Charles; Piché, Mathieu; Descarreaux, Martin

    2014-08-01

    Patients with chronic low back pain exhibit characteristics such as clinical pain, psychological symptoms and neuromuscular adaptations. The purpose of this study was to determine the independent contribution of clinical pain, psychological factors and neuromuscular adaptations to disability in patients with chronic low back pain. Clinical pain intensity, pain catastrophizing, fear-avoidance beliefs, anxiety, neuromuscular adaptations to chronic pain and neuromuscular responses to experimental pain were assessed in 52 patients with chronic low back pain. Lumbar muscle electromyographic activity was assessed during a flexion-extension task (flexion relaxation phenomenon) to assess both chronic neuromuscular adaptations and neuromuscular responses to experimental pain during the task. Multiple regressions showed that independent predictors of disability included neuromuscular adaptations to chronic pain (β=0.25, p=0.006, sr(2)=0.06), neuromuscular responses to experimental pain (β=-0.24, p=0.011, sr(2)=0.05), clinical pain intensity (β=0.28, p=0.002, sr(2)=0.08) and psychological factors (β=0.58, ppain intensity and psychological factors, and contribute to inter-individual differences in patients' disability. This suggests that disability, in chronic low back pain patients, is determined by a combination of factors, including clinical pain, psychological factors and neuromuscular adaptations.

  9. Autologous stem cell therapy to treat chronic ulcer in heifer- A case study

    Directory of Open Access Journals (Sweden)

    Jayakrushna Das

    Full Text Available Aim: The study was conducted to reveal the efficacy of Bone marrow derived mesenchymal stem cells (BM-MSCs based therapy in healing of chronic non-healing and ulcerative wound in bovine species. Materials and Methods: One 2 years old Jersey heifer affected with chronic ulcerative wound involving full thickness skin and under lying muscle at dorsal side of lumbar region since four months at the time of presentation. Bone marrow was collected from tibia, cultured and grown and after achievement of optimum confluence it was applied at the site. Different parameters of clinical, physiological, haematological, biochemical, histochemical, histological, tensile strength and photographic evaluations were done during the study period. Results: The estimated values of above mentioned parameters on zero day and after healing (18 days showed significant difference (P<0.05 in relation to collagen content, tensile strength and physical characteristics of wound like extent of wound, size of wound, type of exudates and photography. But clinical, haematological and biochemical data showed no significant difference. Conclusion: The BM-MSCs were the main pioneers to bring the chronic ulcerative wound towards healing. The procedure is simple, safe and effective in bringing out healing without showing any adverse effect on host. [Vet World 2012; 5(12.000: 771-774

  10. Biochemical association of metabolic profile and microbiome in chronic pressure ulcer wounds.

    Directory of Open Access Journals (Sweden)

    Mary Cloud B Ammons

    Full Text Available Chronic, non-healing wounds contribute significantly to the suffering of patients with co-morbidities in the clinical population with mild to severely compromised immune systems. Normal wound healing proceeds through a well-described process. However, in chronic wounds this process seems to become dysregulated at the transition between resolution of inflammation and re-epithelialization. Bioburden in the form of colonizing bacteria is a major contributor to the delayed headlining in chronic wounds such as pressure ulcers. However how the microbiome influences the wound metabolic landscape is unknown. Here, we have used a Systems Biology approach to determine the biochemical associations between the taxonomic and metabolomic profiles of wounds colonized by bacteria. Pressure ulcer biopsies were harvested from primary chronic wounds and bisected into top and bottom sections prior to analysis of microbiome by pyrosequencing and analysis of metabolome using 1H nuclear magnetic resonance (NMR spectroscopy. Bacterial taxonomy revealed that wounds were colonized predominantly by three main phyla, but differed significantly at the genus level. While taxonomic profiles demonstrated significant variability between wounds, metabolic profiles shared significant similarity based on the depth of the wound biopsy. Biochemical association between taxonomy and metabolic landscape indicated significant wound-to-wound similarity in metabolite enrichment sets and metabolic pathway impacts, especially with regard to amino acid metabolism. To our knowledge, this is the first demonstration of a statistically robust correlation between bacterial colonization and metabolic landscape within the chronic wound environment.

  11. Biochemical association of metabolic profile and microbiome in chronic pressure ulcer wounds.

    Science.gov (United States)

    Ammons, Mary Cloud B; Morrissey, Kathryn; Tripet, Brian P; Van Leuven, James T; Han, Anne; Lazarus, Gerald S; Zenilman, Jonathan M; Stewart, Philip S; James, Garth A; Copié, Valérie

    2015-01-01

    Chronic, non-healing wounds contribute significantly to the suffering of patients with co-morbidities in the clinical population with mild to severely compromised immune systems. Normal wound healing proceeds through a well-described process. However, in chronic wounds this process seems to become dysregulated at the transition between resolution of inflammation and re-epithelialization. Bioburden in the form of colonizing bacteria is a major contributor to the delayed headlining in chronic wounds such as pressure ulcers. However how the microbiome influences the wound metabolic landscape is unknown. Here, we have used a Systems Biology approach to determine the biochemical associations between the taxonomic and metabolomic profiles of wounds colonized by bacteria. Pressure ulcer biopsies were harvested from primary chronic wounds and bisected into top and bottom sections prior to analysis of microbiome by pyrosequencing and analysis of metabolome using 1H nuclear magnetic resonance (NMR) spectroscopy. Bacterial taxonomy revealed that wounds were colonized predominantly by three main phyla, but differed significantly at the genus level. While taxonomic profiles demonstrated significant variability between wounds, metabolic profiles shared significant similarity based on the depth of the wound biopsy. Biochemical association between taxonomy and metabolic landscape indicated significant wound-to-wound similarity in metabolite enrichment sets and metabolic pathway impacts, especially with regard to amino acid metabolism. To our knowledge, this is the first demonstration of a statistically robust correlation between bacterial colonization and metabolic landscape within the chronic wound environment.

  12. Inter rater reliability of Pressure Ulcer Scale for Healing (PUSH) in patients with chronic leg ulcers Confiabilidad inter-observadores del Pressure Ulcer Scale for Healing (PUSH) en pacientes con úlceras crónicas en la pierna Confiabilidade interobservadores do Pressure Ulcer Scale for Healing (PUSH), em pacientes com úlceras crônicas de perna

    OpenAIRE

    Vera Lúcia Conceição de Gouveia Santos; Danielle Sellmer; Marley Maciel Elias Massulo

    2007-01-01

    This study aimed to evaluate the inter rater reliability of the Pressure Ulcer Scale for Healing (PUSH), in its version adapted to the Portuguese language, in patients with chronic leg ulcers. Kappa index was used for the analysis. After accomplishing ethical issues, 41 patients with ulcers were examined. A total of 49% of the ulcers were located in the right leg and 36% of them were venous ulcers. The Kappa indices (0.97 to 1.00) obtained in the comparison between the observations of the cli...

  13. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain.

    Science.gov (United States)

    Ylinen, Jari; Takala, Esa-Pekka; Kautiainen, Hannu; Nykänen, Matti; Häkkinen, Arja; Pohjolainen, Timo; Karppi, Sirkka-Liisa; Airaksinen, Olavi

    2004-10-01

    Several studies have reported lower neck muscle strength in patients with chronic neck pain compared to healthy controls. The aim of the present study was to evaluate the association between the severity of neck pain and disability with neck strength and range of movement in women suffering from chronic neck pain. One hundred and seventy-nine female office workers with chronic neck pain were selected to the study. The outcome was assessed by the self-rating questionnaires on neck pain (visual analogue scale, Vernon's disability index, Neck pain and disability index) and by measures of the passive range of movement (ROM) and maximal isometric neck muscle strength. No statistically significant correlation was found between perceived neck pain and the disability indices and the maximal isometric neck strength and ROM measures. However, the pain values reported during the strength tests were inversely correlated with the results of strength tests (r=-0.24 to -0.46), showing that pain was associated with decreased force production. About two-thirds of the patients felt pain during test efforts. Pain may prevent full effort during strength tests and hence the production of maximal force. Thus in patients with chronic neck pain the results do not always describe true maximal strength, but rather the patients' ability to bear strain, which may be considerably influenced by their painful condition. The results of the present study suggest that rehabilitation in cases of chronic neck pain should aim at raising tolerance to mechanical strain.

  14. The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain - a randomised controlled pilot study

    OpenAIRE

    2011-01-01

    Abstract Background In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Methods Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments ...

  15. A randomized controlled trial of an Internet-based cognitive-behavioural intervention for non-specific chronic pain : An effectiveness and cost-effectiveness study

    NARCIS (Netherlands)

    de Boer, M.J.; Versteegen, G. J.; Vermeulen, K. M.; Sanderman, R.; Struys, M. M.

    2014-01-01

    BACKGROUND: Cognitive-behavioural treatment can nowadays be delivered through the Internet. This form of treatment can have various advantages with regard to availability and accessibility. Previous studies showed that Internet-based treatment for chronic pain is effective compared to waiting-list c

  16. IgG subclasses in human chronic schistosomiasis: over-production of schistosome-specific and non-specific IgG4.

    Science.gov (United States)

    Boctor, F N; Peter, J B

    1990-12-01

    IgG subclasses were determined quantitatively in sera from 63 Egyptian men who were infected with Schistosoma mansoni. Total and antigen-specific IgG was measured pre- and post-treatment. Total IgG subclass antibodies were determined by immunoradiometric assay (IRMA) using monoclonal antibodies (MoAbs). The anti-worm and anti-egg specific S. mansoni IgG subclass antibodies were quantitatively measured by ELISA using specific MoAbs and standards obtained by affinity chromatography. Our data show that total IgG of the patients was elevated in the range of two to three times above normal. The magnitude of increase differed markedly among the four subclasses of IgG. The IgG1, IgG2 and IgG3 concentrations were approximately two to four times higher than normal, whereas the IgG4 concentrations was 20 times normal (9000 mg/l). IgG1 and IgG4 tended to dominate the IgG subclass distribution of anti-soluble worm antigen preparation (SWAP) antibodies followed by IgG2 and IgG3. On the other hand, IgG1 and IgG2 dominated the IgG subclass distribution of anti-soluble egg antigen (SEA) antibodies. As with IgG1, IgG2 and IgG3, most IgG4 was non-specific. The role of IgG subclasses in the pathogenesis of schistosomiasis is not clear. However, the high concentration of IgG4 might act as IgE blocking antibody, possibly as anti-idiotypes that may play a role in down-regulation of the immune system when it is challenged with an excess of antigen.

  17. Electrical stimulation for chronic non-specific low back pain in a working-age population: a 12-week double blinded randomized controlled trial

    OpenAIRE

    2013-01-01

    Background Non-invasive electrotherapy is commonly used for treatment of chronic low back pain. Evidence for efficacy of most electrotherapy modalities is weak or lacking. This study aims to execute a high-quality, double-blinded randomized controlled clinical trial comparing 1) H-Wave® Device stimulation plus usual care with 2) transcutaneous electrical nerve stimulation (TENS) plus usual care, and 3) Sham electrotherapy plus usual care to determine comparative efficacy for treatment of chro...

  18. Effect of antisecretory agents and vagotomy on healing of "chronic" cysteamine-induced duodenal ulcers in rats

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1986-01-01

    Penetrated cysteamine-induced duodenal ulcers in rats have a very prolonged course of healing. In this study, it was investigated how much the healing of these ulcers is accelerated by some treatments. The treatments included omeprazole, cimetidine, and truncal vagotomy. In addition, the effect...... of omeprazole and cimetidine on gastric acid secretion was investigated in chronic gastric fistula rats. After 25 days of treatment, significantly more rats in the treated groups had healed ulcers than in the control group. There was little further improvement up to 100 days of treatment, and the difference...... between treated and untreated groups decreased. The morphology of healing ulcers in treated and untreated rats was also compared. In controls, there was a simultaneous regeneration of mucosa and the submucosal Brunner's glands from the edges of the ulcer, the slow proliferation rate of the latter probably...

  19. Associated risk factors and management of chronic diabetic foot ulcers exceeding 6 months’ duration

    Directory of Open Access Journals (Sweden)

    Hassan Gubara Musa

    2012-10-01

    Full Text Available Background: The management of chronic diabetic foot ulcers (DFU poses a great challenge to the treating physician and surgeon. The aim of this study was to identify the risk factors, clinical presentation, and outcomes associated with chronic DFU > 6 months’ duration. Methods: This prospective study was performed in Jabir Abu Eliz Diabetic Centre (JADC, Khartoum, Sudan. A total of 108 patients who had DFU for >6 months were included. Recorded data included patient's demographics, DFU presentation, associated comorbidities, and outcomes. DFU description included size, depth, protective sensation, perfusion, and presence of infection. Comorbidities assessed included eye impairment, renal and heart disease. All patients received necessary local wound care with sharp debridement of any concomitant necrotic and infected tissues and off-loading with appropriate shoe gear and therapeutic devices. Results: The mean age of the studied patients was 56+SD 9 years with a male to female ratio of 3:3.3. The mean duration of DFU was 18±SD 17 months (ranging from 6 to 84 months. Ulcer healing was significantly associated with off-loading, mainly the use of total contact cast (TCC (p=0.013. Non-healing ulcerations were significantly associated with longer duration of the chronic DFU > 12 months (p=0.002, smoking (p=0.000, poor glycemic control as evidenced by an elevated HbA1c (>7%, large size (mean SD 8+4 cm, increased depth (p<0.001, presence of skin callus (p<0.000, impaired limb perfusion (p=0.001, impaired protective sensation as measured by 10 g monofilament (p=0.002, neuroischemia (p=0.002, and Charcot neuroarthropathy (p=0.017. Discussion: Risk factors associated with chronic DFU of > 6 months’ duration included the presentation of an ulcer with increased size and depth, with associated skin callus and neuroischemia, in a diabetic patient with a history of smoking and increased HbA1c >7%. Off-loading mainly with the use of TCC is an effective method

  20. Open label trial of granulocyte apheresis suggests therapeutic efficacy in chronically active steroid refractory ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Wolfgang Kruis; Robert L(o)fberg; Axel Dignass; Elisabeth Steinhagen-Thiessen; Julia Morgenstern; Joachim M(o)ssner; Stephan Schreiber; Maurizio Vecchi; Alberto Malesci; Max Reinshagen

    2005-01-01

    AIM:To study the efficacy, safety, and feasibility of a granulocyte adsorptive type apheresis system for the treatment of patients with chronically active ulcerative colitis despite standard therapy.METHODS: An open label multicenter study was carried out in 39 patients with active ulcerative colitis (CAI6-8) despite continuous use of steroids (a minimum total dose of 400 mg prednisone within the last 4 wk).Patients received a total of five aphereses using a granulocyte adsorptive technique (Adacolumn(R), Otsuka Pharmaceutical Europe, UK). Assessments at wk 6 and during follow-up until 4 mo comprised clinical (CAI) and endoscopic (EI) activity index, histology, quality of life(IBDQ), and laboratory tests.RESULTS: Thirty-five out of thirty-nine patients were qualified for intent-to-treat analysis. After the apheresis treatment at wk 6, 13/35 (37.1%) patients achieved clinical remission and 10/35 (28.6%) patients had endoscopic remission (CAI<4, EI<4). Quality of life (IBDQ) increased significantly (24 points, P<0.01)at wk 6. Apheresis could be performed in all but one patient. Aphereses were well tolerated, only one patient experienced anemia.CONCLUSION: In patients with steroid refractory ulcerative colitis, five aphereses with a granulocyte/monocyte depleting filter show potential short-term efficacy. Tolerability and technical feasibility of the procedure are excellent.

  1. Ulcerated necrobiosis lipoidica as a rare cause for chronic leg ulcers: case report series of ten patients.

    Science.gov (United States)

    Franklin, Cindy; Stoffels-Weindorf, Maren; Hillen, Uwe; Dissemond, Joachim

    2015-10-01

    Necrobiosis lipoidica is a rare granulomatous disorder of the skin. In up to 30% of the affected patients it can lead to ulcerations, which can impair the quality of life and are also very difficult to treat. Its pathogenesis is not fully understood. Only few studies focussing on necrobiosis lipoidica can be found, but none of them focus on ulcerated necrobiosis lipoidica. Therefore, we collected demographic data and comorbidities and assessed treatment options for patients with ulcerated necrobiosis lipoidica. Data of patients who were treated in the wound care centre of the University Hospital of Essen for ulcerated necrobiosis lipoidica over the past 10 years were retrospectively analysed. Hence, data of altogether ten patients (nine women and one man) with ulcerated necrobiosis lipoidica were collected. Of these, 70% of the patients had diabetes mellitus of which 30% had type I diabetes and 40% had type II diabetes; 60% of the patients suffered from arterial hypertension, obesity and hypercholesterolaemia; 40% of the patients suffered from psychiatric disorders such as depression and borderline disorder. Our clinical data demonstrate an association of ulcerated necrobiosis lipoidica and aspects of metabolic syndrome. This leads to a conclusion that ulcerating necrobiosis lipoidica can be seen as part of a generalised inflammatory reaction similar to the inflammatory reaction already known in the pathophysiology of rheumatoid diseases or psoriasis. In patients with clinical atypical painful ulcerations, necrobiosis lipoidica should be considered as a possible differential diagnosis. Therapists should be aware of associated aspects in patients with ulcerated necrobiosis lipoidica who besides diabetes often suffer from other aspects of a metabolic syndrome with increased cardiovascular risk factors. Therefore, these related comorbidities should also be diagnosed and treated.

  2. The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT

    Directory of Open Access Journals (Sweden)

    van Assen Luite

    2010-01-01

    Full Text Available Abstract Background Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy. Methods/Design This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum till one year (maximum will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands. The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy, also for a period of six weeks. Primary outcomes are Global Perceived Effect (GPE and functional status (Neck Disability Index (NDI-DV. Secondary outcomes are neck pain (Numeric Rating Scale (NRS, Eurocol, costs and quality of life (SF36. Discussion This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial. Trial registration ClinicalTrials.gov Identifier: NCT00713843

  3. Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

    LENUS (Irish Health Repository)

    Quinn, Edel Marie

    2013-01-01

    Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics.

  4. Dipeptidyl peptidase 4 inhibition may facilitate healing of chronic foot ulcers in patients with type 2 diabetes.

    Science.gov (United States)

    Marfella, Raffaele; Sasso, Ferdinando Carlo; Rizzo, Maria Rosaria; Paolisso, Pasquale; Barbieri, Michelangela; Padovano, Vincenzo; Carbonara, Ornella; Gualdiero, Pasquale; Petronella, Pasquale; Ferraraccio, Franca; Petrella, Antonello; Canonico, Raffaele; Campitiello, Ferdinando; Della Corte, Angela; Paolisso, Giuseppe; Canonico, Silvestro

    2012-01-01

    The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19-35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

  5. Dipeptidyl Peptidase 4 Inhibition May Facilitate Healing of Chronic Foot Ulcers in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Raffaele Marfella

    2012-01-01

    Full Text Available The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19–35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

  6. Predictors of short- and long-term outcome in patients with chronic non-specific neck pain undergoing an exercise-based rehabilitation program: a prospective cohort study with 1-year follow-up.

    Science.gov (United States)

    Cecchi, Francesca; Molino-Lova, Raffaele; Paperini, Anita; Boni, Roberta; Castagnoli, Chiara; Gentile, Jacopo; Pasquini, Guido; Macchi, Claudio

    2011-10-01

    The aim of this study was to describe the clinical course of patients with chronic, non-specific neck pain undergoing a public health covered, exercise-based rehabilitation program and to identify predictors of poor outcome. A prospective cohort study was carried out on patients with non-specific neck pain (6 months or longer), referred by their general practitioner to a 6-session program, including education and individually tailored exercise. The primary outcome measure for the course of neck pain was the Northwick neck pain questionnaire (NPQ) administered on baseline, discharge, and 1 year from discharge. Poor outcome was defined as NPQ score improving neck pain history, and the clinical features described by NPQ. From January 2008 to June 2009, 212 patients were consecutively assessed for eligibility: 178 were enrolled and 162 completed follow-up (mean age = 65.3; 75% women). Baseline NPQ average score (40.7 + 17.1) improved by MCID on discharge (26.1 + 16.3) and at 1 year (28.5 + 17.3%). The poor outcome was reported by 45% patients on discharge and by 56% at follow-up. Pain-related medication intake independently predicted poor short- (OR 4.24; 95% CI 1.83-9.84; p = 0.001) and long-term (OR 2.69; 95% CI 1.19-6.06; p = 0.017) outcome, and catastrophizing (OR 2.91; 95% CI 1.31-6.48; p = 0.009) predicted poor outcome at 1 year. Our cohort of patients with chronic neck pain undergoing an exercise-based rehabilitation program reported improvement by or beyond MICD-NPQ in 55% cases on discharge and in 44% cases at 1 year. Poor outcome was predicted by pain-related medication intake in the short and long term, and by catastrophizing in the long term.

  7. Chronic Ulcers in Thromboangiitis Obliterans (Buerger's Disease: Updating Epidemiology, Physiopathology, and Bosentan—A Novel Strategy of Therapy

    Directory of Open Access Journals (Sweden)

    Ignacio López de Maturana

    2013-01-01

    Full Text Available Thromboangiitis obliterans (TAO or Buerger's disease is associated with both distal ulcers in the extremities and the possibility of amputation. The only treatment that has been shown to be effective in TAO is complete abstention from smoking. In spite of this, the disease progresses in up to 30 percent of cases and finally results in limb amputation. Only a few pharmacological and surgical options are available to date to improve healing ulcers in TAO. The efficacy of prostaglandin analogues is controversial. This paper summarizes the current evidence for medical treatment with bosentan in chronic ulcers in TAO patients. These available data up to date allow us to conclude that the beneficial effects of bosentan on improving endothelial function, inflammatory processes, and selective vasodilatation of damaged vessels result in a clinical enhancement regarding healing and preventive digital ulcers in such patients. In any case, these promising findings have to be confirmed with larger randomised trials.

  8. Effect of omeprazole and cimetidine on healing of chronic gastric ulcers and gastric acid secretion in rats

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1988-01-01

    The effect of omeprazole and cimetidine on healing of chronic gastric ulcers and gastric acid secretion was investigated in rats. The effect of three doses of omeprazole given orally once daily for 25 days was investigated. In controls median ulcer healing was 19.6% after 25 days. Omeprazole...... increased median ulcer healing from 36% at 145 mumole/kg/day to 80% at 580 mumole/kg/day. Basal and pentagastrin stimulated gastric acid secretion decreased dose-dependently by nearly 90% at a dose of 580 mumole/kg/day 22-24 hr after the last dose of omeprazole. Cimetidine given twice daily, in a dose...... that initially inhibits gastric acid secretion by 95%, reduced acid secretion by only 50% 11 hr after the last dose. Median ulcer healing after treatment with cimetidine for 25 days was 41%. This study demonstrates that omeprazole has a more long-acting inhibitory effect on gastric acid secretion compared...

  9. Ultrastructural changes in non-specific duodenitis

    Institute of Scientific and Technical Information of China (English)

    Cheng-Xin Wang; Li-Jiang Liu; Jing Guan; Xiao-Ling Zhao

    2005-01-01

    AIM: To investigate the ultrastructural and morphological changes of non-specific duodenitis (NSD) in an attempt to grade them according to the extent of the lesions.METHODS: Biopsies were taken from the mucosa of duodenal bulb of 44 patients selected from the patients undergoing upper gastrointestinal endoscopy for epigastric discomforts. From each patient, two pinch biopsies on the same area were obtained from duodenal bulb. One was for scanning electron microscopy and the other was stained with hematoxylin-eosin, Warthin-Starry silver and both were then examined under light microscope. A total of 12 specimens (three from each degree of the normal and Ⅰ-Ⅲ of NSD diagnosed and graded by histology) selected from the 44patients were dehydrated, critical point dried, coated with gold palladium and examined under a JEOL JSM-30 scanning electron microscope (SEM) at 20 kV.RESULTS: According to the ultrastructural morphologic changes, non-specific duodenitis was divided into normal (as control group), mild, moderate and severe degrees according to results of SEM. The normal villi of duodenal bulb were less than 0.2 mm. There were inflammation cells,occasionally red blood cells and macrophages on the mucosal epithelial surface. Erosion and desquamation of epithelium could be seen. Three cases (25%, 3/12) had gastric metaplasia and Helicobacter pylori(H pylori) infection could be found in 5 cases (41.67%, 5/12) in duodenal bulb mucosa. The most distinctive feature was the ulcer-like defect on the surface of epithelial cells.CONCLUSION: Non-specific duodenitis is a separate entity disease caused by different factors. SEM is of value as an aid in the diagnosis of mucosal diseases of duodenum.

  10. PredyCLU: a prediction system for chronic leg ulcers based on fuzzy logic; part I - exploring the venous side.

    Science.gov (United States)

    de Franciscis, Stefano; Fregola, Salvatore; Gallo, Alessandro; Argirò, Giuseppe; Barbetta, Andrea; Buffone, Gianluca; Caliò, Francesco G; De Caridi, Giovanni; Amato, Bruno; Serra, Raffaele

    2016-12-01

    Chronic leg ulcers (CLUs) are a common occurrence in the western population and are associated with a negative impact on the quality of life of patients. They also cause a substantial burden on the health budget. The pathogenesis of leg ulceration is quite heterogeneous, and chronic venous ulceration (CVU) is the most common manifestation representing the main complication of chronic venous disease (CVD). Prevention strategies and early identification of the risk represent the best form of management. Fuzzy logic is a flexible mathematical system that has proved to be a powerful tool for decision-making systems and pattern classification systems in medicine. In this study, we have elaborated a computerised prediction system for chronic leg ulcers (PredyCLU) based on fuzzy logic, which was retrospectively applied on a multicentre population of 77 patients with CVD. This evaluation system produced reliable risk score patterns and served effectively as a stratification risk tool in patients with CVD who were at the risk of developing CVUs.

  11. Assay of gastrin and somatostatin in gastric antrum tissues of children with chronic gastritis and duodenal ulcer

    Institute of Scientific and Technical Information of China (English)

    Xiao-Zhi Xie; Zhi-Guang Zhao; Dan-Si Qi; Zong-Min Wang

    2006-01-01

    AIM: To study the expressions of gastrin (GAS) and somatostatin (SS) in gastric antrum tissues of children with chronic gastritis and duodenal ulcer and their role in pathogenic mechanism.METHODS: Specimens of gastric antrum mucosa from 83 children were retrospectively analyzed. Expressions of GAS and SS in gastric antrum tissues were assayed by the immunohistochemical En Vision method.RESULTS: The expressions of GAS in chronic gastritis Hp+ group (group A), chronic gastritis Hp- group (group B), the duodenal ulcer Hp+group (group C), duodenal ulcer Hp- group (group D), and normal control group (group E) were 28.50+4.55, 19.60+2.49, 22.69+2.71,25.33 + 4.76, and 18.80 + 2.36, respectively. The value in groups A-D was higher than that in group E. The difference was not statistically significant. The expressions of SS in groups A-E were 15.47 + 1.44, 17.29 + 2.04,15.30 + 1.38, 13.11 + 0.93 and 12.14 + 1.68, respectively.The value in groups A-D was higher than that in group E.The difference was also not statistically significant.CONCLUSION: The expressions of GAS and SS are increased in children with chronic gastritis and duodenal ulcer.

  12. IS PEPTIC ULCER WITH HELICOBACTER INFEC¬TION THE CAUSE OF CHRONIC URTICARIA?

    Directory of Open Access Journals (Sweden)

    A. Farhoudi

    2000-01-01

    Full Text Available Helicobacter pylori, the most important cause of gastritis and peptic ulcer, has recently been associated with several extradigestive diseases. The aim of this study was to assess the prevalence of Helicobacter pylori infection and effects of bacterium eradication in 50 patients affected by idiopathic chronic urticaria. Helicobacter pylori was assessed by serology or biopsy and urease test or 13C urea breath test. Amoxicillin, bismuth subcitrate (Denol, metronidazole and cimetidine were given to infected patients for 2 weeks. The results of therapy were assessed by urea breath test six weeks after therapy. In response to treatment urticaria clinically regressed in 16 out of 24 patients (66.6%. Thus bacterium eradication was associated with a remission of urticaria symptoms, suggesting a possible role in the pathogenesis of this disorder.

  13. A STUDY OF NEGATIVE PRESSURE WOUND THERAPY: VACUUM ASSISTED CLOSURE IN CHRONIC NON-HEALING ULCERS

    Directory of Open Access Journals (Sweden)

    Dhamotharan Senraman

    2016-06-01

    Full Text Available BACKGROUND This study evaluates the advantage of Negative Pressure Wound Therapy-Vacuum Assisted Closure over Conventional Dressing in the management of chronic non-healing ulcers. METHODS From June 2014 to June 2015, 50 patients were selected (25 cases and 25 controls. After wound debridement, VAC dressing is applied. Pre VAC and post VAC culture and sensitivity is taken. Dressing is given for 72 hours and intermittent suction is given for 10 mins. in an hour, daily for 12 hours with negative pressure ranging from 100 to 125 mmHg. Rest of the time drain of the VAC dressing is connected to the Romovac suction drain. Doppler study to assess the vascularity of the limb before the procedure and X-ray is taken to rule out osteomyelitis. Control group patients are given conventional dressings. RESULTS The gender, age and ulcer distributions were almost equal in the case and control groups and were found to be statistically insignificant. Duration of hospital stay in days was found to be statistically significant between groups. Majority (52% of cases left hospital within 3 weeks’ time, while a major chunk (88% of control population stayed more than 3 weeks. VAC dressing shows better results in patients with normal Doppler study. VAC dressing have better results in patients with 48% undergoing split skin grafting and less rate (8% of amputation as against none undergoing split skin grafting and 24% needing amputation in the control group. Patients with sterile pre-VAC culture were not turning unsterile after VAC, but 90% unsterile turns sterile after VAC. CONCLUSION NPWT is a novel technique for managing an open wound by submitting the wound either to intermittent or continuous subatmospheric pressure. Here, we did a study to study the advantage of vacuum assisted closure over conventional dressing in the management of chronic non-healing ulcers and concluded that VAC decreases hospital stay, improves pus culture sterility, has better result in

  14. The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain - a randomised controlled pilot study

    Directory of Open Access Journals (Sweden)

    Dobos Gustav J

    2011-08-01

    Full Text Available Abstract Background In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated. Methods Fifty patients (50.5 ± 11.9 years were randomised to a treatment group (TG or a waiting-list control group (WL. Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR and maximal pain related to movement (PM on a 100-mm visual analogue scale (VAS, pain diary (PD data on a 0-10 numeric rating scale (NRS, Neck Disability Index (NDI, and health-related quality of life (SF-36. In addition, the mechanical-detection thresholds (MDT, vibration-detection thresholds (VDT, and pressure-pain thresholds (PPT were determined at pain-related and control areas. Results Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01. Pain diaries (PD revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001. There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006 and vitality (Δ10.2, p = 0.006. Group differences in PPT were significant at pain-related and control areas (all p Conclusions A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing. Trial registration The trial was registered at

  15. 腰椎稳定性训练治疗慢性非特异性腰痛的研究%EVALUATION OF STABILIZING EXERCISE OF THE LUMBAR SPINE IN THE TREATMENT OF CHRONIC NON-SPECIFIC LOW BACK PAIN

    Institute of Scientific and Technical Information of China (English)

    胡鸢; 秦江; 唐金树

    2011-01-01

    目的:研究腰椎稳定性训练对慢性非特异性腰痛患者的治疗效果.方法:91名慢性非特异性腰痛患者随机分为治疗组(46人)和对照组(45人).两组患者均接受6周共18次治疗,治疗组患者进行腰椎稳定性训练,对照组患者接受磁热治疗.在患者治疗前、治疗6周后以及随访1年后分别评价其疼痛和功能障碍程度.结果:治疗6周后,治疗组较对照组患者在疼痛和功能障碍方面具有更显著的改善(P<0.05),治疗组疗效在随访1年后仍然得到维持(P<0.05).结论:腰椎稳定性训练是一种有效减轻慢性非特异性腰痛患者疼痛程度并改善其功能障碍的疗法.%Objective: To evaluate the efficacy of a specific stabilizing exercise of the lumbar spine in the treatment of patients with chronic non-specific low back pain.Methods: A total of 91 patients were randomly allocated into an exercise group ( n = 46) and a control group ( n = 45 ).Patients in the exercise group had undergone a specific exercise program with activation of the deep lumbar muscles and dynamic strengthening of the lumbar muscles for 6 weeks.Patients in the control group were given thermal magnetic therapy for 6 weeks.Both groups were given back care advice.Subjective pain and disability were measured at baseline, 6-week, and 1-year follow-up.Results: At 6-week, the exercise group had a significantly better improvement in pain( P <0.05 ) and disability score( P <0.05 ).Significant differences between the two groups maintained at 1-year follow-up.Conclusion: The specific stabilizing exercise of the lumbar spine is effective in reducing pain and improving functional status in patients with chronic non-specific low back pain.

  16. Polymicrobial nature of chronic diabetic foot ulcer biofilm infections determined using bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP.

    Directory of Open Access Journals (Sweden)

    Scot E Dowd

    Full Text Available BACKGROUND: Diabetic extremity ulcers are associated with chronic infections. Such ulcer infections are too often followed by amputation because there is little or no understanding of the ecology of such infections or how to control or eliminate this type of chronic infection. A primary impediment to the healing of chronic wounds is biofilm phenotype infections. Diabetic foot ulcers are the most common, disabling, and costly complications of diabetes. Here we seek to derive a better understanding of the polymicrobial nature of chronic diabetic extremity ulcer infections. METHODS AND FINDINGS: Using a new bacterial tag encoded FLX amplicon pyrosequencing (bTEFAP approach we have evaluated the bacterial diversity of 40 chronic diabetic foot ulcers from different patients. The most prevalent bacterial genus associated with diabetic chronic wounds was Corynebacterium spp. Findings also show that obligate anaerobes including Bacteroides, Peptoniphilus, Fingoldia, Anaerococcus, and Peptostreptococcus spp. are ubiquitous in diabetic ulcers, comprising a significant portion of the wound biofilm communities. Other major components of the bacterial communities included commonly cultured genera such as Streptococcus, Serratia, Staphylococcus and Enterococcus spp. CONCLUSIONS: In this article, we highlight the patterns of population diversity observed in the samples and introduce preliminary evidence to support the concept of functional equivalent pathogroups (FEP. Here we introduce FEP as consortia of genotypically distinct bacteria that symbiotically produce a pathogenic community. According to this hypothesis, individual members of these communities when they occur alone may not cause disease but when they coaggregate or consort together into a FEP the synergistic effect provides the functional equivalence of well-known pathogens, such as Staphylococcus aureus, giving the biofilm community the factors necessary to maintain chronic biofilm infections

  17. Genetics Home Reference: ulcerative colitis

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions ulcerative colitis ulcerative colitis Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Ulcerative colitis is a chronic disorder that affects the digestive ...

  18. A STUDY OF EFFICACY OF TOPICAL INSULIN THERAPY IN THE TREATMENT OF CHRONIC DIABETIC FOOT ULCERS

    Directory of Open Access Journals (Sweden)

    Mahidhar Reddy

    2015-08-01

    Full Text Available Chronic wounds are an economic burden to the patient as they put him out of work and consume quality working days. Local insulin therapy is an innovative method in wound care which accelerates wound healing by increasing angiogenesis and granulation tissue formation. This study aims to evaluate its efficacy. OBJECTIVES: To study the efficacy of topical use of insulin in terms of (1 Rate of wound healing (2 Hospital stay. MATERIALS AND METHODS: This is a prospective study carried out in a tertiary health care center in 46 patients after taking informed and written consent. All patients who were satisfying inclusion and exclusion criteria were randomised into two groups A and B. Local insulin therapy was given to group A and normal saline dressing were done to group B. Size and depth were recorded at the start of the treatment and every week thereafter during the period of study. Strict glycemic control was maintained. Results were compared at complete wound healing or at the end of 8 weeks which was earlier. RESULTS: Improvement of the wound in the form of diameter and depth is seen. Significantly increased proliferation of granulation tissue is noticed in most of the patients belonging to group A, that is who received local insulin therapy. CONCLUSION: Local insulin therapy appears to be an efficacious method in the treatment of chronic diabetic foot ulcers and is safe and effective without any systemic side effects. It significantly reduces the hospital stay

  19. Steps Toward Creating A Therapeutic Community for Inpatients Suffering from Chronic Ulcers: Lessons from Allada Buruli Ulcer Treatment Hospital in Benin

    Science.gov (United States)

    Amoussouhoui, Arnaud Setondji; Johnson, Roch Christian; Sopoh, Ghislain Emmanuel; Agbo, Ines Elvire; Aoulou, Paulin; Houezo, Jean-Gabin; Tingbe-Azalou, Albert; Boyer, Micah; Nichter, Mark

    2016-01-01

    Background Reducing social distance between hospital staff and patients and establishing clear lines of communication is a major challenge when providing in-patient care for people afflicted by Buruli ulcer (BU) and chronic ulcers. Research on hospitals as therapeutic communities is virtually non-existent in Africa and is currently being called for by medical anthropologists working in the field of health service and policy planning. This paper describes a pioneering attempt to establish a therapeutic community for patients suffering from BU and other chronic ulcers requiring long term hospital care in Benin. Methods A six-month pilot project was undertaken with the objectives of establishing a therapeutic community and evaluating its impact on practitioner and patient relations. The project was designed and implemented by a team of social scientists working in concert with the current and previous director of a hospital serving patients suffering from advanced stage BU and other chronic ulcers. Qualitative research initially investigated patients’ understanding of their illness and its treatment, identified questions patients had about their hospitalization, and ascertained their level of social support. Newly designed question–answer health education sessions were developed. Following these hospital wide education sessions, open forums were held each week to provide an opportunity for patients and hospital staff to express concerns and render sources of discontent transparent. Patient group representatives then met with hospital staff to problem solve issues in a non-confrontational manner. Psychosocial support for individual patients was provided in a second intervention which took the form of drop-in counseling sessions with social scientists trained to serve as therapy facilitators and culture brokers. Results Interviews with patients revealed that most patients had very little information about the identity of their illness and the duration of their

  20. Phase 3 evaluation of HP802-247 in the treatment of chronic venous leg ulcers.

    Science.gov (United States)

    Kirsner, Robert S; Vanscheidt, Wolfgang; Keast, David H; Lantis, John C; Dove, Cyaandi R; Cazzell, Shawn M; Vartivarian, Mher; Augustin, Matthias; Marston, William A; McCoy Bs, Nicholas D; Cargill PhD, D Innes; Lee Mshs, Tommy D; Dickerson, Jaime E; Slade Md, Herbert B

    2016-09-01

    In 2012 we reported promising results from a phase 2 clinical trial of HP802-247, a novel spray-applied investigational treatment for chronic venous leg ulcers consisting of human, allogeneic fibroblasts and keratinocytes. We now describe phase 3 clinical testing of HP802-247, its failure to detect efficacy, and subsequent investigation into the root causes of the failure. Two randomized, controlled trials enrolled a total of 673 adult outpatients at 96 centers in North America and Europe. The primary endpoint was the proportion of ulcers with confirmed closure at the end of 12 weeks of treatment. An investigation into the root cause for the failure of HP802-247 to show efficacy in these two phase 3 trials was initiated immediately following the initial review of the North American trial results. Four hundred twenty-one patients were enrolled in the North American (HP802-247, 211; Vehicle 210) and 252 in the European (HP802-247, 131; Vehicle 121) trials. No difference in proportion of closed ulcers at week 12 was observed between treatment groups for either the North American (HP802-247, 61.1%; Vehicle 60.0%; p = 0.5896) or the European (HP802-247, 47.0%; Vehicle 50.0%; p = 0.5348) trials. Thorough investigation found no likelihood that design or execution of the trials contributed to the failure. Variability over time during the trials in the clinical response implicated the quality of the cells comprising HP802-247. Concordance between the two separate, randomized, controlled trials with distinct, nonoverlapping investigative sites and independent monitoring teams renders the possibility of a Type II error vanishingly small and provides strong credibility for the unexpected lack of efficacy observed. The most likely causative factors for the efficacy failure in phase 3 was phenotypic change in the cells (primarily keratinocytes) leading to batch to batch variability due to the age of the cell banks.

  1. Three cousins with chronic foot ulcers from late-onset hereditary sensory and autonomic neuropathies type 2 (HSAN2).

    Science.gov (United States)

    Aghaei, Shahin; Pakmanesh, Kambiz

    2006-02-28

    The hereditary sensory and autonomic neuropathies (HSAN) are a group of rare disorders characterized by prominent sensory and autonomic neuropathy without motor involvement. We report three male cousins with chronic foot ulcers, all were affected with late-onset HSAN type 2 (HSAN2). In view of the history of consanguinity and male sex, X-linked recessive transmission was likely in our patients. According to the authors' knowledge this is the first report of HSAN2 from Iran.

  2. 非特异性慢性脑炎所致的难治性癫痫的手术及其疗效分析%Curative effect of surgery on refractory epilepsy induced by non-specific chronic encephalitis

    Institute of Scientific and Technical Information of China (English)

    叶忠兴; 林元相; 康德智; 林章雅; 黄小芬; 王丰

    2013-01-01

    Objective To explore surgical technique for the refractory epilepsy (RE) induced by non-specific chronic encephalitis (NSCE) and curative effect of surgery on RE. Methods The clinical data of 6 patients with RE induced by NSCE, who underwent surgery under monitoring intraoperative electrocephalogram (EEG) from April, 2008 to August, 2010, were analyzed retrospectively, including clinical manifestations, EEG, imaging data, surgical method, curative effect and so on. Results EEG was mildly or moderately abnormal in all the patients. The encephalodialysis in 3 patients, the abnormal signal in 2 patients and no abnormal findings in 1 patient were shown by MRI. The resection of the epileptogenic foci in 2 patients, the resection of the epileptogenic foci plus amygdalo-hippocampectomy in 2 patients and resection of the epileptogenic foci plus multiple subpial transection in 2 patients were performed. The pathological examination showed that there was non-specific chronic encephalitis in all the patients, there was glial cell proliferation in 4 patients and there was focal cortical dysplasia in 3 patients. Of 6 patients, 2 had Engel grade I therapeutic outcome, 1 grade Ⅱ and 2 grade Ⅲ, 1 grade IV. Conclusion The curative effect of surgery on the refractory induced by NSCE is not ideal, especially in the patients with refractory epileptic state.%目的 探讨非特异性慢性脑炎所致的难治性癫痫(NCERE)的手术及其疗效,以提高对本病的认识.方法 回顾性分析6例NCERE患者的临床资料.结果 6例均为简单或复杂部分性发作继发全面性发作,脑电图为轻至中度异常,5例MRI有异常.其中3例为顽固性癫痫持续状态(RSE).全部行癫痫灶切除术,加海马杏仁体切除术2例,加软膜下横切术2例.病理学诊断为非特异性慢性脑炎,4例伴胶质细胞增生,3例伴皮质发育不良.按Engel 分级评估预后,Ⅰ级2例,Ⅱ级1例,Ⅲ级2例,Ⅳ级1例;3例RSE疗效均不满意.结论 NCERE有其

  3. The Association of Helicobacter pylori Eradication with the Occurrences of Chronic Kidney Diseases in Patients with Peptic Ulcer Diseases

    Science.gov (United States)

    Wang, Jiunn-Wei; Hsu, Chien-Ning; Tai, Wei-Chen; Ku, Ming-Kun; Hung, Tsung-Hsing; Tseng, Kuo-Lun; Yuan, Lan-Ting; Nguang, Seng-Howe; Liang, Chih-Ming; Yang, Shih-Cheng; Wu, Cheng-Kun; Hsu, Pin-I; Wu, Deng-Chyang; Chuah, Seng-Kee

    2016-01-01

    The association of Helicobacter pylori eradication with the occurrence of renal dysfunction in patients with peptic ulcer diseases is still unclear. This study aimed to clarify the relevance of H. pylori eradication to the occurrence of chronic kidney diseases in patients with peptic ulcer diseases. Data that were available from 2000–2011 were extracted from the National Health Insurance Research Database in Taiwan, and all patients with peptic ulcer diseases (n = 208 196) were screened for eligibility. We divided randomly selected patients into an H. pylori eradication cohort (cohort A, n = 3593) and matched them by age and sex to a without H. pylori eradication cohort (cohort B, n = 3593). Subgroup analysis was further performed for H. pylori eradication within ≤ 90 days of the diagnosis date (early eradication, n = 2837) and within 91–365 days (non-early eradication, n = 756). Cox proportional hazards regression analysis was used to estimate the association of H. pylori eradication with the risk of developing chronic kidney diseases and mortality. We observed that there were more patients suffering from chronic kidney disease in cohort B than in the early eradication subgroup of cohort A (8.49% vs. 6.70%, respectively, p = 0.0075); the mortality rate was also higher in cohort B (4.76% vs. 3.70%, respectively, p = 0.0376). Old age, pulmonary disease, connective tissue disorders, and diabetes were risk factors for chronic kidney diseases but early H. pylori eradication was a protective factor against chronic kidney diseases (hazard ratio: 0.68, 95% confidence interval: 0.52–0.88, p = 0.0030), and death (hazard ratio: 0.69, 95% confidence interval: 0.49–0.96, p = 0.0297). In conclusion, our findings have important implications suggesting that early H. pylori eradication is mandatory since it is associated with a protective role against the occurrence of chronic kidney diseases. PMID:27764171

  4. Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study.

    Science.gov (United States)

    Verkerk, Karin; Luijsterburg, Pim A J; Heymans, Martijn W; Ronchetti, Inge; Miedema, Harald S; Koes, Bart W; Pool-Goudzwaard, Annelies

    2015-02-01

    This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic non-specific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n = 1760) of a rehabilitation center were used, where patients followed a 2-months cognitive behavior treatment. The outcome 'improvement in quality of life (SF-36)' was defined as a 10% increase in score on the SF-36 at follow-up compared with baseline. On the GPE scale, patients who indicated to be 'much improved' were coded as 'clinically improved'. Multivariable logistic regression analysis included 23 baseline characteristics. At 5-months follow-up, scores on the SF-36 Mental Component Scale (SF-36; MCS) and the Physical Component Scale (SF-36; PCS) had increased from 46.6 (SD 10.3) to 50.4 (SD 9.8) and from 31.9 (SD 7.1) to 46.6 (SD 10.3), respectively. At 5-months follow-up, 53.0% of the patients reported clinical improvement (GPE) which increased to 60.3% at 12-months follow-up. The 10% improvement in quality of life (SF-36 MCS) at 5-months follow-up was associated with patient characteristics and psychological factors. At 5-months follow-up, the 10% improvement in quality of life (SF-36 PCS) and GPE was associated with patient characteristics, physical examination, work-related factors and psychological factors; for GPE, an association was also found with clinical status. At 12-months follow-up GPE was associated with patient characteristics, clinical status, physical examination and work-related factors. The next phase in this prognostic research is external validation of these results.

  5. Nutritional profile of older adults with chronic venous leg ulcers: a pilot study.

    Science.gov (United States)

    McDaniel, Jodi C; Kemmner, Kaitlyn G; Rusnak, Sarah

    2015-01-01

    The purpose of this cross-sectional descriptive pilot study was to describe daily intake of select nutrients important for efficient wound healing and general health in a sample of older adults (64.25 ± 9.49 years of age) with chronic venous leg ulcers (CVLUs; N = 12), compared to recommended dietary allowances (RDA). Anthropometric data were also collected. Compared to RDA, participants on average consumed lower vitamin C (60.03 ± 49.73 mg/d) and higher sodium (3197.07 ± 1455.04 mg/d), sugar (181.21 ± 115.45 g/d), and saturated fat (33.75 ± 1.06 g/d). They also demonstrated a relatively high plasma n-6/n-3 polyunsaturated fatty acid ratio, a biomarker of inflammation (11.25 ± 1.99). The mean body mass index indicated extreme obesity (41.48 ± 11.47). A multidisciplinary treatment approach that includes routine dietary assessments followed by tailored dietary interventions may improve wound healing and long-term health outcomes in this population.

  6. Helicobacter pylori virulence factors in duodenal ulceration: A primary cause or a secondary infection causing chronicity

    Institute of Scientific and Technical Information of China (English)

    Frank I Tovey; Michael Hobsley; John Holton

    2006-01-01

    Reports from countries with a high prevalence of Helicobacter pylori (H pylori) infection do not show a proportionately high prevalence of duodenal ulceration,suggesting the possibility that H pylori cannot be a primary cause of duodenal ulceration. It has been mooted that this discrepancy might be explained by variations in the prevalence of virulence factors in different populations. The aim of this paper is to determine whether the published literature gives support to this possibility. The relevant literature was reviewed and analyzed separately for countries with a high and low prevalence of H pylori infection and virulence factors. Although virulent strains of H pylori were significantly more often present in patients with duodenal ulcer than without the disease in countries with a low prevalence of H pyloriinfection in the population, there was no difference in the prevalence of virulence factors between duodenal ulcer, non- ulcer dyspepsia or normal subjects in many countries, where the prevalence of both H pylori infection and of virulence factors was high.In these countries, the presence of virulence factors was not predictive the clinical outcome. To explain the association between virulence factors and duodenal ulcer in countries where H pylori prevalence is low,only two papers were found that give little support to the usual model proposed, namely that organisms with the virulence factors are more likely than those without them to initiate a duodenal ulcer. We offer an alternative hypothesis that suggests virulence factors are more likely to interfere with the healing of a previously produced ulcer. The presence of virulence factors only correlates with the prevalence of duodenal ulcer in countries where the prevalence of H pylori is low. There is very little evidence that virulence factors initiate duodenal ulceration, but they may be related to failure of the ulcer to heal.

  7. Changes in Disability, Physical/Mental Health States and Quality of Life during an 8-Week Multimodal Physiotherapy Programme in Patients with Chronic Non-Specific Neck Pain: A Prospective Cohort Study

    Science.gov (United States)

    Cuesta-Vargas, Antonio Ignacio; González-Sánchez, Manuel

    2015-01-01

    Aim The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP), integrating physical land-based therapeutic exercise (TE), adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP), on disability, general health/mental states and quality of life. Methods 175 CNSNP patients from a community-based centre were recruited to participate in this prospective study. Intervention: 60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel). Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session. Study outcomes: primary: disability (Neck Disability Index); secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively). Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables. Results Disability showed a significant improvement of 24.6% from a mean (SD) of 28.2 (13.08) at baseline to 16.88 (11.62) at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2) at baseline to 0.83 (0.2), for EuroQoL-5D, and from a mean of 40.6 (12.7) at baseline to 56.9 (9.5), for mental health state, at the end of the 8-week intervention. Conclusion After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical

  8. Changes in disability, physical/mental health states and quality of life during an 8-week multimodal physiotherapy programme in patients with chronic non-specific neck pain: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Antonio Ignacio Cuesta-Vargas

    Full Text Available The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP, integrating physical land-based therapeutic exercise (TE, adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP, on disability, general health/mental states and quality of life.175 CNSNP patients from a community-based centre were recruited to participate in this prospective study.60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel. Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session.primary: disability (Neck Disability Index; secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively. Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables.Disability showed a significant improvement of 24.6% from a mean (SD of 28.2 (13.08 at baseline to 16.88 (11.62 at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2 at baseline to 0.83 (0.2, for EuroQoL-5D, and from a mean of 40.6 (12.7 at baseline to 56.9 (9.5, for mental health state, at the end of the 8-week intervention.After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical efficacy requires verification using a randomised controlled study

  9. Stress is dominant in patients with depression and chronic low back pain. A qualitative study of psychotherapeutic interventions for patients with non-specific low back pain of 3–12 months’ duration

    Directory of Open Access Journals (Sweden)

    Ellegaard Hanne

    2012-09-01

    Full Text Available Abstract Background There is continuing uncertainty in back pain research as to which treatment is best suited to patients with non-specific chronic low back pain (CLBP. In this study, Gestalt therapy and the shock trauma method Somatic Experiencing® (SE were used as interventions in parallel with the usual cross-disciplinary approach. The aim was to investigate how these treatments influence a patient’s capacity to cope with CLBP when it is coupled with depression. Methods In this qualitative explorative study, a phenomenological–hermeneutic framework was adopted. Patients were recruited on the basis of following criteria: A moderate depression score of 23–30 according to the Beck Depression Inventory Scale and a pain score of 7–10 (Box scale from 0–10 and attendance at five- six psychotherapeutic sessions. Six patients participated in the study. The data was comprised of written field notes from each session, which were subsequently analysed and interpreted at three levels: naive reading, structural analysis and critical interpretation and discussion. Results Three areas of focus emerged: the significance of previous experiences, restrictions in everyday life and restoration of inner resources during the therapy period. The study revealed a diversity of psychological stressors that related to loss and sorrow, being let down, violations, traumatic events and reduced functioning, which led to displays of distress, powerlessness, reduced self-worth, anxiety and discomfort. Overall, the sum of the stressors together with pain and depression were shown to trigger stress symptoms. Stress was down-played in the psychotherapeutic treatment and inner resources were re-established, which manifested as increased relaxation, presence, self-worth, sense of responsibility and happiness. This, in turn, assisted the patients to better manage their CLBP. Conclusions CLBP is a stress factor in itself but when coupled with depression, they can be

  10. Negative Pressure Wound Therapy with Instillation in a Chronic Non-Healing Right Hip Trochanteric Pressure Ulcer

    Science.gov (United States)

    Broder, Kevin W; Bodor, Richard M

    2016-01-01

    Complex pressure ulcer wound sites often present with a wide scope of barriers to healing ranging from high colonization of multi-drug-resistant pathogens to tortuous internal anatomy which make the wound recalcitrant to traditional wound care including standard negative pressure wound therapy (NPWT). Negative pressure wound therapy with instillation (NPWTi-d) provides an opportunity to manage and heal wounds with indications not met by standard NPWT such as cavitating wounds with complex undermining and tunneling. In this clinical case report, a patient who presented with a chronic, non-healing Stage IV pressure ulcer underwent a tensor fascia lata flap reconstruction that was complicated by a partial flap-tip nonadherence with associated partial dehiscence of the flap incision that proved unresolvable until application of adjunctive NPWTi-d which allowed the wound to experience a robust rate of granulation, contraction, and closure. PMID:28003941

  11. Multidisciplinary and comprehensive approaches to optimal management of chronic pressure ulcers in the elderly

    Directory of Open Access Journals (Sweden)

    Jaul E

    2014-05-01

    Full Text Available Efraim Jaul Skilled Geriatric Nursing Department, Herzog Memorial Hospital, Affiliated to the Hebrew University Hadassah Medical School, Jerusalem, Israel Abstract: The occurrence of pressure ulcers (PUs is common and poses serious problems for the frail elderly, with implications for functional disability and reduced quality of life. PUs are preventable in a majority of cases. The increase in PU occurrence, however, appears regardless of higher awareness in prevention and improvement through utilization of pressure relieving devices. Multiple changes in the elderly body systems occur over time including aging, multiple chronic conditions, and functional impairment, potentially culminating in the final pathways of geriatric syndrome, unless awareness to the development of PUs is reversible and prevented. The assumption is that the development of PUs is based on multifactorial causes (extrinsic and intrinsic factors; thus, the optimal management for elderly patients requires a comprehensive approach in all medical settings (community, hospital, and at the long term care [LTC] level. Comprehensiveness signifies looking beyond the wounds, assisting the patient through both local (wound and systemic (medical condition treatment, using a strategy of prevention and supporting quality of life. Within the multidisciplinary involvement team approach, each professional discipline contributes its own task in coordination with other disciplines to address PU prevention, assessment, and treatment. The entire medical staff and the multidisciplinary team work together and communicate frequently in order to prevent, halt at an early stage, and provide healing in a timely fashion. Limiting the formation of PUs is facilitated through early identification, treating contributing causes, eliminating all unnecessary medications, instituting supportive interventions which include the family. Understanding the relationship between the formation of PUs and the

  12. Effects of laser therapy on chronic skin ulcers healing interventions for Sudanese patients

    Directory of Open Access Journals (Sweden)

    Abdelrazig M. Abdelbagi

    2015-12-01

    Results: Utilization of laser dosage (energy density of 40 J/cm2 and 1.6 w/cm2 power density of the wavelength 820 nm and 30 J/cm2 energy density and power density of 0.24 w/cm2 of 780 nm wavelength, in addition to energy density of 8 J/cm2 and power density of 0.24 w/cm2 and 0.40 w/cm2 and energy density of 1.6 J/cm2 for the 675 wavelength was applied. In this study, we used the bio-stimulation effect of LLLT to enhance healing through immune modulation. However, the application of low level diode laser in the treatment of diabetic wounds can be accompanied by low energy density and short wavelength to give better results in a short time and a good diagnostic accuracy for its potentiality in the field. Conclusions: Consequently, the brown skins in Sub-Saharan region for different tissues of Sudanese diabetic patients of chronic skin ulcer can be treated with different wavelengths and energy relative to tissues softening and laser parameters of that optimum values were obtained. The assessment of skin regeneration using laser therapy expose that the quality of growth, the reasonable period of healing and decreases the risk skin infection were achieved. The process of diabetic wounds curing and de-pigmentation, potential resident of decreasing pain and an efficient adjunct to a standard wound management was obtained. [Int J Res Med Sci 2015; 3(12.000: 3720-3725

  13. The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT).

    NARCIS (Netherlands)

    Groeneweg, R.; Kropman, H.; Leopold, H.; Assen, L. van; Mulder, J.; Tulder, M.W. van; Oostendorp, R.A.B.

    2010-01-01

    BACKGROUND: Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU) has not been the subject of a randomized controlled trial. MTU differs in diagnoses an

  14. Gastroprotective effects of thymol on acute and chronic ulcers in rats: The role of prostaglandins, ATP-sensitive K(+) channels, and gastric mucus secretion.

    Science.gov (United States)

    Ribeiro, Ana Roseli S; Diniz, Polyana B F; Pinheiro, Malone S; Albuquerque-Júnior, Ricardo L C; Thomazzi, Sara M

    2016-01-25

    Thymol, a monoterpene phenol derivative of cymene, is found in abundance in the essential oils of Thymus, Origanum, and Lippia species. The present study investigated the gastroprotective actions of thymol (10, 30, and 100 mg/kg, p.o.) in the acute (ethanol- and nonsteroidal anti-inflammatory drug-induced ulcers) and chronic (acetic acid-induced ulcers) ulcer models in rats. Some of the mechanisms underlying to the gastroprotective effect of thymol were investigated in the ethanol-induced ulcer model. Gastric secretion parameters (volume, pH, and total acidity) were also evaluated by the pylorus ligature model, and the mucus in the gastric content was determined. The anti-Helicobacter pylori activity of thymol was performed using the agar-well diffusion method. Thymol (10, 30, and 100 mg/kg) produced dose dependent reduction (P ulcer model. The gastroprotective response caused by thymol (30 mg/kg) was significantly attenuated (P ulcer index (P ulcer models, respectively. In the model pylorus ligature, the treatment with thymol failed to significantly change the gastric secretion parameters. However, after treatment with thymol (30 and 100 mg/kg), there was a significant increase (P ulcer models through mechanisms that involve increased in the amount of mucus, prostaglandins, and ATP-sensitive K(+) channels.

  15. Comparison of Helicobacter pylori infection and gastric mucosal histological features of gastric ulcer patients with chronic gastritis patients

    Institute of Scientific and Technical Information of China (English)

    Chuan Zhang; Nobutaka Yamada; Yun-Lin Wu; Min Wen; Takeshi Matsuhisa; Norio Matsukura

    2005-01-01

    AIM: To compare Helicobacter pyloriinfection and gastric mucosal histological features of gastric ulcer patients with chronic gastritis patients in different age groups and from different biopsy sites.METHODS: The biopsy specimens were taken from the antrum, corpus and upper angulus of gastric ulcer and chronic gastritis patients. Giemsa staining, improved Toluidine-blue staining and H pylori-specific antibody immune staining were performed as appropriate for the histological diagnosis of H pylori infection. Hematoxylineosin staining was used for the histological diagnosis of activity of H pylori infection, mucosal inflammation,glandular atrophy and intestinal metaplasia and scored into four grades according to the Updated Sydney System.RESULTS: Total rate of H pylori infection, mucosal inflammation, activity of H pylori infection, glandular atrophy and intestinal metaplasia in 3 839 gastric ulcer patients (78.5%, 97.4%, 82.1%, 61.1% and 64.2%,respectively) were significantly higher than those in 4 102chronic gastritis patients (55.0%, 90.3%, 56.2%, 36.8%,and 37.0%, respectively, P<0.05). The rate of H pylori colonization of chronic gastritis in <30 years, 31-40 years,41-50 years, 51-60 years, 61-70 years and >70 years age groups in antrum was 33.3%, 41.7%, 53.6%, 57.3%,50.7%, 43.5%, respectively; in corpus, it was 32.6%,41.9%, 53.8%, 60.2%, 58.0%, 54.8%, respectively; in angulus, it was 32.4%, 42.1%, 51.6%, 54.5%, 49.7%,43.5%, respectively. The rate of Hpyloricolonization of gastric ulcer in <30 years, 31-40 years, 41-50 years,51-60 years, 61-70 years and >70 years age groups in antrum was 60.5%, 79.9%, 80.9%, 66.8%, 59.6%, 45.6%,respectively; in corpus, it was 59.7%, 79.6%, 83.6%,80.1%, 70.6%, 59.1%, respectively; in angulus, it was61.3%, 77.8%, 75.3%, 68.8%, 59.7%, 45.8%,respectively. The rate of H pylori colonization at antrum was similar to corpus and angulus in patients, below50 years, with chronic gastritis and in patients, below40 years, with

  16. Significance of serum markers pepsinogen I and II for chronic atrophic gastritis, peptic ulcer, and gastric cancer.

    Science.gov (United States)

    Matsukura, N; Onda, M; Tokunaga, A; Fujita, I; Okuda, T; Mizutani, T; Kyono, S; Yamashita, K

    1993-01-01

    Chronic atrophic gastritis (CAG) is closely correlated with gastric cancer and is predominant in Japan. Epidemiologically, food habits are the primary factor in both CAG and gastric cancer. Two potential serum markers for CAG have recently been investigated, i.e., the concentration of serum pepsinogen (PG) and the presence of serum antibodies against Helicobacter pylori. Serum PG I and II and the PG I:PG II ratio have been reported to be useful as indicators of recurrent peptic ulcer and for screening of patients at risk from gastric cancer. In this study, we examined PG I and II in serum from 483 patients by RIA (DAINABOT), and endoscopic examination performed in the same patients before serological assay revealed CAG in 68, peptic ulcer in 91, and gastric cancer in 48. Analysis of the mean values according to patients age showed that CAG patients in their forties to eighties had low ( or = 70 ng/ml) levels, except for those in their seventies, and gastric cancer patients in their twenties to sixties had low (< 3.0) PG I:PG II ratios, except for those in their sixties. Thus serum PG assay has potential utility for detection of CAG, peptic ulcer, and gastric cancer.

  17. Differential diagnosis of leg ulcers.

    Science.gov (United States)

    Pannier, F; Rabe, E

    2013-03-01

    Leg and foot ulcers are symptoms of very different diseases. The aim of this paper is to demonstrate the differential diagnosis of leg ulcers. The majority of leg ulcers occur in the lower leg or foot. In non-venous ulcers the localization in the foot area is more frequent. The most frequent underlying disease is chronic venous disease. In 354 leg ulcers, Koerber found 75.25% venous leg ulcers, 3.66% arterial leg ulcers, 14.66% ulcers of mixed venous and arterial origin and 13.5% vasculitic ulcers. In the Swedish population of Skaraborg, Nelzen found a venous origin in 54% of the ulcer patients. Each leg ulcer needs a clinical and anamnestic evaluation. Duplex ultrasound is the basic diagnostic tool to exclude vascular anomalies especially chronic venous and arterial occlusive disease. Skin biopsies help to find a correct diagnosis in unclear or non-healing cases. In conclusion, chronic venous disease is the most frequent cause of leg ulcerations. Because 25% of the population have varicose veins or other chronic venous disease the coincidence of pathological venous findings and ulceration is very frequent even in non-venous ulcerations. Leg ulcers without the symptoms of chronic venous disease should be considered as non-venous.

  18. Defensin expression in chronic pouchitis in patients with ulcerative colitis or familial adenomatous polyposis coli

    Institute of Scientific and Technical Information of China (English)

    Karlheinz Kiehne; Gabriele Brunke; Franziska Wegner; Tomas Banasiewicz; Ulrich R F(o)lsch; Karl-Heinz Herzig

    2006-01-01

    AIM:Pouchitis develops in ileoanal pouches in up to 50% of patients with ulcerative colitis during the first 10years after pouch surgery while being rare in patients after proctocolectomy for familial adenomatous polyposis coii (FAP) syndrome. Defensins are major components of the innate immune system and play a significant role in gastrointestinal microbial homeostasis. Pouch defensin and cytokine expression were correlated with states of pouch inflammation to study their role in pouchitis.METHODS:Patients with ulcerative colitis and FAP syndrome were stratified into groups with pouches after surgery, pouches without or with pouchitis. Biopsies from terminal ileum from a healthy intestine or from normal terminal ileum of patients with ulcerative colitis served as controls, mRNA from pouches and controls was analysed for defensin and cytokine expression.RESULTS: Expression of defensins was increased in all pouches immediately after surgery, compared to ileum of controls. Initially, pouches in ulcerative colitis revealed higher defensin expression than FAP pouches. Defensin expression declined in both patient groups and increased again slightly in pouchitis in patients with ulcerative colitis. FAP pouches without pouchitis had strong expression of β-defensin hBD-1, while all other defensins remained at low levels. Cytokine expression in ulcerative colitis pouches was high, while FAP pouches showed moderately elevated cytokines only after surgery.CONCLUSION: Development of pouchitis correlates with decreased defensin expression in ulcerative colitis in addition to high expression of cytokines. The low incidence of pouchitis in FAP pouches correlates with increased expression of hBD-1 β- defensin in association with low cytokine levels.

  19. Clinical outcome of ileal pouch-anal anastomosis for chronic ulcerative colitis in China

    Institute of Scientific and Technical Information of China (English)

    Liu Gang; Han Hongqiu; Liu Tong; Fu Qiang; Lyu Yongcheng

    2014-01-01

    Background The incidence of chronic ulcerative colitis (CUC) in China is remarkably increasing,while little information on surgical treatment has been reported.This study aimed to completely describe and analyze the clinical outcome of restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for CUC in China.Methods Ninety-five consecutive patients,who suffered CUC and had surgical indications,were carefully selected.All patients underwent IPAA.Data on patient characteristics,surgical indications,surgical details,postoperative complications,functional outcome,and quality of life were collected.Results The mean patient age at the time of the operation was 32 years.Twenty-nine (31%) patients underwent an emergency operation,and 66 (69%) underwent elective procedures.Four patients with severe dysplasia underwent operations,but no carcinoma was histologically confirmed.A two-stage operation was performed in 87 (92%) patients,and a hand-sewn technique was applied in 88 (93%) patients.Sixteen patients (17.0%) experienced early complications,and there was a significant difference between the emergency surgery group and the elective group (31.0% vs.10.6%,respectively; P <0.01).Five (5.3%) patients developed pouchitis as a late complication.The mean stool frequency after the operation was 4.6 (2-11) during the first 24 hours and 1.5 (0-4) overnight.According to the Kirwan grading scale,87 (91.8%) patients showed satisfactory anal continence function.The quality of life improved significantly from a preoperative mean value of 0.28-0.61 before ileostomy closure to 0.78 after ileostomy closure (P <0.01) according to the Cleveland Global Quality of Life index.Conclusions IPAA is an effective and safe surgical procedure for patients with CUC in China.However,some characteristics,such as the low incidence of pouchitis,require further study.

  20. A study to determine the knowledge and practice of foot care in patients with chronic diabetic ulcers

    Directory of Open Access Journals (Sweden)

    Chamil Vidusha Madushan Jinadasa

    2011-01-01

    Full Text Available Introduction: Diabetic foot ulcers accounts for many hospital admissions and it is also a major cause of amputations. More importantly it is preventable by effective identification, education and preventive foot care practice. Therefore, lifestyle modification remains a cornerstone of management.Objective: Determine the level of knowledge and practice of foot care among patients with chronic diabetic foot ulcers.Methodology: Individuals having diagnosed diabetic foot ulcers (n=110 were selected from National Hospital of Sri Lanka(NHSL for this descriptive cross sectional study. They were given an interviewer administered, pre tested questionnaire following informed consent. Patient perceptions of foot care were inquired. A scoring system ranging from 0-10 was employed to analyze the responses given for level of knowledge and practice of diabetic foot care. The study was approved by the Ethics Review Committees of Faculty of Medicine, Colombo.Results: Mean age was 58.4 years( SD ±8.6 and 57.3% were males. Non healing ulcers were present among 82.7% and amputations amounted to 38.2%. The control of diabetes was poor in 60%. Regarding foot care knowledge, the mean score was 8.37, 75.5% had scored above mean and 52.7% were aware of all principles of foot care. Regarding foot care practices, the mean score was 4.55, 47.3% participants had scored below mean and 22.7% did not practice any foot care principle and hence scored 0. A Statistically significant difference exists between the foot care knowledge and practice scores (p<0.001, z= -8.151. In the study sample 51% were not educated prior to occurrence of complications.Conclusion: Results demonstrate a satisfactory knowledge on diabetic foot disease, however their practices of preventive techniques were unsatisfactory. Implementation of a national policy on diabetic foot management and good patient follow-up to increase compliance would help to improve this situation.

  1. Development of Marjolin's ulcer following successful surgical treatment of chronic sacral pressure sore

    DEFF Research Database (Denmark)

    Knudsen, M.A.; Biering-Sørensen, Fin

    2008-01-01

    of surgical excision and successful closure of the wound, the patient developed Marjolin's ulcer 2.5 years later. Yet it illustrates the primary importance of preventing the development pressure sores, of aggressive (surgical) therapy with healing when they do arise and of taking frequent biopsies......STUDY DESIGN: Case report. OBJECTIVE: Report of an unusual case, where a Marjolin's ulcer that developed 2.5 years after surgical excision and successful closure. SETTING: Department of Plastic and Reconstructive Surgery and Burn Unit and the Clinic for Spinal Cord Injuries, Copenhagen University...... Hospital, Rigshospitalet, Copenhagen, Denmark. METHODS AND RESULTS: A 22-year-old man sustained a fracture with luxation of the 5th and 6th cervical vertebrae and loss of sensory and motor function after a diving accident (complete C8 lesion). During initial hospitalization, he developed a sacral ulcer...

  2. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops

    Directory of Open Access Journals (Sweden)

    Abhijeet D Sawant

    2016-04-01

    Full Text Available Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

  3. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops.

    Science.gov (United States)

    Sawant, Abhijeet D; Shah, Rasik; Shah, Nitin; Gupta, Tarun

    2016-01-01

    Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT) bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis) and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

  4. Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report

    Directory of Open Access Journals (Sweden)

    Pavlakis Emmanouil

    2011-08-01

    Full Text Available Abstract Introduction Gout is a common inflammatory arthritis caused by articular precipitation of monosodium urate crystals. It usually affects the first metatarsophalangeal joint of the foot and less commonly other joints, such as wrists, elbows, knees and ankles. Case presentation We report the case of a 75-year-old Caucasian man with tophaceous multiarticular gout, soft-tissue involvement and ulcerated tophi on the first metatarsophalangeal joint of the left foot, on the first interphalangeal joint of the right foot and on the left thumb. Conclusion Ulcers due to tophaceous gout are currently uncommon considering the positive effect of pharmaceutical treatment in controlling hyperuricemia. Surgical treatment is seldom required for gout and is usually reserved for cases of recurrent attacks with deformities, severe pain, infection and joint destruction.

  5. The effect of tri-potassium di-citrato bismuthate (De-Nol) on the healing of chronic duodenal ulcers.

    Science.gov (United States)

    Coughlin, G P; Kupa, A; Alp, M H

    1977-02-26

    Forty-six patients suffering from chronic duodenal ulcer, proven endoscopically, were treated in a randomized double-blind cross-over trial with either tri-potassium di-citrato bismuthate (De-Nol) or placebo for four weeks and assessed symptomatically and endoscopically. Those patients who failed to heal after treatment with either agent were crossed over to the alternative preparation and reassessed after a further 28 days. Forty-two patients completed the study involving 57 patient treatments. A highly significant improvement in both symptomatic response (P less than 0.01) and endoscopic healing (P less than 0.01) was seen in those patients receiving tri-potassium di-citrato bismuthate (De-Nol) as against placebo therapy.

  6. Anterior seromyotomy with posterior truncal vagotomy in uncomplicated chronic duodenal ulcer.

    Directory of Open Access Journals (Sweden)

    Supe A

    1995-07-01

    Full Text Available Thirty cases of uncomplicated duodenal ulcer treated by anterior superficial lesser curvature seromyotomy and posterior truncal vagotomy were studied to evaluate the efficacy of this procedure. There was completeness of vagotomy in all the cases as shown by endoscopic Congo Red test. Twenty-seven cases were asymptomatic at 1-48 months (Mean 22.3 follow up, while 3 patients had controllable side effects such as dumping and diarrhoea. There was no mortality. This procedure is safe, effective and is a favourable alternative to highly selective vagotomy.

  7. Risk of ulcerative colitis and Crohn's disease among offspring of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Orholm, Marianne; Fonager, Kirsten; Sørensen, Henrik Toft

    1999-01-01

    ) and Crohn's disease (CD) among first-degree relatives of patients with these diseases. To give more precise risk estimates we conducted a nationwide study using population-based data from the Danish National Registry of Patients (NRP). METHODS: All patients from the entire Danish population (5.2 million......OBJECTIVE: The incidence of inflammatory bowel disease (IBD) varies among and within countries, but several studies have indicated that genetic factors may play an important role in the etiology of IBD. A Danish regional study has observed an almost 10-fold increased risk for ulcerative colitis (UC...

  8. How is trunk muscle activity during forward bending in standing in chronic non-specific low back pain patients presenting with psychosocial characteristics such as fear avoidance beliefs, pain catastrophizing or kinesiophobia? A systematic review of the literature

    DEFF Research Database (Denmark)

    Sørensen, Brian Østergaard

    2016-01-01

    Low back pain (LBP) is the most common single reason for addressing the health care system due to musculoskeletal pain. More than 80% will experience LBP at some point in life; 6 - 10% of those experiencing LBP will develop persistent and chronic pain with great variance in level of disability...... and pain. Research indicates that LBP is multifactorial and calls for a biopsychosocial model when approaching the patient experiencing LBP. Despite this recognition LBP is poorly understood. A factor for debate has been the contribution of pain-related fear regarding maintenance of chronicity. Recently...

  9. Helicobacter pylori lipopolysaccharide:Biological activities in vitro and in vivo, pathological correlation to human chronic gastritis and peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Yi-Hui Luo; Jie Yan; Ya-Fei Mao

    2004-01-01

    AIM: To determine the biological activity of Helicobacter pylori (Hpylori) lipopolysaccharide (H-LPS) and understand pathological correlation between H-LPS and human chronic gastritis and peptic ulcer.METHODS: H-LPS of a clinical Hpylori strain and LPS of Escherichia coli strain O55:B5 (E-LPS) were extracted by phenol-water method. Biological activities of H-LPS and E-LPS were detected by limulus lysate assay, pyrogen assay,blood pressure test and PBMC induction test in rabbits,cytotoxicity test in NIH 3T3 fibroblast cells and lethality test in NIH mice. By using self-prepared rabbit anti-H-LPS serum as the first antibody and commercial HRP-labeled sheep anti-rabbit sera as the second antibody, H-LPS in biopsy specimens from 126 patients with chronic gastritis (68 cases) or gastric ulcer (58 cases) were examined by immunohistochemistry.RESULTS: Fibroblast cytotoxicity and mouse lethality of H-LPS were weaker than those of E-LPS. But the ability of coagulating limulus lysate of the two LPSs was similar (+/0.5 ng/mL). At 0.5 h after H-LPS injection, the blood pressures of the 3 rabbits rapidly declined. At 1.0 h after H-LPS injection, the blood pressures in 2 of the 3 rabbits fell to zero causing death of the 2 animals. For the other one rabbit in the same group, its blood pressure gradually elevated. At 0.5 h after E-LPS injection, the blood pressures of the three rabbits also quickly declined and then maintained at low level for approximately 1.0 h. At 0.5 h after injection with H-LPS or E-LPS, PBMC numbers of the rabbits showed a remarkable increase. The total positivity rate of H-LPS from 126 biopsy specimens was 60.3%(76/126). H-LPS positivity rate in the biopsy specimens from chronic gastritis (50/68, 73.5%) was significantly higher than that from gastric ulcer (26/58, 44.8%) (X2=10.77,P<0.01). H-LPS positivity rates in biopsy specimens from chronic superficial gastritis (38/48, 79.2%) and chronic active gastritis (9/10, 90.0%) were significantly higher than

  10. Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study

    NARCIS (Netherlands)

    Verkerk, K.; Luijsterburg, P.A.J.; Heymans, M.W.; Ronchetti, I.; Miedema, H.S.; Koes, B.W.; Pool-Goudzwaard, A.

    2015-01-01

    This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic nonspecific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n ¼ 1760) of

  11. Determination of Oxidative Stress in Patients With Chronic Venous Ulcer%慢性静脉性溃疡组织中氧化应激产物的测定

    Institute of Scientific and Technical Information of China (English)

    杨帆; 邓璐

    2016-01-01

    ABSTRACT:ObjectiveTo clarify whether there is oxidative stress in chronic venous ulcer, and to lay a theoretical foundation for the further study of the pathogenesis of chronic venous ulcer. Methods 36 cases were diagnosed from January 2015 to October 2015 were treated for chronic venous insufficiency of lower extremity ulcers in patients with ulcer specimens, determination of malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) content and compared with the burn ulcer tissue and normal skin tissue.Results With the control group (normal skin, burn ulcer group),duration of ulcer2 weeks and> 1 month group, venous ulceration of the concentration of MDA significantly increased (P2weeks and >1 month group, the SOD、GSH of venous ulcer group significantly reduced (P2周和>1月组,静脉性溃疡MDA浓度显著增加(P2周和>1月组中,静脉性溃疡组SOD、GSH明显减少(P<0.05)。结论静脉性溃疡创面氧化应激反应增强,抗氧化能力减弱,并产生了大量的氧化应激产物。

  12. Non-specific ileojejunitis in Arequipa, Peru.

    Science.gov (United States)

    Perea, V D; Fernan-Zegarra, L; Cruz, V M; Ballon, R; Picoaga, J L

    1978-09-09

    Non-specific ileojejunitis, characterised by mild to moderate structural changes in the intestinal mucosa and often associated with asymptomatic malabsorption, is known to occur in the tropics and in countries with hot climates. This acquired condition is probably related to environmental factors, and some consider it to be a subclinical form of tropical sprue. Changes in the intestinal mucosa typical of non-specific ileojejunitis were found in 10 indigenous Indians as well as 5 people of Latin stock living in the Southern Peruvian sierra, where tropical sprue has not as yet been demonstrated and which has a temperate climate.

  13. Klinefelter Syndrome With Leg Ulcers

    Directory of Open Access Journals (Sweden)

    Narendra G

    1999-01-01

    Full Text Available Leg ulcers are frequently caused by venous insufficiency, arterial insufficiency, neuropathy, or a combination of these factors. Klinefelter syndrome in association with chronic leg ulcers have been reported earlier. We report a case of Klinefelter syndrome with non- healing ulcer. The diagnosis of the Klinefelter syndrome was confirmed by karyotyping.

  14. Etiological analysis of the children with non-specific chronic cough in Fuzhou area of Fujian province%福建省福州地区儿童慢性咳嗽病因分析

    Institute of Scientific and Technical Information of China (English)

    唐素萍; 刘艳琳; 董李; 华云汉; 郭依华; 陆权

    2011-01-01

    目的 探讨福建省福州地区儿童慢性咳嗽的病因.方法 根据中华医学会儿科学分会呼吸学组与编辑委员会2008年制定的的标准,对福建省福州儿童医院哮喘专科门诊诊断的364例慢性咳嗽患儿,按照指南的诊断流程询问病史,进行体检、辅助检查,初步确定病因后,并针对病因进行特异性治疗,分别在初诊后半个月、1个月、3个月对患儿进行随访,根据辅助检查及疗效判定病因诊断,进而分析病因构成比.结果 364例慢性咳嗽患儿病因依次为:咳嗽变异性哮喘171例(47.0%),上气道咳嗽综合征104例(28.6%),呼吸道感染和感染后咳嗽58例(15.9%),胃食管反流17例(4.7%),支气管异物3例(0.8%);引起慢性咳嗽只有单一病因的299例(82.1%),同时有2种病因的56例(15.4%),同时有3种病因的9例(2.5%).结论 福建省福州地区儿童慢性咳嗽的病因依次为咳嗽变异性哮喘、上气道咳嗽综合征、呼吸道感染和感染后咳嗽、胃食管反流、支气管异物;不同年龄组儿童慢性咳嗽病因构成比不同;部分患儿合并有2或3种病因,表明儿童慢性咳嗽病因呈多因素.%Objective Chronic cough in children is a common pediatric symptom with complex causes and its diagnosis is difficult; chronic cough affects the life of children in both physical and mental health and also learning. Therefore this study aimed to investigate the causes of chronic cough in children in Fuzhou area of Fujian province. Method Data were collected from 364 children with chronic cough who visited the asthma specialist clinic of Children's Hospital of Fuzhou, Fujian Province from March 2009 to April 2010. The diagnosis was made according to Guideline for Diagnosis and Treatment of Chronic Cough in Pediatrics published in 2008. Among the patients, 241 were boys and 123 girls. The patients were divided into 3 age groups: group 1, 1 to 3 years old ( infants and young children group, n =75); group 2, 4 to 6years

  15. Low level laser therapy (GaAlInP 660 nm) in healing of a chronic venous ulcer: a case study

    Science.gov (United States)

    Botaro, C. A.; Faria, L. A.; Oliveira, R. G.; Bruno, R. X.; Rocha, C. A. Q. C.; Paiva-Oliveira, E. L.

    2015-07-01

    The venous ulcer represents approximately 70% to 90% of inferior member ulcers, and the most common etiological factor is venous insufficiency, triggered by venous hypertension. Currently in Brazil there are several types of lasers used in physiotherapy, which benefit biological potential, emitting low power radiation, with anti-inflammatory, analgesic, healing and circulatory effects. This study aimed at the analysis of low level laser therapy effects (LLLT) on the process of tissue repair in chronic venous ulcers. We conducted a case study of a patient with a venous ulcer in the lateral region of the right inferior member. The patient underwent LLLT, which used a GaAlInP diode laser, with a wavelength of 660 nm and energy density of 4 J cm-2 applied punctually at the edges of the wound, with an average distance of 1 cm between the points with a pen-laser perpendicular wrapped in paper and a plastic wrap, keeping contact with the tissue. After four months of therapy and a total of 21 sessions, an improvement was noticeable in the gross appearance of the wound, but after a month and a half without therapy, the dimensions of the wound increased in length and width. Analyzing the results of this case study allows us to conclude that the LLLT GaAlInP (660 nm) with an energy density of 4 J cm-2, was not successful in the healing of venous ulcers.

  16. Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

    Directory of Open Access Journals (Sweden)

    Edel Marie Quinn

    Full Text Available BACKGROUND: Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics. OBJECTIVE: We propose utilizing mobile phone technology to decentralise care from tertiary centres to the community, improving efficiency and patient satisfaction, while maintaining patient safety. METHODS: Bespoke mobile software was developed for Apples iPhone 4 platform. This allowed for the remote collection of patient images prospectively and their transmission with clinical queries, from the primary healthcare team to the tertiary centre. Training and iPhones were provided to five public health nurses in geographically remote areas of the region. Data were uploaded securely and user end software was developed allowing the review and manipulation of images, along with two way communication between the teams. Establishing reliability, patients were reviewed clinically as well as remotely, and concordance analysed. Qualitative data were collected through focus group discussion. RESULTS: From October to December 2011 eight patients (61-83 yrs, mean 75.3 yrs with chronic venous ulceration and their five public health nurses were recruited. Data were transmitted using 3 G, Edge, GPRS and WiFi, at a mean speed of 69.03 kps. Concordance was 100% for wound bed assessment, 80% for skin integrity/colour and 60% for exudate assessment. Focus group analysis explored the concept, practicalities and future applications of the system. CONCLUSIONS: With an evolving national data network, the secure transmission of clinical images is a safe alternative to regular clinic appointments for patients with chronic venous ulceration. With further development, and packaged as a freely downloadable application, this has the potential to support the community care of chronic wounds.

  17. The Effects of Stabilization and Mckenzie Exercises on Transverse Abdominis and Multifidus Muscle Thickness, Pain, and Disability: A Randomized Controlled Trial in NonSpecific Chronic Low Back Pain.

    Science.gov (United States)

    Hosseinifar, Mohammad; Akbari, Mohammad; Behtash, Hamid; Amiri, Mohsen; Sarrafzadeh, Javad

    2013-12-01

    [Purpose] This study compared the effectiveness of stabilization and McKenzie exercises on pain, disability, and thickness of the transverse abdominis and multifidus muscles in patients with nonspecific chronic low back pain. [Subjects] Thirty patients were randomly assigned into two groups: the McKenzie and stabilization exercise groups. [Methods] Before and after intervention, pain, disability, and thickness of the transverse abdominis and multifidus muscles were evaluated by visual analogue scale, functional rating index, and sonography, respectively. The training program was 18 scheduled sessions of individual training for both groups. [Results] After interventions, the pain score decreased in both groups. The disability score decreased only in the stabilization group. The thickness of the left multifidus was significantly increased during resting and contracting states in the stabilization group. The thickness of the right transverse abdominis during the abdominal draw-in maneuver, and thickness of the left transverse abdominis during the active straight leg raising maneuver were significantly increased in the stabilization group. The intensity of pain, disability score, thickness of the right transverse abdominis during the abdominal draw-in manouver, and thickness of the left transverse abdominis during active straight leg raising in the stabilization group were greater than those on the Mackenzie. [Conclusion] Stabilization exercises are more effective than McKenzie exercises in improving the intensity of pain and function score and in increasing the thickness of the transverse abdominis muscle.

  18. Comparison and significance of specific and non-specific cellular immunity in patients with chronic hepatitis B caused by infection with genotypes B or C of hepatitis B virus

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The present study was designed to investigate possible relationships between the genotypes of hepatitis B virus(HBV) and the HBV-specific cytotoxic T lymphocyte(CTL) responses.HBV genotypes,HBV specific CTL HBV DNA and other markers of HBV infection were determined in 138 patients with chronic hepatitis B.The results showed that the patients infected with genotype C(n=62) had a significantly lower HBV-specific CTL response than those who were infected with HBV genotype B(P<0.01).HBV DNA titer was higher in patients infected with HBV genotype C than in those infected with HBV geno-type B(P<0.01).Both alanine aminotransferase(ALT) and total bilirubin(TBIL) were higher in HBV genotype C infected patients than in those infected with genotype B(P<0.01 and <0.05,respectively).These results suggest that compared with CHB patients infected with HBV genotype B,the higher HBV DNA level and more severe liver damages in the patients infected with genotype C of HBV may be associated with genotype C of the virus.

  19. Abductor Hallucis: Anatomical Variation and Its Clinical Implications in the Reconstruction of Chronic Nonhealing Ulcers and Defects of Foot

    Science.gov (United States)

    Chittoria, Ravi Kumar; Pratap, Harsha; Yekappa, Suma Hottigoudar

    2015-01-01

    Abductor hallucis (AH) is an intrinsic muscle of sole of the foot. It is commonly used in the coverage of ankle and heel defects and chronic nonhealing ulcers of the foot; its use is reported to have a favorable long-term outcome. The muscle's apt bulk and size, its simple surgical isolation, absence of donor-site defect, unvaried anatomy, and long neurovascular pedicle are some of the advantages that make it a promising muscle flap. During routine cadaver dissection in the Department of Anatomy of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, we identified an anatomical variation in AH in both feet of a 45-year-old embalmed male Indian cadaver. The variant muscle had innumerable proximal attachments, a majority of them arising atypically in the form of tough tendinous slips from the medial intermuscular septum at the junction of central and tibial components of plantar aponeurosis, the medial surface of first metatarsal and the intermuscular septum separating AH from the flexor hallucis brevis. The tendon: muscle ratio was 1.76, higher than the normal reported ratio of 0.56±0.07. This article highlights the variation noted and its implication for clinicians. On Internet search, we did not come across the variations described in our article. Findings of the anatomical variation reported in this article could benefit surgeons who decide to use AH flaps in the future. PMID:26634184

  20. Inter rater reliability of Pressure Ulcer Scale for Healing (PUSH in patients with chronic leg ulcers Confiabilidad inter-observadores del Pressure Ulcer Scale for Healing (PUSH en pacientes con úlceras crónicas en la pierna Confiabilidade interobservadores do Pressure Ulcer Scale for Healing (PUSH, em pacientes com úlceras crônicas de perna

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Conceição de Gouveia Santos

    2007-06-01

    Full Text Available This study aimed to evaluate the inter rater reliability of the Pressure Ulcer Scale for Healing (PUSH, in its version adapted to the Portuguese language, in patients with chronic leg ulcers. Kappa index was used for the analysis. After accomplishing ethical issues, 41 patients with ulcers were examined. A total of 49% of the ulcers were located in the right leg and 36% of them were venous ulcers. The Kappa indices (0.97 to 1.00 obtained in the comparison between the observations of the clinical nurses and the stomal therapists for all sub-scales and for total score, confirmed the tool inter rater reliability, with statistical significance (pEl objetivo del estúdio fue probar la confiabilidad inter-observadores del Pressure Ulcer Scale for Healing (PUSH, en su versión adaptada al portugués, en pacientes con úlceras crónicas en la pierna. Para el análisis de concordancia se utilizó el Indice Kappa. Posterior a la aprobación del Comité de Ética, 41 pacientes con úlcera fueron examinados, siendo que 49% de las úlceras se localizaron a la derecha y 36% eran de etiología venosa. Los indices Kappa obtenidos (0,97 a 1,00, con un nivel significativo de pTestar a confiabilidade interobservadores do Pressure Ulcer Scale for Healing (PUSH, em sua versão adaptada para o português, em pacientes com úlceras crônicas de perna foi o objetivo deste estudo. Para a análise de concordância, utilizou-se o índice Kappa. Após aprovação pelo Comitê de Ética, pacientes com úlceras (41 úlceras foram examinados, sendo que 49% das úlceras localizavam-se à direita e 36% eram de etiologia venosa. Os índices Kappa obtidos (0,97 a 1,00, com significância estatística (p<0,001, ratificaram a confiabilidade interobservadores, ao ser obtida concordância de muito boa a total entre as observações de enfermeiros clínicos e especialistas em estomaterapia (padrão-ouro, para todas as subescalas do PUSH, como para o escore total. Esses resultados

  1. Combination therapy using fexofenadine, disodium cromoglycate, and a hypoallergenic amino acid-based formula induced remission in a patient with steroid-dependent, chronically active ulcerative colitis.

    Science.gov (United States)

    Raithel, M; Winterkamp, S; Weidenhiller, M; Müller, S; Hahn, E G

    2007-07-01

    Corticosteroids and 5-aminosalicylic acid are the primary standard therapy for inflammatory bowel disease. Recent immunologic data implicate an involvement of mast cell activation followed by increased histamine secretion and elevated tissue concentrations of histamine in the pathogenesis of ulcerative colitis. In the present case, the clinical course of a 35-year-old man with steroid-dependent chronic active ulcerative colitis, who did not respond to high-dose steroids, antibiotics, or azathioprine during 3 years, is reported. Clinical disease activity and established serological markers were recorded during 6 weeks of unsuccessful therapy and during the next 6 weeks, as a new nonsedative antihistaminergic drug, a mast cell stabilizer, and an hypoallergenic diet were implemented in addition to conventional therapy. Induction of remission was achieved within 2 weeks after treatment with fexofenadine, disodium cromoglycate, and an amino acid-based formula. Clinical disease activity, stool frequency, leukocytes, c-reactive protein, and orosomucoid levels in serum decreased rapidly. Daily steroid administration could be gradually reduced along with 6 weeks of this treatment. This report suggests that histamine and mast cell activity may be important pathophysiological factors responsible for persistent clinical and mucosal inflammatory activity in ulcerative colitis despite the use of steroids. In ulcerative colitis, patients unresponsive to conventional treatment, therapeutic considerations should also include an antiallergic approach when further signs of atopy or intestinal hypersensitivity are present.

  2. Stomach ulcer

    Science.gov (United States)

    ... the acid and enzymes by a mucous lining. Ulcers are caused when there is an imbalance between ... protect the lining of the stomach. Symptoms of ulcers may include bleeding. On rare occasions, an ulcer ...

  3. The terminal complement complex is generated in chronic leg ulcers in the absence of protectin (CD59)

    DEFF Research Database (Denmark)

    Balslev, E; Thomsen, H K; Danielsen, L;

    1999-01-01

    hypertension leg ulcers. The deposition of complement, plasma complement regulators and expression of membrane regulators were detected by immunohistochemical methods, including immunofluorescence with antibodies against C3d, the terminal complement complex (TCC), vitronectin, clusterin, decay......-accelerating factor (CD55) and protectin (CD59). Eleven frozen biopsies from ischaemic leg ulcers, 10 biopsies from venous hypertension leg ulcers, and 10 biopsies from normal skin were studied. In 9 of 11 ischaemic and in 5 of 10 venous hypertension leg ulcers, marked staining for TCC was found around...... the capillaries, most often at the ulcer margin. No TCC staining was found in normal skin. Staining for TCC was always accompanied by staining for clusterin and vitronectin and C3d. In normal skin, CD59 was found on the elastic fibers in the dermis, on the muscle coat, the Schwann sheath and acinar cells...

  4. Increased expression of heat shock protein 70 and heat shock factor 1 in chronic dermal ulcer tissues treated with laser-aided therapy

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-da; LUO Cheng-qun; XIE Hui-qing; NIE Xin-min; ZHAO Yan-zhong; WANG Shao-hua; XU Yi; Pashupati Babu Pokharel; XU Dan

    2008-01-01

    Background Chronic dermal ulcers are also referred to as refractory ulcers, This study was conducted to elucidate the therapeutic effect of laser on chronic dermal ulcers and the induced expression of heat shock factor 1 (HSF1) and heat shock protein 70 (HSP70) in wound tissues.Methods Sixty patients with 84 chronic dermal ulcers were randomly divided into traditional therapy and laser therapy groups. Laser treatment was performed in addition to traditional therapy in the laser therapy group. The treatment efficacy was evaluated after three weeks. Five tissue sections of healing wounds were randomly collected along with five normal skin sections as controls. HSP70-positive cells from HSP70 immunohistochemical staining were counted and the gray scale of positive cells was measured for statistical analysis. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were performed to determine the mRNA and protein expressions of HSF1 and HSP70.Results The cure rate of the wounds and the total efficacy in the laser therapy group were significantly higher than those in the traditional therapy group (P<0.05, P<0.01, respectively). Immunohistochemical staining revealed that the HSP70-positive cell count was significantly higher in laser therapy group than those in the traditional therapy group and controls (P<0.01), and the gray scale of the cell signal was obviously lower than traditional therapy group and controls (P <0.05). By contrast, the traditional therapy group and the control group were not significantly different. The RNA levels of HSF1 and HSP70 were higher in the laser therapy group by RT-PCR, but very low in normal skin and the traditional therapy group. The analysis on the gray scale of the Western blot bands indicated that the expression of HSF1 and HSP70 in the laser therapy group was significantly higher than in the traditional therapy group and the control group (P <0.01), and the expression in the traditional therapy group was also

  5. Effectiveness evaluation of an integrated automatic termomechanic massage system (SMATH® system in non-specific sub-acute and chronic low back pain - a randomized double-blinded controlled trial, comparing SMATH therapy versus sham therapy: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mazzolari Rita

    2011-10-01

    Full Text Available Abstract Background Low back pain (LBP is a major health problem in modern society, with 70-85% of the population experiencing LBP at some time in their lives. Each year, 5-10% of the workforce misses work due to LBP, most for less than 7 days. Almost 10% of all patients are at risk of developing chronic pain and disability. Little clinical evidence is available for the majority of treatments used in LBP therapy. However, moderate evidence exists for interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation, and cognitive behavioral therapy for subacute and chronic LBP. The SMATH® system (system for automatic thermomechanic massage in health is a new medical device (MD that combines basic principles of mechanical massage, thermotherapy, acupressure, infrared therapy, and moxibustion. SMATH® is suitable for automatic multidisciplinary treatment on patients with non-specific sub-acute and chronic LBP. Methods/design This paper describes the protocol for a double-blinded, sham-controlled, randomized, single-center short term clinical trial in patients with non-specific sub-acute and chronic LBP aged 18 to 70 years. The primary outcome will be the effectiveness of SMATH® versus sham therapy (medical device without active principles determined by evaluating self perceived physical function with Roland Morris Disability Questionnaire (RMDQ scores after 4 weeks of treatment (end of treatment. Major secondary outcome will be effectiveness of SMATH® determined by evaluating self perceived physical function comparing RMDQ scores between end of treatment and baseline. The trial part of the study will take 7 months while observational follow-up will take 11 months. The sample size will be 72 participants (36 for each arm. The project has been approved by the Ethical Committee of Cremona Hospital, Italy on 29 November 2010. Discussion Compared to other medical specialties, physical and rehabilitation medicine (PRM has not yet received

  6. Comparison of solcoseryl and epidermal growth factors (EGF) in healing of chronic gastroduodenal ulcerations and mucosal growth in rats.

    Science.gov (United States)

    Konturek, S J; Brzozowski, T; Dembinski, A; Warzecha, A; Drozdowicz, D

    1988-02-01

    Solcoseryl, a deproteinized extract of calf blood, and EGF, produced by salivary glands, have been shown to enhance the healing of peptic ulcerations, but the mechanism of this effect is unknown. Since both solcoseryl and EGF have been reported to stimulate cell proliferation, we designed the study to compare the ulcer healing and growth promoting actions of these two agents in the same animals. Gastric and duodenal ulcerations were produced by serosal application of 100% acetic acid on an area of 13.8 mm2 of gastric and duodenal wall, respectively. In the control animals, 7 days after ulcer induction, the mean ulcer area was reduced to 7.1 +/- 1.2 mm2 in the stomach, and to 6.1 +/- 0.8 mm2 in the duodenum. After 14 days all ulcers were healed, both in the stomach and duodenum. Oral administration of solcoseryl (10 ml/kg-day) or EGF (30 micrograms/kg-day) for 7 days after ulcer induction resulted in a significant reduction in the ulcer area in the stomach, and to a greater extent in the duodenum. This enhancement of ulcer healing by solcoseryl was accompanied by a significant increase in the weight of the duodenal mucosa and the total contents of DNA and RNA after 7 days of treatment, and in the weight and nucleic acid contents in both the gastric and duodenal mucosa after 14 days of treatment. EGF also increased the weights and the nucleic acid contents in gastric and duodenal mucosa, but this was significant only after 14 days of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Treatment of chronic plantar ulcer of the diabetic foot using an irremovable windowed fibreglass cast boot: prospective study of 177 patients.

    Science.gov (United States)

    Ha Van, Georges; Michaux, Caroline; Parquet, Hugues; Bourron, Olivier; Pradat-Diehl, Pascale; Hartemann, Agnes

    2015-10-01

    The objective of this study was to evaluate the level of healing of chronic neuropathic plantar ulcers, using an irremovable windowed fibreglass cast boot, which is only opened after healing. A single-centre prospective study of a cohort of 177 diabetic patients with chronic neuropathic plantar ulcers was carried out. The duration of neuropathic plantar ulcers was 604 ± 808 days, with a mean surface area of 4.6 ± 6.5 cm(2) , a mean depth of 1.04 ± 1.08 cm and a mean volume of 5.9 ± 17.7 cm(3) . After a mean of 96 days of wearing a windowed fibreglass cast boot (min 9 days, max 664 days and median 68 days), the level of healing reached 83.6%, although 29 patients did not heal (16.4%). The compliance was at 95%. NPUs with bigger volumes (p = 0.037) and those located at the heels ( p = 0.004) had significantly lower healing levels. Twenty-one patients had moderate peripheral arterial disease (12%), and 24 patients were ostectomized for underlying osteomyelitis (14%), before inclusion. Moderate peripheral arterial disease (p = 0.970) or operated osteomyelitis (p = 0.128) did not modify the level of healing significantly, which were of 81% and 70.8%, respectively. Complications include 12 ulcers due to the windowed fibreglass cast boot (i.e. 7%) and two other ulcers being moderately infected, resulting in 2% of toe amputation, but there was no major amputation or phlebitis. The treatment of old and deep NPUs of the diabetic foot by wearing a windowed fibreglass cast boot without opening the boot prior to healing offers very high ulcer recovery levels. Windowed fibreglass cast boots were changed in only 26 cases (14.6%). In addition, compliance was excellent and of the order of 95%. Furthermore, moderate peripheral arterial disease or a recent ostectomy did not affect the efficacy of windowed fibreglass cast boot.

  8. Effectiveness and safety of oxycodone/naloxone in the management of chronic pain in patients with systemic sclerosis with recurrent digital ulcers: two case reports.

    Science.gov (United States)

    Ughi, Nicola; Crotti, Chiara; Ingegnoli, Francesca

    2016-01-01

    Digital ulcers (DUs) are a severe and frequent clinical feature of patients with systemic sclerosis (SSc). The presence of DUs may cause severe pain and often lead to impairment of patient's functional activities and health-related quality of life. Moreover, poor patient cooperation during the wound care procedure due to pain may be associated with a negative outcome of DU healing. Therefore, pain management has a key role in patients with SSc. These two case reports describe the effectiveness and safety of oxycodone/naloxone in patients with SSc complicated by painful chronic DUs. Such a therapy has provided pain relief and consequently an increased compliance during redressing wounds.

  9. Equally high prevalences of infection with cagA-positive Helicobacter pylori in Chinese patients with peptic ulcer disease and those with chronic gastritis-associated dyspepsia.

    OpenAIRE

    Pan, Z J; Hulst, R.W. van der; Feller, M.; Xiao, S D; Tytgat, G N; Dankert, J.; Ende, A. van der

    1997-01-01

    Approximately 60% of Helicobacter pylori isolates in the Western world possess the cytotoxin-associated gene A (cagA). cagA-positive H. pylori is found to be associated with peptic ulcer disease (PUD) and gastric adenocarcinoma. To investigate the cagA status of H. pylori isolates from Chinese patients with PUD and chronic gastritis (CG), H. pylori populations from 83 patients, 48 with PUD and 35 with CG, were assessed by two different cagA-specific PCRs, Southern blotting, and colony hybridi...

  10. 冉氏“益气通经”指针结合阿是穴苍龟探穴法治疗慢性非特异性下腰痛%Treatment of Chronic and Non-specific Low Back Pain through“the Rans” Pointer with Ashi Canggui Tanxue Therapy

    Institute of Scientific and Technical Information of China (English)

    滕迎春; 于冬冬; 关伟强; 郑若楠; 路玫

    2013-01-01

    目的:观察冉氏“益气通经”指针法结合阿是穴苍龟探穴针法治疗慢性非特异性下腰痛的临床疗效,为慢性非特异性下腰痛提供新的临床思路和治疗方法。方法:将符合入选标准的慢性非特异性腰痛患者60例,随机分为治疗组和对照组,每组30例,分别采用冉氏“益气通经”指针与阿是穴苍龟探穴针法、常规推拿针刺法,每组各治疗1个疗程,观察临床综合疗效。结果:从临床症状方面评价,冉氏“益气通经”指针结合阿是穴苍龟探穴法均优于常规推拿针刺法。结论:冉氏“益气通经”指针结合阿是穴苍龟探穴法治疗慢性非特异性下腰痛效显便廉,值得临床推广。%Objective:To provide new clinical thinking and therapies through observation of“ the Rans” Pointer with Ashi Canggui Tanxue therapy .Methods:Randomly allocate 60 patients with chronic and non -specific low back pain matched with the inclusion criteria into treatment group and control group ,each group with 30 cases and the treatment group was treated with “the Rans”Pointer with Ashi Canggui Tanxue therapy and the control group received regular massage and acupuncture .Observe the comprehensive clinical effects after one course of treatment in each group .Resulst :Evaluated from clinical symptoms ,“the Rans”Pointer with Ashi Canggui Tanx-ue therapy was superior to the regular massage .Conclusion:The treatment of chronic and non -specific low back pain through “the Rans”Pointer with Ashi Canggui Tanxue therapy is more effective ,convenient and eco-nomical ,and is worth popularizing clinically .

  11. Cissus quadrangularis L. extract attenuates chronic ulcer by possible involvement of polyamines and proliferating cell nuclear antigen

    Directory of Open Access Journals (Sweden)

    Mallika Jainu

    2010-01-01

    Full Text Available The present study was designed to investigate whether Cissus quandrangularis extract (CQE had healing effects on gastric ulcer, through modulation of polyamines and proliferating cell nuclear antigen (PCNA in rats. Administration of acetic acid (AA was accompanied by reduced PCNA which was determined by immunohistochemical staining, 3 H-thymidine incorporation using liquid scintillation spectrometry, mitochondrial marker enzymes, polyamine contents and transforming growth factor-alpha (TGF-a expression in gastric mucosa of rats. Administration of CQE after the application of AA to the stomach enhanced the reduction of ulcer area in a dose-dependent manner which was confirmed by histoarchitecture. Moreover, CQE significantly increased the 3 H-thymidine incorporation and the levels of polyamines such as putrescine, spermine and spermidine in ulcerated rats. In addition, the extract offers gastroprotection in the ulcerated area by increased expression of TGF-a and also reversed the changes in the gastric mucosa of ulcerated rats with significant elevation in mitochondrial tricarboxylic acid (TCA cycle enzymes and PCNA levels. Based on these results, the healing effect of CQE on AA induced gastric mucosal injury in rats may be attributed to its growth promoting and cytoprotective actions, possibly involving an increase in tissue polyamine contents and cell proliferation.

  12. Idiopathic non-specific interstitial pneumonia.

    Science.gov (United States)

    Belloli, Elizabeth A; Beckford, Rosemarie; Hadley, Ryan; Flaherty, Kevin R

    2016-02-01

    Non-specific interstitial pneumonia (NSIP) is an interstitial lung disease that may be idiopathic or secondary to connective tissue disease, toxins or numerous other causes. Idiopathic NSIP is a rare diagnosis and requires exclusion of these other possible causes. Patients typically present in mid-adulthood with dyspnoea, cough and often constitutional symptoms including fever and fatigue. The disease has a female predominance, and more than 50% of patients have never smoked. Physical exam features mild hypoxaemia and inspiratory rales. Pulmonary function tests demonstrate restriction and a low diffusing capacity for carbon monoxide. High-resolution computed tomography abnormalities include predominantly lower lobe subpleural reticular changes, traction bronchiectasis and ground-glass opacities; honeycombing is rarely seen. An evaluation of the underlying pathology is necessary for a firm diagnosis. Histologically, alveolar and interstitial mononuclear cell inflammation and fibrosis are seen in a temporally uniform pattern with preserved underlying alveolar architecture. NSIP must be differentiated from other parenchymal lung diseases including idiopathic pulmonary fibrosis and hypersensitivity pneumonitis. A thorough exposure history and assessment for underlying connective tissue diseases are highly important, as positive findings in these categories would likely denote a case of secondary NSIP. A multi-disciplinary discussion that includes pulmonologist(s), radiologist(s) and pathologist(s) assists in reaching a consensus diagnosis and improves diagnostic accuracy. Treatment of idiopathic NSIP, although not well proven, is generally instituted in the form of immunosuppression. Prognosis is favourable compared with idiopathic pulmonary fibrosis, although the diagnosis still carries an attributable mortality. Herein we will summarize the clinical characteristics and management of idiopathic NSIP.

  13. Marjolin ulcer with multifocal origin

    Directory of Open Access Journals (Sweden)

    Das Sudip

    2009-01-01

    Full Text Available Marjolin ulcer developed from a twenty years old post burn scar. The patient presented with chronic ulceration followed by multifocal development of squamous cell carcinoma with different growth pattern. One nodular lesion grew rapidly to produce a large lesion with history of a little bleeding after trauma but without any pain. Excision followed by skin grafting resulted in good cosmetic scar.

  14. Cryoglobulin induced skin ulceration

    Directory of Open Access Journals (Sweden)

    Fatima Razvi

    2015-01-01

    Full Text Available Lupus Erythematosus (LE is a multi-organ auto-immune disease which results from complex interaction of genetic and environmental factors. The clinical spectrum ranges from minor cutaneous lesions to life threatening multi-organ dysfunction. The skin manifestations are variable and common and range from LE specific to LE non-specific cutaneous disease. Vasculitis is one of the most common non-specific skin lesion of Systemic lupus erythematosus (SLE and appears as purpuric lesions, infarcts along lateral nail folds, peripheral gangrene, sub-cutaneous nodules and ulcers. Mixed cryoglobulinaemia (type II is associated with connective tissue disorders including SLE. Skin manifestations are seen in 60-100% patients and are more common in females. The most common manifestation is palpable purpura of lower extremities seen in 30-100% which often is triggered in winter or on cold exposure. Skin infarction, hemorrhagic crusts and ulcers are seen in 25% of patients. Wide spread necrotic ulcers are seen in 10-25% of patients which are often exacerbated by cold.

  15. Efficacy and cost-effectiveness of octenidine wound gel in the treatment of chronic venous leg ulcers in comparison to modern wound dressings.

    Science.gov (United States)

    Hämmerle, Gilbert; Strohal, Robert

    2016-04-01

    The aim of this study was to determine the efficacy, safety and cost-effectiveness of an octenidine-based wound gel in the treatment of chronic venous leg ulcers. For this purpose, 49 wounds were treated with either modern wound-phase-adapted dressings alone (treatment arm 1; n = 17), octenidine wound gel plus modern wound-phase-adapted dressings (treatment arm 2; n = 17) or octenidine wound gel alone (treatment arm 3; n = 15). During the study period of 42 days with dressing changes every 3-5 days, wound healing characteristics and treatment costs of different dressings were analysed. Wound size reduction was significantly better (P = 0·028) in both octenidine wound gel treatment arms compared to modern dressings alone with total reductions of 14·6%, 64·1% and 96·2% in treatment arms 1-3. Early wound healing was merely observed under octenidine wound gel treatment (n = 9), whereby lowest treatment costs were generated by octenidine wound gel alone (€20·34/dressing change). As a result, the octenidine wound gel is cost-effective and well suitable for the treatment of chronic venous leg ulcers, considering both safety and promotion of wound healing.

  16. Pressure Ulcers Surveillance Report

    Directory of Open Access Journals (Sweden)

    Zehra Esin Gencer

    2015-04-01

    Full Text Available Objective: Pressure ulcer is a chronic wound. It reduces the quality of life of the elderly and individuals with restricted range of motion. It prolongs hospital stay and increases the risk of complications. The cost is quite high. Preventive actions for the prevention of pressure ulcers should be developed. Planning protocols and standards of care are among the main targets. Material and Method: Research was conducted in one-year period between 2012 May and 2013 May on patients who were followed up in Akdeniz University Hospital clinics and intensive care unit with pressure ulcers. The research population consisted of 569 patients. Patient data were recorded in SPSS 16 for Windows program. Statistical analyzes were performed with retrospective methods. The demographic characteristics of patients with pressure ulcers were analyzed as frequency and descriptive statistics. Prevalence and incidence of one year were calculated. Results: Of the patients, 58% were males, 42% were females. Of the patients, 36% were in the age range of 61-80 years, and their average length of stay was 42,9 days. Of the patients, 70% were at stage 2 and 3. In 15% of patients pressure ulcers occurred on the first day of hospitalization. Pressure ulcers were developed between days 2 and 10 in 59% of the patients. Prevalence rate was 2.5%, the incidence was 1.9%, the prevalence rate was 5.9% in the intensive care unit. Conclusion: It is easier to prevent pressure ulcers than treating.

  17. RNPT Clinical Research in the Treatment of Chronic Ulcer%RNPT在慢性溃疡治疗中的临床探索

    Institute of Scientific and Technical Information of China (English)

    雷娜

    2015-01-01

    Objective To evaluate RNPT technology in the treatment of chronic ulcer clinical effect and summary treatment experience.Methods From 2014.1 to 2014.12, to select 30 burn orthopaedic patients in our hospital with RNPT treatment as experimental group, and 30 burn orthopaedic patients with normal treatment as control group,evaluation of wound healing in patients with symptom and sign integral.Results Switching frequency (5.8±1.4), carrion purification time (11.7±2.1) d, ulcer surface granulation growth time (17.1±1.8) d, wound epithelial time (28.4±5.7) d, negative pressure treatment (4.3±1.0) points, discharge rate 6.67% was lower than one before treatment 30%;1~12 months after treatment,there wasn’t sequelae; 2 groups patients’ number of ulcer, ulcer area, the depth of the ulcer, students of granulation tissue, epithelial tissue, the granulation of colour and lustre, gen margin of colour and lustre, ulcer surface of bitterness, pus necrosis, skin temperature, nature, and necrotic material quantity, the total score were lower than ones before the treatment, experimental group was lower than the control group, difference has statistical significance (P<0.05). ConclusionRNPT is better curative effect on chronic ulcer, indications, operation simple, and can fuly improve the symptoms and signs.%目的:评价RNPT技术治疗慢性溃疡临床疗效,总结治疗经验。方法2014年1月~2014年12月,新疆石河子大学医学院第一附属医院烧伤整形科就诊住院以RNPT治疗慢性溃疡30例,纳入实验组,另选30例纳入对照组采用常规换药治疗,以症状体征积分量表评价患者创面愈合情况。结果换药次数(5.8±1.4)次、腐肉净化时间(11.7±2.1)d、溃疡面肉芽生长时间(17.1±1.8)d,创面上皮化时间(28.4±5.7) d、负压治疗期间疼痛峰值(4.3±1.0)分,分泌物阳性率6.67%低于治疗前30.00%;治愈后,随访1~12个月,无后遗症;末次换药,

  18. Peptic Ulcer

    Science.gov (United States)

    A peptic ulcer is a sore in the lining of your stomach or your duodenum, the first part of your small ... and goes for several days or weeks Peptic ulcers happen when the acids that help you digest ...

  19. Peptic ulcer

    Science.gov (United States)

    ... result may be: Swollen and inflamed tissue, called ( gastritis ) An ulcer Watch this video about: Stomach ulcer ... PA: Elsevier Saunders; 2016:chap 51. Read More Gastritis Intestinal obstruction Peritonitis Zollinger-Ellison syndrome Patient Instructions ...

  20. Ulcerative Colitis

    Science.gov (United States)

    ... or worsen symptoms. Who is more likely to develop ulcerative colitis? Ulcerative colitis can occur in people ... any age. However, it is more likely to develop in people between the ages of 15 and ...

  1. Risk factors and prediction for functional and chronic inflammatory bowel diseases in infants

    Directory of Open Access Journals (Sweden)

    Marushko RV

    2014-03-01

    Full Text Available Objective — to determine mainly significant risk factors and prediction for development of functional bowel disease and chronic non-ulcerative non-specific colitis in infants. Materials and methods. Retrospective studies were conducted using the method of questioning parents and analysis of medical records of 344 infants in the age from 6 months to 3 years of life, including 134 infants with functional constipation (FC , 64 infants with functional diarrhea (FD and 146 children with chronic non-specific not-ulcerative colitis (CNNC. The control group included 50 healthy children of similar age and gender. In groups of children retrospectively determined the frequency of risk factors. To compare the data between different groups was used analysis of Pearson c2 criteria and relative risks (relative risk, RR with 95% confidence intervals. Prediction for the development of FC, FD and CNNC was applied the method of discriminant function analysis based on the analysis of 51 essential marks. Results. Mathematical analysis of risk factors for bowel diseases allowed to identify the most important of them, in particular, family history of diseases of the digestive system, including bowel disease, complications during pregnancy and at birth disorders, women chronic extragenital diseases, chronic diseases of women characterized by prolonged exposure in the body to opportunistic or pathogenic bacteria, nutritional and feeding disorders, high infection index and history of infectious diseases. Revealed by the discriminant function analysis significant risk factors, represent their important role in the development of functional bowel disorders and chronic non-specific non-ulcerative colitis. Conclusions. Identifying the risk factors for the development and application of prediction algorithm for functional bowel diseases and chronic non-specific non-ulcerative colitis is enable to develop the effective treatment and preventive measures to reduce the

  2. The vegetal biomembrane in the healing of chronic venous ulcers Biomembrana vegetal na cicatrização de úlceras venosas crônicas

    Directory of Open Access Journals (Sweden)

    Marco Andrey Cipriani Frade

    2012-02-01

    Full Text Available BACKGROUND: The vegetal biomembrane has been used to treat cutaneous ulcers. OBJECTIVES: To assess the role of the vegetal biomembrane on the chronic venous ulcers treatment compared to treatment with collagenase cream. METHODS: Fourteen patients were selected to be treated with vegetal biomembrane and 7 with Fibrase®(CONTROL, followed clinically and photographically by the Wound Healing Index by ImageJ during 120 days and biopsied on the 1st and 30th days for histological examination. RESULTS: The vegetal biomembrane was better in promoting healing of the ulcers, especially on the inflammatory phase, confirmed by abundant exudation and wound debridement than the CONTROL group, on the 30th day. There was a greater tendency to angiogenesis followed by re-epithelialization with highest wound healing index on the 90th and 120th days. CONCLUSION: A combined analysis of clinical and histopathological findings suggests that the vegetal biomembrane acted as a factor inducing wound healing, especially on the inflammatory phase, confirmed by abundant exudation of the lesions promoting the transformation of the microenvironment of the chronic venous ulcers, and also stimulating angiogenesis and subsequent re-epithelialization.FUNDAMENTOS: A biomembrana vegetal tem sido usada para tratamento de úlceras cutâneas. OBJETIVOS: Avaliar a ação da biomembrana vegetal no tratamento de úlceras venosas crônicas, comparando-a ao tratamento à base de colagenase. MÉTODOS: Foram selecionados 14 pacientes tratados com biomembrana vegetal e sete com Fibrase® (grupo controle, acompanhados clínico-fotograficamente pelo índice de cicatrização das úlceras (ICU por 120 dias, por meio do software ImageJ, e biopsiados no primeiro e 30º dias para estudo histopatológico. RESULTADOS: A biomembrana vegetal foi superior em relação ao controle na cicatrização das úlceras no 30º dia, especialmente na fase inflamatória, confirmada pela exsudação abundante e

  3. A Randomized Single Blind Parallel Group Study Comparing Monoherbal Formulation Containing Holarrhena antidysenterica Extract with Mesalamine in Chronic Ulcerative Colitis Patients

    Directory of Open Access Journals (Sweden)

    Sarika Johari

    2016-01-01

    Full Text Available Background: Incidences of side effects and relapses are very common in chronic ulcerative colitis patients after termination of the treatment. Aims and Objectives: This study aims to compare the treatment with monoherbal formulation of Holarrhena antidysenterica with Mesalamine in chronic ulcerative colitis patients with special emphasis to side effects and relapse. Settings and Design: Patients were enrolled from an Ayurveda Hospital and a private Hospital, Gujarat. The study was randomized, parallel group and single blind design. Materials and Methods: The protocol was approved by Institutional Human Research Ethics Committee of Anand Pharmacy College on 23rd Jan 2013. Three groups (n = 10 were treated with drug Mesalamine (Group I, monoherbal tablet (Group II and combination of both (Group III respectively. Baseline characteristics, factors affecting quality of life, chronicity of disease, signs and symptoms, body weight and laboratory investigations were recorded. Side effects and complications developed, if any were recorded during and after the study. Statistical Analysis Used: Results were expressed as mean ± SEM. Data was statistically evaluated using t-test, Wilcoxon test, Mann Whitney U test, Kruskal Wallis test and ANOVA, wherever applicable, using GraphPad Prism 6. Results: All the groups responded positively to the treatments. All the patients were positive for occult blood in stool which reversed significantly after treatment along with rise in hemoglobin. Patients treated with herbal tablets alone showed maximal reduction in abdominal pain, diarrhea, and bowel frequency and stool consistency scores than Mesalamine treated patients. Treatment with herbal tablet alone and in combination with Mesalamine significantly reduced the stool infection. Patients treated with herbal drug alone and in combination did not report any side effects, relapse or complications while 50% patients treated with Mesalamine exhibited the relapse with

  4. Chronic ulcerative gastroduodenitis as a first gastrointestinal manifestation of Hermansky-Pudlak syndrome in a 1O-year-old child

    Institute of Scientific and Technical Information of China (English)

    Anselm Chi-Wai Lee; Kin-Hung Poon; Wing-Hong Lo; Lap-Gate Wong

    2008-01-01

    A 10-year-old Chinese boy who had a history of congenital thrombocytopathy presented with severe iron deficiency anemia secondary to chronic gastric inflammation and duodenal ulcerations. Subtle oculocutaneous albinism led to the finding of diminished dense bodies in the platelets under electron microscopy,hence the diagnosis of Hermansky-Pudlak syndrome (HPS). Biopsies from the stomach and duodenumrevealed a lymphocytic infiltration in the submucosa,but H pylori infection was absent. The gastroduodenitis responded to the treatment with omeprazole while iron deficiency anemia was corrected by oral iron therapy.HPS is a rare cause of congenital bleeding disorder with multisystemic manifestations. Upper gastrointestinal involvement is rare and should be distinguished from a mere manifestation of the bleeding diathesis.

  5. Effects of daidzein on expressions of BDNF and NPY in hippocampus rats with chronic stress depression and non-specific immune regulation%大豆甙元对慢性应激大鼠海马BDNF和NPY表达及非特异免疫调节的作用

    Institute of Scientific and Technical Information of China (English)

    田玉慧; 袁文清; 马倩; 杜志敏; 李万里; 吕路线

    2015-01-01

    Objective:To investigate the effects of Daidzein on behavior of chronic stress depression rats and the expression of hippocampal brain-derived neurotrophic factor ( BDNF ) , neuropeptide Y ( NPY ) and non-specific immune regulation.Methods: 40 healthy adult male SD rats with body weight(210±19)g,clean grade,were chosen and fed with 1%sucrose solution for 4 d to change drinking habits.On the fifth day rats were subjected to water deprivation for 24 h without fasting.On the sixth day rats were fed with 1%surcrose solution.4 h later, preference of 1% surcrose solution was examined.According to the 1% sucrose solution preference and weight rats were randomly divided into 4 groups,normal control group(CG),model control group,(MG),fluoxetine group(FG,10.0 mg/kg),daidzein group(DG,80.0 mg/kg).At the same time of establishing model,rats were administered orally once a day for 32 d.The depression model was established by chronic unpredictable mild stress model and separation.The behavioral changes of the rats were observed, and expression of BNDF in hippocampus and NPY was measured by Western blot technology and immunohistochemistry.It was observed the proliferation function of lymphocytes,spleen index,the number of peripheral blood leukocytes and antibody-secreting cell function.Results: Compared with the normal control group(CG),the weight of rats with chronic stress protocol was lower, 1%sucrose consumption decreased,scores of rats in the open field test dropped significantly,the immobility time in the forced swimming test prolonged,the level of expression of BNDF and NPY decreased,all the differences above were statistically sig-nificant(P<0.01).Compared with model group,weight of rats in fluoxetine treatment group(FG) and daidzein treatment group(DG)in-creased,sugar consumption,scores in the open field test and the levels of expression of BNDF and NPY significantly increased,the differences were statistically significant( P<0.05 or P<0.01 ).The number of peripheral

  6. Vernal ulcer

    OpenAIRE

    Srinivasan M.; Srinivasan S

    1990-01-01

    Vernal ulcer is a rare entity not reported in Indian ophthalmic literature. 76 patients in the age group ranging from 3-43 years diagnosed as having vernal conjunctivitis had been referred from general ophthalmology clinic to cornea service of the same institute during 1988-89. Among them 60 were males and 16 were females. 55 of the 76 patients had corneal involvement in the form of vernal keratitis or vernal ulcer. 16 had typical vernal ulcers. vernal ulcer was found more in the palpebral ty...

  7. A case of cutaneous large B-cell lymphoma of the legs appearing as chronic venous ulceration

    Directory of Open Access Journals (Sweden)

    Alfredo Rossi

    2012-05-01

    Full Text Available We report here a case of a woman with a cutaneous large B-cell lymphoma of the legs. She had a plaque lesion, superficially ulcerated and necrotized with tumorous borders situated on the posterior side of the right leg and two red or bluish-red nodular lesions. A skin biopsy from both nodular and plaque lesion showed a diffuse infiltrate of atypical large B cells CD20+ and CD79a+, spanning epidermis, dermis and subcutaneous tissue. A therapeutic approach containing anti-CD20 monoclonal antibody (rituximab was suggested.

  8. Actovegin administration in patients with ulcerated gout tophuses

    Directory of Open Access Journals (Sweden)

    M S Eliseev

    2005-01-01

    Full Text Available Objective. To study actovegin efficacy in the treatment of chronic skin ulcers due to ulceration of tophuses in pts with chronic tophaceous gout. Materials and methods. 6 pts with chronic tophaceous gout aged 52 to 77 years with disease duration from 6 to 20 years with longstanding persisting skin ulcers due to tophuses ulceration were included. In addition to allopuri- nol, steroid and nonsteroidal anti-inflammatory drugs they were treated with actovegin 20% intravenously and local applications of 2% actovegin gel. Clinical examination was performed before and after the course of therapy- Results. Two from six pts showed healing of single chronic ulcers to the end of the treatment course. In the remaining pts ulcer count and size decrease was achieved. Conclusion. Actovegin administration in combined therapy of chronic skin ulcers in pts with chronic tophaceous gout promoted healing of the defects in all cases.

  9. Lipschutz ulcer

    Directory of Open Access Journals (Sweden)

    Bhat Ramesh

    2007-01-01

    Full Text Available Lipschütz first identified an acute disease with ulceration of the external genital organs of young women. The syndrome has been termed acute vulvar ulcer or ulcus vulvae acutum. The following typical case history of a 19-year-old girl is a good illustration of this interesting clinical entity.

  10. Leg ulcers due to hyperhomocysteinemia

    Directory of Open Access Journals (Sweden)

    Krupa Shankar D

    2006-01-01

    Full Text Available Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.

  11. Vernal ulcer

    Directory of Open Access Journals (Sweden)

    Srinivasan M

    1990-01-01

    Full Text Available Vernal ulcer is a rare entity not reported in Indian ophthalmic literature. 76 patients in the age group ranging from 3-43 years diagnosed as having vernal conjunctivitis had been referred from general ophthalmology clinic to cornea service of the same institute during 1988-89. Among them 60 were males and 16 were females. 55 of the 76 patients had corneal involvement in the form of vernal keratitis or vernal ulcer. 16 had typical vernal ulcers. vernal ulcer was found more in the palpebral type of vernal conjunctivitis and affects males more frequently. One patient had an inferior vernal ulcer. It also occurred in the bulbar type of spring catarrh.

  12. 慢性氨暴露对中华鳖幼鳖生长及非特异性免疫反应的影响%Effects of chronic ammonia exposure on growth and non specific immune responses of juvenile soft-shelled turtle Pelodiscus immune responses of juvenile soft-shelled turtle Pelodiscus sinensis

    Institute of Scientific and Technical Information of China (English)

    陈欣然; 牛翠娟; 蒲丽君

    2006-01-01

    Soft-shelled turtles are often exposed to high ambient ammonia levels in intensive rearing conditions. This work evaluated the effects of chronic ammonia exposure on growth and nonspecific immune parameters in juvenile soft-shelled in juvenile soft-shelled turtles Pelodiscus sinensi. Turtles (body weight: 90.5±20.5 g) were subjected to three ammonia concentrations, 1.5 concentrations, 1.5mg/L (C1), 2.6 mg/L (C2) and 4.1 mg/L (C3) unionized ammonia nitrogen (UIA-N) for 84 days. A control group ntrol group (C0) was also set up, in which the animals were reared in tap water with no extrinsic NH4Cl. Consistent ambient temrinsic NH4Cl. Consistent ambient temperatures (29.5 ± 0.5℃ ) and pH (7.8 ± 0.1 ) in each treatment were maintained throughout the experiment. Body n each treatment were maintained throughout the experiment. Body weight was measured at 21, 42 and 84 days after initiation of ammonia exposure. Blood was sampled on day 84 after inixposure. Blood was sampled on day 84 after initiation of ammonia exposure. In the present concentration range, ammonia showed no clear influence on the turtle's ammonia showed no clear influence on the turtle's growth. Also, ammonia had no significant effects on non-specific immune parameters such as serum hemolytic activity, immune parameters such as serum hemolytic activity,bactericidal activity, bacteriolytic activity and the spleen index. However, the non-specific a-naphathyl acetate esterase However, the non-specific a-naphathyl acetate esterase (ANAE) positive ratios of the blood and spleen lymphocytes both declined in the ammonia treatment groups in relation to th declined in the ammonia treatment groups in relation to the control. The present results indicate that the turtle is fairly resistant to ammonia and may be able to endure much ant to ammonia and may be able to endure much higher ambient ammonia levels than fish.%在高密度养殖模式下,中华鳖经常暴露于高氨环境中.本研究评价了

  13. The importance of growth factors for the treatment of chronic wounds in the case of diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Ehm, Alexandra

    2010-01-01

    Full Text Available Introduction: Ulcers as a result of diabetes mellitus are a serious problem with an enormous impact on the overall global disease burden due to the increasing prevalence of diabetes. Because of long hospital stays, rehabilitation, often required home care and the use of social services diabetic foot complications are costly. Therapy with growth factors could be an effective and innovative add-on to standard wound care. Research questions: What is the benefit of therapies with growth factors alone or in combination with other technologies in the treatment of diabetic foot ulcer assessed regarding medical, economical, social, ethical and juridical aspects? Methods: We systematically searched relevant databases limited to English and German language and publications since 1990. Cost values were adjusted to the price level of 2008 and converted into Euro. A review and an assessment of the quality of publications were conducted following approved methodical standards conforming to evidence-based medicine and health economics. Results: We identified 25 studies (14 randomized controlled trials (RCT, nine cost-effectiveness analyses, two meta-analyses. The RCT compared an add-on therapy to standard wound care with standard wound care/placebo alone or extracellular wound matrix: in six studies becaplermin, in two rhEGF, in one bFGF, and in five studies the metabolically active skin grafts Dermagraft and Apligraf. The study duration ranged from twelve to 20 weeks and the study population included between 17 to 382 patients, average 130 patients. The treatment with becaplermin, rhEGF and skin implants Dermagraft and Apligraf showed in eight out of 13 studies an advantage concerning complete wound closure and the time to complete wound healing. Evidence for a benefit of treatment with bFGF could not be found. In four out of 14 studies the proportion of adverse events was 30% per study group with no difference between the treatment groups. The methodological

  14. Perinuclear anti-neutrophil cytoplasmic antibodies (p-anca) in chronic ulcerative colitis: Experience in a Mexican institution

    Institute of Scientific and Technical Information of China (English)

    Jesus K Yamamoto-Furusho; Takeshi Takahashi-Monroy; Omar Vergara-Fernandez; Edgardo Reyes; Luis Uscanga

    2006-01-01

    AIM: To assess the prevalence and clinical value of p-ANCA in a sample of Mexican ulcerative colitis (UC) patients.METHODS: In a prospective, IRB-approved protocol,p-ANCA was determined in 80 patients with UC (mean age, 32 ± 12.9 years). The severity and extension of disease were determined by clinical methods, searching a statistical association with p-ANCA status.RESULTS: p-ANCA were detected in 41 (51%) patients.Severity of disease was the only clinical variable statistically associated with their presence (P < 0.0001; OR = 9;CI 95% = 3.2-24.7).CONCLUSION: The prevalence of p-ANCA was similar to that reported in other countries. Their presence was associated to UC severity, but offered no more information than the obtained by clinical methods.

  15. Marjolin ulcer: a case report

    Directory of Open Access Journals (Sweden)

    Beatriz Di Martino Ortiz

    2014-01-01

    Full Text Available Marjolin’s ulcer is part of a group of neoplasms arising in chronic skin lesions, whether inflammatory or traumatic. Squamous cell carcinoma is the most frequently reported in the literature, it appears most frequently in burn scars, although also described in other types of lesions. We report a case of Marjolin ulcer in a male, native, 65 years old, from the Paraguayan Chaco, with antecedents of scar post trauma in youth.

  16. Etiology and pathogensis of chronic venous ulcer of lower extremities%下肢静脉性溃疡相关病因及其发生机制的研究

    Institute of Scientific and Technical Information of China (English)

    查斌山; 朱化刚

    2010-01-01

    Venous leg ulceration is a common, debilitating chronic condition, which is the most severe complications of chronic venous insufficiency. The persistent venous hypertension is the primary cause of ve-nous ulcer, and leukocyte activation plays a key role in the formation of venous ulcers,and other related fac-tors such as heart disease also play an important role in the development of varicose to ulceration.%慢性静脉性溃疡是下肢慢性静脉功能不全中最严重的最难治的并发症.持续性的静脉高压是引起静脉性溃疡的主要原因;白细胞激活在静脉性溃疡的形成中起关键作用;心脏病等相关因素在静脉曲张向溃疡发展的过程中亦发挥着重要作用.

  17. The amylase-to-creatinine clearance ratio--a non-specific response to acute illness?

    Science.gov (United States)

    McMahon, M J; Playforth, M J; Rashid, S A; Cooper, E H

    1982-01-01

    It was felt that the apparent specificity of the amylase-to-creatine clearance ratio (ACCR) in several previous studies of pancreatitis might reflect a failure to utilize adequately ill control subjects. The ACCR and the renal clearances of beta 2-microglobulin (B2-m), similarly related to creatinine (BCCR) as well as the urinary concentration of albumin, were compared in 27 patients with acute pancreatitis, 8 with a perforated peptic ulcer and 7 with mild biliary colic, during the first 5 days in hospital. Acute pancreatitis was graded as mild (6), moderate (14) or severe (7), using a combination of clinical data, diagnostic peritoneal lavage and multiple criteria. Further assessment of the severity of the acute illness was obtained from measurement of C-reactive protein (C-RP). Lowest C-RP levels were found in the patients with mild pancreatitis and biliary colic, and highest levels in the patients with severe pancreatitis and perforated ulcer (P less than 0.002). Similarly, ACCR and BCCR levels were significantly lower in the two mild groups than in the two severe ones (P less than 0.01 and less than 0.002 respectively), although plasma amylase was raised only in patients with pancreatitis and plasma B2-m was similar in all groups. Electrophoresis of urine showed dense bands of tubuloprotein in patients from both severe groups. Urine albumin was higher in severe pancreatitis than in perforated ulcer (P less than 0.1), perhaps indicating a more specific glomerular lesion in pancreatitis. Thus a rise in amylase clearance appeared to be related to the severity of the acute illness, and may be a component of a non-specific tubuloproteinuria. In this study patients with a perforated peptic ulcer had increases in ACCR similar to those seen in patients with severe pancreatitis, and we are therefore doubtful whether ACCR has any role in the clinical diagnosis of pancreatic disease.

  18. Ulcerative Colitis in Infancy

    OpenAIRE

    Md Rukunuzzaman; A. S. M. Bazlul Karim

    2011-01-01

    Ulcerative colitis (UC) is a chronic idiopathic inflammatory disorder of colon. Frequency of UC is gradually increasing over few years worldwide. Prevalence is 35 to 100/100 000 people in USA, 1% of them are infants. UC develops in a genetically predisposed individual with altered intestinal immune response. An eight-month-old girl presented with loose bloody stool, growth failure, and moderate pallor. The girl was diagnosed as a case of UC by colonoscopy and biopsy. Treatment was thereafter ...

  19. Ulcerative colitis - discharge

    Science.gov (United States)

    Inflammatory bowel disease - ulcerative colitis - discharge; Ulcerative proctitis - discharge; Colitis - discharge ... were in the hospital because you have ulcerative colitis. This is a swelling of the inner lining ...

  20. Comprehensive treatment of chronic venous leg ulcers%下肢慢性静脉溃疡的综合治疗

    Institute of Scientific and Technical Information of China (English)

    黄楷; 梁思华; 黄明清; 朱晓彤; 吴文洁; 黎洪浩

    2013-01-01

    Objective To discuss comprehensive surgery strategy of chronic venous ulcerations (CVU). Methods From July 2012 to January 2013,the clinical date of ten patients (10 limbs) with CVU treated in our hospital were reviewed. All cases received great saphenous vein high ligation and stripping, transilluminated powered phlebectomy (TIPP), subfascial endoscopic perforators surgery (SEPS) and foam sclerotherapy. Venous Clinical Severity Score (VCSS) was assessed preoperation and three months after surgery. Results Comprehensive surgery was performed successfully in all patients. VCSS was improved from preoperation(12.3 ± 2.06)to postoperation(9.6 ± 1.71). After (6.70±1.45) months follow-up, for all cases, pain relieved and no recurrence of varicose superficial veins presented. Moreover, ulceration healing happened in 8 cases, while, residual ulcerations presented in only 2 cases(diameter<2cm). No recurrence presented in healing ulcerations. Conclusion The comprehensive surgery strategy treating CVU is feasible and safe, with favourable short-term outcomes.%目的探讨下肢慢性静脉溃疡的综合治疗方法。方法回顾性分析2012年7月~2013年1月我科收治的10例下肢慢性静脉溃疡患者(10条患肢)的临床资料,均采用大隐静脉高位结扎加抽剥并联合应用透光曲张静脉刨吸术、泡沫硬化剂注射、腔镜深筋膜下交通静脉结扎术等方法处理小腿病灶。分别在术前及术后3个月对临床症状的改善情况采集数据,按临床严重程度评分(VCSS)方法进行评估。结果患者均成功实施联合手术治疗方案,在术后的VCSS评分项目中得到改善[(12.3±2.06)v s (9.6±1.71)]。随访(6.70±1.45)个月,疼痛较前均有缓解,未发现患肢有曲张浅静脉残余或复发,8例溃疡基本愈合,仅有2例还有残余溃疡,但都控制在2 cm内,已愈合的溃疡未见复发。结论下肢慢性静脉溃疡经正确选择联合治疗方案进

  1. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration.

  2. Ulcerative necrobiosis lipoidica responsive to colchicine.

    Science.gov (United States)

    Schofield, Clare; Sladden, Michael J

    2012-08-01

    Necrobiosis lipoidica is an uncommon granulomatous disease of unknown aetiology. Few treatments have emerged with consistent efficacy and the ulcerated form of necrobiosis lipoidica can be particularly difficult to treat. A 56-year-old non-diabetic woman with chronic ulcerative necrobiosis lipoidica unresponsive to other therapies was commenced on colchicine treatment. Complete resolution of the ulcers was observed after 2 months' therapy with colchicine 500 µg twice daily.

  3. Sarcoidosis mimicking a venous ulcer: a case report.

    Science.gov (United States)

    Joshi, Smita S; Romanelli, Paolo; Kirsner, Robert S

    2009-11-01

    Sarcoidosis--a chronic, multisystem disease of unknown etiology characterized by noncaseating granulomas--may cause ulcerative lesions, particularly in African American women. A case of ulcerative sarcoidosis mimicking a venous ulcer is presented. The patient is a 44-year-old African American hypertensive, obese woman with a nonhealing medially based lower leg ulcer of 3 years' duration clinically consistent with a venous ulcer. The ulcer did not heal with compression therapy and pentoxifylline. Subsequent biopsies showed granulomatous inflammation consistent with sarcoidosis. When intralesional triamcinolone was added to compression therapy, the ulcer resolved after 3 months. Given its propensity toward formation on the lower extremities and ulcerative and atrophic appearance, ulcerative sarcoidosis should be considered in the differential diagnosis of a venous ulcer refractory to standard therapy, especially in African American women.

  4. Transcutaneous oximetry but not arterial toe blood pressure or ankle-brachial index is related to macular thickness in patients with chronic diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Per Katzman

    2013-04-01

    Full Text Available Objectives: Diabetes related vascular complications of the lower extremity could be classified as micro- and macrovascular. Ankle-brachial index (ABI and toe blood pressure (TBP measurements evaluate macro-circulation, whereas transcutaneous oximetry (TcPO2 is considered to be a composite measure of vascular function, thereby also reflecting microcirculation. Microvascular disease in the eye involves abnormal capillary permeability and possibly thereby increased macular thickness. The aim of the present clinical study was to evaluate if microvascular disease in the eye was related to measures of foot ischemia in patients with diabetes mellitus. Methods: Twenty consecutive patients with diabetes and chronic full-thickness foot ulcers were included. Peripheral ischemia was diagnosed using TcPO2, TBP and ABI. Macular thickness was measured with optical coherence tomography technique. Results: Based on TcPO2, TBP and ABI measurements 14, 13 and 13 patients, respectively, were classified as ischemic. Patients with ischemic TcPO2 levels at the dorsum of the foot had significantly higher macular thicknesses. This was not the case in patients with ischemic TBP or ABI levels. Conclusion: TcPO2, unlike TBP and ABI, seems to be a clinically relevant measure of peripheral microvascular disease in patients with diabetes mellitus and may, if low, indicate an increased risk of macular edema. [J Exp Integr Med 2013; 3(2.000: 81-85

  5. Is oxycodone/naloxone effective and safe in managing chronic pain of a fragile elderly patient with multiple skin ulcers of the lower limbs? A case report 

    Directory of Open Access Journals (Sweden)

    Guerriero F

    2015-08-01

    Full Text Available Fabio Guerriero,1,2 Niccolo Maurizi,1 Matthew Francis,1 Carmelo Sgarlata,1 Giovanni Ricevuti,1,2 Mariangela Rondanelli,2,3 Simone Perna,2,3 Marco Rollone21Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, 2Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, 3Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Pavia, Italy Abstract: Skin ulcers are a common issue in the elderly, as physiological loss of skin elasticity, alterations in microcirculation, and concomitant chronic diseases typically occur in advanced age, thereby predisposing to these painful lesions. Wound-related pain is often associated with skin ulcers and negatively impacts both the patient’s quality of life and, indirectly, wound healing. Pain management is an ongoing issue in the elderly, and remains underestimated and undertreated in this fragile population. Recent guidelines suggest the use of opioids as the frontline treatment of moderate and severe pain in nononcological pain in the elderly. However, due to the concerns of adverse reactions, drug interactions, and addiction, clinicians frequently hesitate to prescribe opioids. This case report describes an elderly diabetic patient with multiple ulcers of the lower limbs suffering wound-related pain. In our report, oxycodone/naloxone has proved to be an effective and safe drug, providing pain relief as well as increased compliance when redressing wounds and faster healing compared to that in similar patients. Our case provides anecdotal evidence, supported by other studies, to justify future, larger studies on chronic pain using this therapy. Keywords: chronic pain, skin ulcers, elderly, opioids, oxycodone, naloxone

  6. Air pollution from biodegradable wastes and non-specific health symptoms among residents

    DEFF Research Database (Denmark)

    Blanes-Vidal, Victoria

    2015-01-01

    Adverse health effects of exposure to high levels of air pollutants from biodegradable wastes have been well-studied. However, few investigations have examined the potential effects of chronic exposure to low-to-moderate levels on non-specific health symptoms among residents. Besides, most studies...... that environmental exposures play an important role in the genesis of non-specific symptoms among residents exposed to low-to-moderate air pollution from biodegradable wastes, although the effects seem to be indirect, relayed through stress-related mechanisms....... have relied on distances to waste sites to assign exposure status, and have not investigated whether the exposure-symptoms associations are direct or mediated by odor annoyance. In this study, individual-level exposures to a proxy indicator of biodegradable waste pollution (ammonia, NH3) in non...

  7. Ischemic Gastropathic Ulcer Mimics Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Saleh Daher

    2016-01-01

    Full Text Available Gastric ulcer due to mesenteric ischemia is a rare clinical finding. As a result, few reports of ischemic gastric ulcers have been reported in the literature. The diagnosis of ischemic gastropathy is seldom considered in patients presenting with abdominal pain and gastric ulcers. In this case report, we describe a patient with increasing abdominal pain, weight loss, and gastric ulcers, who underwent extensive medical evaluation and whose symptoms were resistant to medical interventions. Finally he was diagnosed with chronic mesenteric ischemia, and his clinical and endoscopic abnormalities resolved after surgical revascularization of both the superior mesenteric artery and the celiac trunk.

  8. [Peptic ulcer disease. Clinical evaluation in 2006].

    Science.gov (United States)

    Malfertheiner, P; Bellutti, M

    2006-06-01

    Treatment of peptic ulcer disease has undergone a radical change due to the discovery of its main cause, the Helicobacter pylori infection. The management of the chronic infection is now the primary aim. Treatment of peptic ulcer essentially consists of eradicating H. pylori. A current problem is the resistance developed by H. pylori to the antibiotics used in eradication regimen. Ulcers that are induced by nonsteroidal antirheumatic (NSAR) agents and acetylsalicylic acid are gaining in importance. Optimized inhibition of acid secretion with proton pump inhibitors has made it possible to both prevent and cure ulcers in the stomach and duodenum caused by NSAR agents.

  9. Pathogenesis of foot ulcers and the need for offloading.

    Science.gov (United States)

    Rathur, H M; Boulton, A J

    2005-04-01

    Diabetic foot ulceration represents a major medical, social and economic problem all over the world. While more than 5% of diabetic patients have a history of foot ulceration, the cumulative lifetime incidence may be as high as 15%. Ethnic differences exist in both ulcer and amputation incidences. Foot ulceration results from the interaction of several contributory factors, the most important of which is neuropathy. The use of the total-contact cast is demonstrated in the treatment of plantar neuropathic ulcers. Histological evidence suggests that pressure relief results in chronic foot ulcers changing their morphological appearance by displaying some features of an acute wound. Thus, repetitive stresses on the insensate foot appear to play a major role in maintaining ulcer chronicity. It is hoped that research activity in foot disease will ultimately result in fewer ulcers and less amputation in diabetes.

  10. Dehydrated Amniotic Membrane Allograft for Treatment of Chronic Leg Ulcers in Patients With Multiple Comorbidities: A Case Series

    Science.gov (United States)

    Barr, Stephen M.

    2016-01-01

    Cellular and/or tissue-based products (CTPs) are emerging treatment options for chronic non-healing wounds. Dehydrated amniotic membrane allograft (DAMA) was used in 7 patients whose wounds had not responded adequately to standard and adjuvant therapies; four VLUs, 2 surgical wounds, and 1 DFU. Patients had multiple comorbidities, including 2 with autoimmune disorders (CREST syndrome and systemic lupus erythematosus). Patients received 3–8 applications of DAMA at weekly to biweekly intervals (average, 5.4 applications). Complete wound healing was observed in 6 of 7 patients during study period, with an average time to closure of 7.9 weeks. Closure was achieved in 3 of 7 patients after 3 DAMA applications. In the patient with CREST syndrome who did not completely close, DAMA reduced the area and volume by nearly 50% and later went on to closure. These cases suggest that DAMA is a viable option for recalcitrant DFUs, VLUs, and surgical wounds. PMID:27104144

  11. [Chronic skin ulcer in a 24-year-old man after a journey to Southeast Asia].

    Science.gov (United States)

    Rueda Guzmán, A; Slesak, G; Fleck, R; Ignatius, R; Oehme, R; Schäfer, J

    2017-02-24

    Our report concerns a 24-year-old man with a chronic exsudative skin lesion after a journey to Southeast Asia. The diagnosis of melioidosis was made by the identification of Burkholderia pseudomallei from the ichor. The diagnosis was confirmed by polymerase change reaction. The patient was treated with meropenem i. v. for about 10 days and with trimethoprim/sulfamethoxazole for the following 12 weeks. Melioidosis is an endemic disease in Southeast Asia and North Australia which in some cases can run a severe course and can have a high fatality rate. The relevance of melioidosis becomes more important against the background of the increasing global movement of travelers and migration.

  12. Non-specific esterases in partly mineralized bovine enamel

    DEFF Research Database (Denmark)

    Moe, D; Kirkeby, S

    1990-01-01

    Activity for non-specific esterase was demonstrated in the matrix of developing bovine enamel with alpha-naphthyl acetate and 5-bromoindoxyl acetate as the esterase substrates. By use of high-performance liquid chromatography gel filtration, ion-exchange chromatography, and electrophoresis three ...

  13. Marjolin's Ulcer. A Case Report

    Directory of Open Access Journals (Sweden)

    Sergio Morales Piñeiro

    2016-02-01

    Full Text Available Marjolin's ulcer is rare and aggressive cutaneous malignancy that develops in previously traumatized or chronically inflamed skin. We present the case of a 43-year-old white man suffering from an exophytic bleeding ulcerated lesion on the distal third of the left leg where he already had a large scar from a compound fracture of the tibia and fibula complicated with chronic osteomyelitis. Surgical excision and biopsy were performed, showing a squamous cell carcinoma consistent with Marjolin's ulcer. We decided to present this case given the rare occurrence of the disease. We concluded that patients with this type of lesion should be subject to periodic examinations to prevent or treat potential recurrences.

  14. Peptic Ulcers

    Science.gov (United States)

    ... ulcer. H. pylori infection is usually contracted in childhood (perhaps through food, water, or close contact with an infected individual), but most people won't have any symptoms until they're older. Although H. pylori ... in childhood, it can cause gastritis (irritation and inflammation of ...

  15. The relationship between helicobacter pylori infection with chronic gastritis and peptic ulcer%幽门螺杆菌感染与慢性胃炎和消化性溃疡的关系

    Institute of Scientific and Technical Information of China (English)

    赵荣章

    2015-01-01

    Objective:To investigate the relationship between helicobacter pylori(Hp) infection with chronic gastritis and peptic ulcer.Methods:151 patients with chronic gastritis or peptic ulcer were selected,including chronic superficial gastritis,chronic erosive gastritis,chronic atrophic gastritis,bile reflux gastritis,gastric and duodenal ulcer.All of those patients were treated with gastric mucosal biopsy and rapid urease test to detected helicobacter pylori infection,then we analyzed the relationship between inflammatory response and Hp infection.Results:37 cases were with chronic atrophic gastritis,and the positive rate of Hp infection was 86.48%;36 cases were chronic erosive gastritis,and the positive rate was 80.56%;26 cases were chronic superficial gastritis, and the positive rate was 65.38%;22 cases were bile reflux gastritis,and the positive rate was 36.36%;30 cases were peptic ulcer, and the positive rate was 80%.The positive rate of chronic atrophic gastritis was highest,and the bile reflux gastritis positive rate was lowest,P<0.05,with statistically significant difference.Conclusion:Those several kinds of common chronic gastritis and peptic ulcer are associated with different degree of Hp infection,and the Hp infection rate in different gastritis and peptic ulcer has statistically significant difference.The Hp infection in patients with chronic erosive gastritis,chronic atrophic gastritis or peptic ulcer is higher than in the normal people,so we put forward that Hp infection is an important pathogenic factors of chronic gastritis and peptic ulcer.%目的:探讨幽门螺杆菌(Hp)感染与慢性胃炎、消化性溃疡的关系。方法:收治胃镜检查确诊的慢性胃炎、消化性溃疡患者151例,包括慢性浅表性胃炎、慢性糜烂性胃炎、慢性萎缩性胃炎、胆汁反流性胃炎以及胃和十二指肠溃疡,分别给予胃黏膜组织活检及快速尿素酶试验检查Hp感染情况,分析炎性反应情况与Hp感染的关

  16. Non-specific Adaptive Reactions of Athletes: Evaluation and Correction

    Directory of Open Access Journals (Sweden)

    K. N. Naumova

    2015-12-01

    Full Text Available This work studies changes in non-specific adaptive reactions (NSAR of athletes who practice Wushu and Qigong and take Kladorod, a biological product made from plant material. The results of our study demonstrate the effectiveness of Kladorod as a remedy to enhance adaptive capacity with the possibility of application for training of athletes without any restrictions within the criteria of doping control.

  17. Transversal escharotomies: a new surgical technique adjuvant in the treatment of chronic ulcers with non-arterial etiology in the lower limbs Escarotomias transversais: uma nova opção cirúrgica adjuvante no tratamento de úlceras crônicas de etiologia não arterial em membros inferiores

    OpenAIRE

    2006-01-01

    PURPOSE: Propose a new and alternative surgical procedure in order to aid on treatments of chronic ulcers with non-arterial etiology in the lower limbs, especially those that reoccurs and accomplish of dermatosclerosis and skin contractures determining ankle and foot limits. METHODS: It describes a medical case regarding a female, 54 years old, with a pre-existing ulcer (sixteen years) on her left leg. Despite of conventional treatments such as curatives, compressive therapy and surgeries, th...

  18. The stomach ulcer: character of morphogenesis.

    Directory of Open Access Journals (Sweden)

    Scherbinina M.B.

    2007-01-01

    Full Text Available Until now there were not completely known the causes of ulcerogenesis and chronisation of ulcerous gastric lesions as well as mechanisms of disorders of regeneration of gastroduodenal mucosa at all. The aim of this work was revealing the structural peculiarities of gastric mucosa that led to forming chronic ulcers. There was performed the histological examination of 24 biopsies in patients with mediogastral ulcer as well as the material of autopsies of 18 persons died due to the hemorrhage from gastric peptic ulcer. The biopsy material from curvature minor of gastric corpus in 12 persons without gastroduodenal diseases was control. There were determined the thickness of mucosa, thickness of submucosa, submucosal-mucosal index, height of superficial epitheliocytes and their nuclear diameter, nuclear-cytoplasmic interrelations, volume summary density of microcirculation in mucosa, mitotic index of growth zone of gastric glands using morphometry. Chronic gastric ulcers showed to form in the background of prolonged chronic gastritis associated with Helicobacter pylori. The structural peculiarities wall of a stomach which developed as result of progressing the chronic inflammation and led to forming the chronic ulcers were thickening submucosal layer as well as its sclerosis and hialinization, decrease of volumous summary density of microcircula-tion.

  19. DIFFERENTIAL DIAGNOSIS OF LONG TERM TONGUE ULCERS

    Directory of Open Access Journals (Sweden)

    Hegde Nidarsh D.

    2012-08-01

    Full Text Available Oral ulcers is a very common disorder of the oral mucosa. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease, some with a chronic non- healing ulcer are advised biopsy. Indeed, a spectrum of disorders can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. Lesions of the tongue have a broad differential diagnosis ranging from benign idiopathic processes to infections, cancers, and infiltrative disorders. This article will focus on common ulcerative disorders of the tongue in aspects of their clinical features and differential diagnosis, two case reports with the diagnosis and conservative management for long-term chronic ulcers. The two cases which are reported in this article had a differential diagnosis of Squamous cell carcinoma of the tongue. The clinical picture was craterlike lesion, having a velvety-red base and a rolled, indurated border and most important painless in both cases. Removal of the irritant which was the tooth, rehabilitation of the oral mucosa by lubrication with Cocus Nucifera resulted in the healing of the ulcers. Functional components of Cocus Nucifera are Squaline, tocopherol, phytosterols and other sterols which are all plant steroids.

  20. Dyskeratosis Congenita Associated Non-Specific Interstitial Pneumonia

    Directory of Open Access Journals (Sweden)

    Unnati D. Desai

    2017-01-01

    Full Text Available Dyskeratosis Congenita (DC is a rare inherited disorder of ectodermal dysplasia. It consists of a classical mucocutaneous triad of abnormal skin pigmentation, nail dystrophy and leukoplakia. Pulmonary disease is seen in 10-15%. It is characterized by Idiopathic Pulmonary Fibrosis (IPF, or Idiopathic Familial Pulmonary Fibrosis (IFPF. Non-specific Interstitial Pneumonia (NSIP has been reported rarely in children with DC and in an isolated adult patient. Our patient had classical clinical presentation of DC with pancytopenia and portal hypertension and clinic-radiological features of NSIP which is a rare association.

  1. Carbohydrate malabsorption in patients with non-specific abdominal complaints

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Non-specific abdominal complaints are a considerable problem worldwide. Many patients are affected and many differential diagnoses have to be considered.Among these, carbohydrate malabsorption seems to play an important role. However, so far, only incomplete absorption of lactose is broadly accepted, while the malabsorption of fructose and sorbitol is still underestimated, although in many parts of the world it is much more frequent. Despite the success of dietary interventions in many patients, there are still a lot of unanswered questions that make further investigations necessary.

  2. Preliminary Study Application of Placenta in Treatment of Patients with Refractory Chronic Ulcer%紫河车在慢性难愈性溃疡中的应用

    Institute of Scientific and Technical Information of China (English)

    朱朝军; 张朝晖; 李雅潇; 马静

    2012-01-01

    Objective; To review the application of placenta in the treatment of with chronic refractory ulcer and to investigate the form of placenta used as medicines. Method;The relevant articles were searched for in China Journal Full-text Database (CJFD) in China National Knowledge Infrastructure (CNKI) network with the key words ' placenta' , one hundred and thirty-eight articles were retrieved , with the key words ' placenta and ulcer' 1 article was retrieved. This paper describes the records of the ancient literature of the Placenta, explores the main components of placenta and the role of these components in treatment of chronic ulcers. Then, the clinical application of the placenta was studied. Finally, we investigate the form of placenta used as medicines. Result; Placenta plays an important role in the treatment of patients with refractory chronic ulcer. However, placenta used as medicines mostly was internal medicine, hardly used for external. Conclusion; Placenta used as internal medicine can supplement yin and yang, qi and blood. Placenta used for external can accelerate the healing of the wound.%目的:对紫河车在治疗慢性难愈性溃疡中应用的情况进行文献整理,并探讨紫河车治疗慢性难愈性溃疡的入药形式.方法:应用CNKI中国学术文献网络出版总库,检索近20年来紫河车治疗慢性难愈性溃疡的相关文献,以紫河车为题名,检索到文献138篇,以紫河车及溃疡为题名,检索到文献1篇.首先介绍古代文献对紫河车的记载,然后探讨了紫河车的主要成分以及这些成分在慢性溃疡治疗过程中的作用及紫河车的临床应用情况,初步论述了紫河车在治疗慢性难愈性溃疡中的应用形式.结果:在慢性难愈性溃疡的治疗中,紫河车发挥重要作用,其多以内服入药,作为外用入药甚少.结论:紫河车以其善五体之功,内服补阴阳气血,外用可以促进伤口愈合.

  3. Aetiopathology of ulcers of oral cavity and oropharynx: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Thimmappa T.D.

    2013-08-01

    Full Text Available Background: Oral ulcers are common diseases for which patient seeks medical advice. Till date the clinical profile to diagnose the oral ulcers, management and risk of malignancy is not well established. Hence, the study has been taken up to investigate the aetiopathology of ulcers of oral cavity and oropharynx. Methods: 60 cases of ulcers of oral cavity and oropharynx were included in the study. The aetiopathology of ulcers of oral cavity and oropharynx were investigated on the basis of age, sex, duration, etiological factors, symptom Index, socioeconomic status and anatomical distribution. Values are expressed as percentages. Results: The highest incidence was found in low socioeconomic status. The lesions studied in this study were 50% of Non Specific ulcers [Short term (3 wks 10-33%], 15% of Aphthous ulcers, 8.3% of Traumatic Ulcers, 6.5% of Malignant ulcers, 6.5% of Dental ulcers, 3.2% of HIV infection & AIDS, 3.2% of ulcer due to T.B and 6.5% of ulcers. The majority of the cases were between the age 21-30 years constituting 35% followed by 11-12 years constituting 26.6%.d 62% of the short term ulcers, Female 38%. Conclusions: Low socioeconomic status, lack of education, bad oral hygiene, bad habits cultivated in early childhood is predisposing factors. Hence early diagnosis and prompt treatment is advised in all cases of ulcers. [Int J Res Med Sci 2013; 1(4.000: 496-500

  4. Non-specific sensor arrays for chemical detection

    Science.gov (United States)

    Johnson, Kevin; Minor, Christian

    2015-05-01

    Non-specific chemical sensor arrays have been the subject of considerable research efforts over the past thirty years with the idea that, by analogy to vertebrate olfaction, they are potentially capable of rendering complex chemical assessments with relatively modest logistical footprints. However, the actual implementation of such devices in challenging "real world" scenarios has arguably continued to fall short of these expectations. This work examines the inherent limitations of such devices for complex chemical sensing scenarios, placing them on a continuum between simple univariate sensors and complex multivariate analytical instrumentation and analyzing their utility in general-purpose chemical detection and accurate chemical sensing in the presence of unknown "unknowns." Results with simulated and acquired data sets are presented with discussion of the implications in development of chemical sensor arrays suitable for complex scenarios.

  5. The economics of adalimumab for ulcerative colitis.

    Science.gov (United States)

    Xie, Feng

    2015-06-01

    Ulcerative colitis is a chronic inflammatory disease, characterized by diffuse mucosal inflammation in the colon. Adalimumab, as a TNF-α blocker, offers a safe and efficacious treatment option for patients with moderate to severe ulcerative colitis and refractory or intolerant to conventional medications; however, its cost-effectiveness profile has not yet been well established. Future economic evaluations should choose appropriate comparators in the context of target-reimbursement decision making and focus on cost-effectiveness over a long time horizon.

  6. Multiple bacterial species reside in chronic wounds

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Christensen, Jens Jørgen; Karlsmark, Tonny;

    2006-01-01

    The aim of the study was to investigate the bacterial profile of chronic venous leg ulcers and the importance of the profile to ulcer development. Patients with persisting venous leg ulcers were included and followed for 8 weeks. Every second week, ulcer samples were collected and the bacterial s...

  7. Oral Ulcerations

    Directory of Open Access Journals (Sweden)

    Brandon Fetterolf

    2015-12-01

    Full Text Available A 35-year-old male presented with lower gum pain associated with fever, chills, and sore throat. His medical history included intravenous drug use, human immunodeficiency virus infection, and hepatitis C. Physical exam revealed tachycardia, a temperature of 38.9°C, anterior cervical lymphadenopathy, halitosis, an edematous lower lip, and purulent ulcers anterior and posterior to lower central incisors with marked tenderness and erythema (Figure. His laboratory work was notable for a low white blood cell count (2.6 thousand/µl, neutropenia (0.11 thousand/µl, a low absolute CD4 lymphocyte count (0.5 thousand/µl, and elevated C-reactive protein (129mg/L and sedimentation rate (23mm/hr. A computed tomography study showed a 0.5×1.3×0.3cm abscess anterior to the mandibular symphysis.

  8. Small bowel ulcerative lesions are common in elderly NSAIDs users with peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Panagiotis; Tsibouris; Chissostomos; Kalantzis; Periklis; Apostolopoulos; Antonios; Zalonis; Peter; Edward; Thomas; Isaacs; Mark; Hendrickse; Georgios; Alexandrakis

    2014-01-01

    AIM: To determine the frequency of small bowel ulcerative lesions in patients with peptic ulcer and define the significance of those lesions. METHODS: In our prospective study, 60 consecutive elderly patients with upper gastrointestinal bleeding from a peptic ulceration(cases) and 60 matched patients with a non-bleeding peptic ulcer(controls) underwent small bowel capsule endoscopy, after a negative colonoscopy(compulsory in our institution). Controls were evaluated for non-bleeding indications. Known or suspected chronic inflammatory conditions and medication that could harm the gut were excluded. During capsule endoscopy, small bowel ulcerative lesions were counted thoroughly and classified according to Graham classification. Other small bowellesions were also recorded. Peptic ulcer bleeding was controlled endoscopically, when adequate, proton pump inhibitors were started in both cases and controls, and Helicobacter pylori eradicated whenever present. Both cases and controls were followed up for a year. In case of bleeding recurrence upper gastrointestinal endoscopy was repeated and whenever it remained unexplained it was followed by repeat colonoscopy and capsule endoscopy.RESULTS: Forty(67%) cases and 18(30%) controls presented small bowel erosions(P = 0.0001), while 22(37%) cases and 4(8%) controls presented small bowel ulcers(P < 0.0001). Among non-steroidal antiinflammatory drug(NSAID) consumers, 39(95%) cases and 17(33%) controls presented small bowel erosions(P < 0.0001), while 22(55%) cases and 4(10%) controls presented small bowel ulcers(P < 0.0001). Small bowel ulcerative lesions were infrequent among patients not consuming NSAIDs. Mean entry hemoglobin was 9.3(SD = 1.4) g/d L in cases with small bowel ulcerative lesions and 10.5(SD = 1.3) g/dL in those without(P = 0.002). Cases with small bowel ulcers necessitate more units of packed red blood cells. During their hospitalization, 6(27%) cases with small bowel ulcers presented bleeding recurrence most

  9. 放射性皮肤溃疡中端粒酶逆转录晦表达与癌变及难愈合的机制%Differential expression of telomerase reverse transcriptase in chronic human skin ulcer induced by radiation and mechanism of cancer transformation and poor healing

    Institute of Scientific and Technical Information of China (English)

    赵坡; 刘武; 李志军; 吕亚莉; 钟梅; 谷庆阳; 王德文

    2003-01-01

    AIM: To study the expression of the catalytic subunit of telomerase, telomerase revere transcriptase(TRT) and explore the possible relationship between the TRT and cancer txanaformation or poor healing in radiation-induced chronic human skin ulcer. METHODS: Rabbit antibody to human TRT and SP immunohistochemical method were used to detect TRT expression in 24 cases of formalin-fixed, paraffin-embeded chronic human skin ulcer tissues induced by radiation, 5 cases of normal skin, 2 of burnt skin, and 8 of carcinoma. RESULTS: The TRT was detected positive in 14 of 24 (58.3%) chronic radiation ulcers, of which the stxongly positive was 10 of 24 (41.7%) and the weakly positive 4 of 24 (16. 7% ); in 0 of 5 normal and 0 of 2 burnt skins; and in 8 of 8 (100%) carcinomas. The expression of TRT was observed almost always strongly positive in the cytoplasm and nucleus of squamous epithelial cells of epidermis but negatively in the endoepithelial cells of capillaries and small blood vessels, or weakly in the cytoplasm of smooth myocytes of media and fibroblssts, of dermis. Chronic inflammtory cells, such an plasma cells and lymphocytes also showed weakly positive for TRT. CONCLUSION: The strong TRT expression in the epidermis could be involved in the cancer transformation from chronic radiation ulcer to scuamous carcinoma, whereas the negative or weak TRT expression in the capillaries, small blood vessels and fibroblasts of dermis might be responsible for the poor healing of chronic ulcers induced by radiation, caused by sclerosis of small blood vessels and lack of granulation tissue consisting of capillaries and fibroblasts.

  10. A RETROSPECTIVE EVALUATION OF PATIENTS WITH NON ALARMING LOWER GASTROINTESTINAL SYMPTOMS AND COLONOSCOPIC FINDINGS OF ILEAL OR COLONIC ULCERATIONS AND HISTOPATHOLOGICAL EVIDENCE OF NONSPECIFIC COLITIS

    Directory of Open Access Journals (Sweden)

    Jeffey

    2016-05-01

    Full Text Available BACKGROUND The clinical course and treatment modalities for patients with non alarming lower gastrointestinal symptoms and colonoscopic findings of isolated or random ileal or colonic ulcerations which are histologically proven to be non-specific inflammation, are unknown. OBJECTIVE To evaluate the clinical course and significance of non-specific colonic inflammation in patients presenting with lower gastrointestinal symptoms of hypogastric or iliac fossa pain and altered bowel habits. DESIGN Single Centre Retrospective Analysis. SETTING Tertiary Care Referral Hospital. PATIENTS AND INTERVENTIONS All patients presenting with lower GI symptoms and who had colonoscopic evidence of isolated or random ileal or colonic ulcerations with histopathologic evidence of mild or active inflammation analysed by a single pathologist between January 2012– December 2012 were followed up either as outpatient visit or by telephonic interview. Patients with alarm symptoms, red flags, age more than 60 years and other co morbid illness were excluded. MAIN OUTCOME MEASUREMENTS The clinical courses of these patients were followed up for a mean period of 39 months. RESULTS Of the 31 patients who were included, 6 were lost to follow up. 19 patients were off medications and asymptomatic during the follow up. 2 patients were asymptomatic with mesalamine tablets and another asymptomatic patient had resorted to homeopathic medication. Of the two patients who were on mesalamine, one had endoscopic evidence of linear ulcerations in rectum and the second patient had peri appendiceal inflammation on colonoscopy, both of whom had mild or focal colitis histologically. 3 patients were symptomatic during the follow up but only on symptomatic medications on and off, of which one of them had aphthous ulcerations throughout the entire colon and the other had histologically active chronic ileitis. LIMITATIONS Retrospective data and a relatively short follow up and small patient number

  11. 负压封闭引流术联合皮瓣移植在慢性溃疡创面中的应用%Application of the vacuum sealing drainage technique combined with skin flap in chronic ulcerative wounds

    Institute of Scientific and Technical Information of China (English)

    郭晓波; 李金晟; 张菊芳; 贾明; 曹树英; 唐亮; 蔡莺莲

    2012-01-01

    目的 探讨负压封闭引流术(vacuum sealing drainage,VSD)联合皮瓣移植治疗慢性溃疡性创面的可行性及有效性.方法 2009年6月至2011年8月,应用VSD联合皮瓣移植治疗不同病因致慢性溃疡性创面者15例,经辅助应用VSD于创面1~6次,待感染控制、肉芽组织生长良好后选择皮瓣转移修复刨面.结果 除1例皮瓣尖端小面积坏死,经皮片移植后愈合外,其余皮瓣均存活良好,创面一期愈合,术后随访6~24个月,无一例感染复发.结论 VSD联合皮瓣移植治疗慢性溃疡性创面,具有并发症少、皮瓣存活率高、术后感染不易复发的特点,临床效果显著.%Objective To explore the feasibility and efficacy of the vacuum sealing drainage (VSD) technique combined with skin flap for the treatment of chronic ulcerative wounds.Methods From June 2009 to Aug.2011,the VSD technique combined with skin flap has been applied in the treatment of 15patients with chronic ulcerative wounds caused by various reasons.The VSD was applied to the wound for 1-6 times.When infection was controlled and fresh granulation grew,skin flap was used to cover the wound.Results Flap necrosis happened in a small area at the distal end in one case,which healed after skin graft.All the other flaps survived with primary healing.The patients were followed up for 6-24 months postoperatively with no recurrence of infection.Conclusions VSD combined with skin flap is an ideal choice for reconstruction of chronic ulcerative wounds.h has the advantages of low complications,reliable flap survival rate,and low infection recurrence.

  12. Potential role of probiotics in the management of gastric ulcer

    OpenAIRE

    KHODER, GHALIA; Al-Menhali, Asma A.; AL-YASSIR, FARAH; Sherif M. Karam

    2016-01-01

    Gastric ulcer is one of the most common chronic gastrointestinal diseases characterized by a significant defect in the mucosal barrier. Helicobacter pylori (H. pylori) infection and the frequent long-term use of non-steroidal anti-inflammatory drugs are major factors involved in gastric ulcer development. Acid inhibitors and antibiotics are commonly used to treat gastric ulcer. However, in the last few decades, the accumulating evidence for resistance to antibiotics and the side effects of an...

  13. Non-specific inhibitors of influenza viruses in normal sera.

    Science.gov (United States)

    ANANTHANARAYAN, R; PANIKER, C K

    1960-01-01

    The presence of non-specific inhibitors in immune influenza sera may falsify the antibody pattern as shown by the haemagglutination-inhibition test, and it is consequently often necessary to pre-treat sera in order to inactivate these inhibitors. A number of different methods are in use for this purpose. It was therefore thought useful to compare the efficacy of the various methods with different representative influenza strains and normal sera from eight animal species and acute-phase human sera. Tests were carried out with simple heating at 56 degrees C, the use of receptor-destroying enzyme, the use of potassium periodate, and two methods involving the use of trypsin. No one technique was found to be universally applicable for all types of serum against all strains, and further testing with larger numbers of sera is advocated. It is felt that a combination of potassium periodate and trypsin with a change in concentration and times of action may be found advantageous.

  14. Non specific aorto-arteritis. Clinical picture, diagnosis and therapy.

    Science.gov (United States)

    Miani, S; De Monti, M; Keller, G; Bordoni, M G; Bianchi, E; Giordanengo, F

    1999-06-01

    This study is aimed at analyzing clinical features, angiographic findings and evolution of Takayasu's arteritis and the criteria adopted to establish the indication for non-surgical versus operative treatment. Eighteen patients affected by non specific aortarteritis were observed and treated at our Department between 1973 and 1996. All patients met the American College of Rheumatology 1990 criteria of classification of Takayasu's arteritis. Sixteen patients were young females. Two patients were males. Nine patients underwent surgical procedures. One young female underwent a PTA. All eight asymptomatic patients were only medically treated. One patient died some days after an aorto-bicarotid bypass graft due to acute myocardial infarction. Two other patients died two and four years after intervention for renal and cardiac failure respectively. One patient after an aorto bicarotid bypass underwent a left hemiplegia due to thrombosis of the right graft branch. All the other 14 patients either surgically or medically treated are well and are under strict surveillance through rigorous follow-up. The 10 patients who underwent surgical or interventional radiological treatment were certainly the most seriously affected patients and were symptomatic (presented neurological disturbances or a severe hypertensive state). This fact explains, to some extent, the mortality and morbidity rate observed in this group. The seven medically treated patients were completely asymptomatic in spite of a major involvement of various vascular districts.

  15. 数字医疗康复技术在悬吊运动治疗(SET)慢性非特异性下背痛中的应用研究%Ana lysis of Digital Medical Rehabilitation Technolgo y in Sling Eeex rciseT hera py for Chronic non specific Low Back Pain

    Institute of Scientific and Technical Information of China (English)

    张任君; 李志辉; 韦玉玲; 葛俊胜; 曾珂; 林晋锐

    2016-01-01

    Objective:To investigate the curative effect of Sling exercise therapy treatment of chronic nonspecific low back pain , Methods:The application of digital medical rehabilitation technology to build healthy person standard multi fidus database and virtual model.Chronic nonspecific low back pain were divided into treatment group and control group .The two groups using the same sling exer-cise therapy .Following the principle of control group when treatment is painless , treatment group with ultrasonic imaging acquisition of the multi fidus cross-sectional area and other data , Import data into the software established in patients with lumbar multi fidus virtual mod-el, The control of healthy people standard data and the virtual model , adjust the amount of sling exercise therapy .Results:The treatment group patients the multifidus cross -sectional area and the virtual model close faster than the control group of healthy people , visual ana-logue scale,Oswestry disability indexevaluation improvement than the control group .Conclusions:The application of digital medical re-habilitation technology can regulate the amount of Sling Exercise Therapy in treatment of chronic nonspecific low back pain , avoid blind-ness at the treatment site and treatment intensity , improve the curative effect of suspension movement .%目的:探讨悬吊运动治疗慢性非特异性下背痛的量效关系。方法:运用数字医疗康复技术构建健康人标准多裂肌数据库与虚拟模型。将慢性非特异性下背痛分为治疗组与对照组。2组采用相同的悬吊运动疗法。对照组治疗时遵循无痛原则,治疗组用超声波成像采集多裂肌横切面积等数据,将数据导入软件建立患者腰部多裂肌虚拟模型,对照健康人标准数据与虚拟模型,调整悬吊运动治疗量。结果:治疗组患者多裂肌横切面积与虚拟模型接近健康人快于对照组,视觉模拟评分、改良Oswe-stry功能障碍指数评

  16. Ulcerative colitis in infancy

    Directory of Open Access Journals (Sweden)

    Md Rukunuzzaman

    2011-01-01

    Full Text Available Ulcerative colitis (UC is a chronic idiopathic inflammatory disorder of colon. Frequency of UC is gradually increasing over few years worldwide. Prevalence is 35 to 100/100 000 people in USA, 1% of them are infants. UC develops in a genetically predisposed individual with altered intestinal immune response. An eight-month-old girl presented with loose bloody stool, growth failure, and moderate pallor. The girl was diagnosed as a case of UC by colonoscopy and biopsy. Treatment was thereafter started with immunosuppressive drugs. After initial induction therapy with parenteral steroid and infliximab, the patient is now on remission with azathioprine and mesalamine. UC is rare in Bangladesh, especially in children, and it is rarer during infancy. Several conditions like infective colitis, allergic colitis, Meckel′s diverticulitis, Crohn′s disease, etc. may mimic the features of UC. So, if a child presents with recurrent bloody diarrhea, UC should be considered as differential diagnosis.

  17. Noninfectious genital ulcers.

    Science.gov (United States)

    Kirshen, Carly; Edwards, Libby

    2015-12-01

    Noninfectious genital ulcers are much more common than ulcers arising from infections. Still, it is important to take a thorough history of sexual activity and a sexual abuse screen. A physical exam should include skin, oral mucosa, nails, hair, vulva, and vaginal mucosa if needed. The differential diagnosis of noninfectious genital ulcers includes: lipschütz ulcers, complex aphthosis, Behçet's syndrome, vulvar metastatic Crohn's disease, hidradenitis suppurativa, pyoderma gangrenosum, pressure ulcers, and malignancies. It is important to come to the correct diagnosis to avoid undue testing, stress, and anxiety in patients experiencing genital ulcerations.

  18. Diabetic foot disease: impact of ulcer location on ulcer healing

    DEFF Research Database (Denmark)

    Pickwell, KM; Siersma, Volkert Dirk; Kars, M

    2013-01-01

    Healing of heel ulcers in patients with diabetes is considered to be poor, but there is relatively little information on the influence of ulcer location on ulcer healing.......Healing of heel ulcers in patients with diabetes is considered to be poor, but there is relatively little information on the influence of ulcer location on ulcer healing....

  19. Non-specific neck pain in preadolescent to adolescent populations

    OpenAIRE

    2014-01-01

    Neck pain is a common health problem globally. In addition to individual suffering, it causes a huge burden on societies. Some evidence suggests that neck pain in adolescence predicts frequent neck symptoms also in adulthood. A steady increase in prevalence of frequent and persistent neck pain among Finnish adolescents was observed in the 1990s, which might predict an increasing amount of adults with chronic neck pain in the near future. Thus, better understanding neck pain in children and ad...

  20. Acupuncture Treatment for 76 Cases of Ulcerative Colitis

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Ulcerative colitis is also called nonspecific chronic ulcerative colitis. The author of this essay has treated 76 such cases with acupuncture and obtained satisfactory therapeutic effect. Meanwhile, the results were compared with 45 cases treated with azulfidine.A report follows.

  1. The recalcitrant venous leg ulcer - A never ending story?

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan); M.B. Maessen-Visch (Birgitte); S.I. Langendoen; K.P. de Roos; H.A.M. Neumann (Martino)

    2013-01-01

    textabstractIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is lipodermat

  2. Glucagonoma, chronic recurrent peptic ulcer disease, and enhanced amylase-creatinine clearance ratio. Report of a case with review of the literature.

    Science.gov (United States)

    Pitchumoni, C S; Thelmo, W; Ahmed, K S; Kumar, A; Davidian, M; Einhorn, R; Adler, J; McCarthy, J

    1979-09-01

    A 53-year-old white woman developed diabetes mellitus, migratory erythema, and anemia, clinical features suggesting the presence of a "glucagonoma." Ten years earlier, after laparotomy and pancreatic biopsy, she had been told that she had an inoperable pancreatic carcinoma. Review of that biopsy together with current hormonal assay now confirms the diagnosis of glucagonoma. The recurrent peptic ulcer in this patient despite high levels of glucagon, a gastric inhibitory agent, is noted but not explained. An enhanced amylase-creatinine clearance ratio supports the notion that glucagon increases the clearances of amylase.

  3. Preventing pressure ulcers

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000147.htm Preventing pressure ulcers To use the sharing features on this page, please enable JavaScript. Pressure ulcers are also called bedsores, or pressure sores. They ...

  4. Acute genital ulcers.

    Science.gov (United States)

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-28

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers.

  5. Types of Ulcerative Colitis

    Science.gov (United States)

    ... Colitis? > Types of Ulcerative Colitis Types of Ulcerative Colitis Email Print + Share If you are diagnosed with ... abdomen may occur in active disease. Left-sided Colitis Continuous inflammation that begins at the rectum and ...

  6. Diabetic foot ulceration with osteomyelitis: the importance of early detection

    OpenAIRE

    Tranter, Jennifer; McIntosh, Caroline

    2008-01-01

    This case study explores the\\ud management of a chronic diabetic\\ud foot ulcer complicated by severe\\ud soft tissue infection (cellulitis) and\\ud bony infection (osteomyelitis) in a\\ud patient with type 2 diabetes.

  7. Extraintestinal manifestations in Crohn's disease and ulcerative colitis

    DEFF Research Database (Denmark)

    Isene, Rune; Bernklev, Tomm; Høie, Ole

    2015-01-01

    BACKGROUND: In chronic inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]), symptoms from outside the gastrointestinal tract are frequently seen, and the joints, skin, eyes, and hepatobiliary area are the most usually affected sites (called extraintestinal...

  8. Intestinal microbiota and ulcerative colitis.

    Science.gov (United States)

    Ohkusa, Toshifumi; Koido, Shigeo

    2015-11-01

    There is a close relationship between the human host and the intestinal microbiota, which is an assortment of microorganisms, protecting the intestine against colonization by exogenous pathogens. Moreover, the intestinal microbiota play a critical role in providing nutrition and the modulation of host immune homeostasis. Recent reports indicate that some strains of intestinal bacteria are responsible for intestinal ulceration and chronic inflammation in inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). Understanding the interaction of the intestinal microbiota with pathogens and the human host might provide new strategies treating patients with IBD. This review focuses on the important role that the intestinal microbiota plays in maintaining innate immunity in the pathogenesis and etiology of UC and discusses new antibiotic therapies targeting the intestinal microbiota.

  9. A study on the clinical profile of ulcers and membranous lesions of oral cavity and oropharynx

    Directory of Open Access Journals (Sweden)

    T. D. Thimmappa

    2014-02-01

    Full Text Available Background: An ulcer is a discontinuity of an epithelial surface. Many a times, patients with oral ulcers are treated sympathetically without even coming to a definitive conclusion of their problem. Oral ulcers are common diseases for which patient seeks medical advice. Till date the clinical profile to diagnose the oral ulcers, membranous lesions of oral cavity and oropharynx is not well established. Hence, the study has been taken up to investigate the aetiopathology of ulcers of oral cavity and oropharynx. Methods: 60 cases of ulcers of oral cavity and oropharynx were included in the study. The aetiopathology of ulcers of oral cavity and oropharynx were investigated on the basis of age, sex, duration, etiological factors, symptom Index, socioeconomic status and anatomical distribution. Values are expressed as percentages. Results: The highest incidence was found to be in low socioeconomic group, where there is lack of education, improper food habits, cultivation of bad habits in early childhood and negligence of the disease are the predisposing factors in most of the malignancies. The highest incidence was found in low socioeconomic status. The lesions studied in this study were 50% of non-specific ulcers (Short term (3 wks 10-33%, 15% of Aphthous ulcers, 8.3% of Traumatic Ulcers, 6.5% of Malignant ulcers, 6.5% of Dental ulcers, 3.2% of HIV infection & AIDS, 3.2% of ulcer due to T.B. and 6.5% of ulcers. The majority of the cases were between the age 21-30 yrs constituting 35% followed by 11-12 years constituting 26.6%.d 62% of the short term ulcers, Female 38%. Conclusions: Low socioeconomic status, lack of education, bad oral hygiene, bad habits cultivated in early childhood is predisposing factors. Hence early diagnosis and prompt treatment is advised in all cases of ulcers. [Int J Res Med Sci 2014; 2(1.000: 180-185

  10. The Effect of Autologous Platelet-Rich Gel on the Dynamic Changes of the Matrix Metalloproteinase-2 and Tissue Inhibitor of Metalloproteinase-2 Expression in the Diabetic Chronic Refractory Cutaneous Ulcers.

    Science.gov (United States)

    Li, Lan; Chen, Dawei; Wang, Chun; Liu, Guanjian; Ran, Xingwu

    2015-01-01

    Aim. To investigate the dynamic changes on the expression of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) in the diabetic chronic refractory cutaneous ulcers after the autologous platelet-rich gel (APG) treatment. Methods. The study was developed at the Diabetic Foot Care Centre, West China Hospital. The granulation tissues from the target wounds were taken before and within 15 days after APG application. The expression of MMP-2 and TIMP-2 as well as transforming growth factor-β1 (TGF-β1) in the granulation tissue was detected by q TR-PCR and IHC. The relationship between the expression level of MMP-2 and TIMP-2 and their ratio and that of TGF-β1 was analyzed. Results. The expression of MMP-2 (P < 0.05) was suppressed, and the expression of TIMP-2 (P < 0.05) was promoted, while the ratio of MMP-2/TIMP-2 (P < 0.05) was decreased after APG treatments. The expression of TGF-β1 had negative correlation with the ratio of MMP-2/TIMP-2 (P < 0.05) and positive correlation with the expression of TIMP-2 (P < 0.05). Conclusions. APG treatment may suppress the expression of MMP-2, promoting that of the TIMP-2 in the diabetic chronic refractory cutaneous wounds. TGF-β1 may be related to these effects.

  11. Nonspecific Cecal Ulcer: An Obsolete Jargon

    Directory of Open Access Journals (Sweden)

    Duvuru Ram

    2013-04-01

    Full Text Available Non specific cecal ulcer (NSCU is a rare entity described by Cruveilhier in 1832. NSCU has no specific presenting features and it can mimic a host of conditions like appendicitis, diverticulosis and colonic carcinoma. Earlier, this terminology was used to depict those ulcers where it was not possible to make the exact diagnosis. There are only a few cases where a specific preoperative diagnosis was made. The number of NSCUs being reported recently is less. This is due to the advent of newer diagnostic techniques to identify the etiology of these ulcers. Hence the term NSCU is no longer employed in current literature because a specific diagnosis is attained in most ulcers. Therefore the term NSCU is no longer valid and its use should be largely restricted to those cases where a specific diagnosis is not possible even after exhausting the currently available investigative techniques. This article provides an overview of this outdated term and outlines how to proceed when NSCU is encountered in clinical practice. [J Interdiscipl Histopathol 2013; 1(2.000: 85-88

  12. Microarray Assisted Gene Discovery in Ulcerative Colitis

    DEFF Research Database (Denmark)

    Brusgaard, Klaus

    Inflammatory Bowel disease (IBD) is a condition characterised by chronic recidivous inflammation of the bowel and intestine. IBD includes chron´s disease (CD) and ulcerative colitis (UC). The combined prevalence of CD and UC are app. 1 in 500 in the general Caucasian population. In 25% of the cases...

  13. Refractory duodenal ulcer

    Directory of Open Access Journals (Sweden)

    Al Freihi Hussein

    1995-01-01

    Full Text Available Refractory or intractable ulcer is defined as an ulcer that fails to heal completely after eight to twelve weeks, despite appropriate treatment with a modern antiulcer therapy in a compliant patient. Refractory ulcer should be suspected in individuals diagnosed to have peptic ulcer if their symptoms persist longer than usual: occurrence of complications or simply their ulcers fail to heal, since up to 25% of such patients remain asymptomatic. Conditions associated with refractory ulcer include noncompliance, continuous consumption of nonsteroidal anti-inflam-matory drugs, acid hypersecretion, smoking. male gender and other factors with questionable role like advanced age, large ulcer size, prolonged duration of symptoms and the presence of complication like bleeding. Nonpeptic ulcers like tuberculosis, malignancy, Crohn′s disease and primary intestinal lymphoma should always be considered in the differential diagnosis. Colonization with H. pylori which is well-known as a cause of frequent recurrences, has not been linked with refractoriness. Patients with refractory ulcers must undergo thorough re-evaluation including repeated endoscopies, obtaining biopsies for microbiology and histology and determination of serum-gastrin level. Once diseases with identifiable etiologies have been ruled out, aggressive medical management with single or multiple antiulcer drugs should be instituted. Such treatments will virtually heal all refractory ulcers. Surgery should be reserved for patients whose ulcers fail to respond to optimal medical therapy or those who develop com-plications necessitating surgical intervention.

  14. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  15. Vulvar ulcer as a presentation of systemic langerhans cell histiocytosis

    Directory of Open Access Journals (Sweden)

    Nina A Madnani

    2011-01-01

    Full Text Available We report a 38-year-old housewife with systemic Langerhans cell histiocytosis (LCH presenting as a chronic vulvar and peri-anal ulcer. She had systemic involvement in the form of diabetes insipidus and bone "hot-spots". She responded favorably to etoposide, 6-mercaptopurine, and systemic steroids, and has been in remission since 10 years. Chronic vulvar ulcers not responding to routine therapy should not be neglected and need to be biopsied repeatedly to come to a specific diagnosis. The vulvar ulcer in our case provided a vital clue to a systemic LCH, with a successful outcome.

  16. Genotypes of Helicobacter pylori in patients with peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Chin-Lin Perng; Hwai-Jeng Lin; Wen-Ching Lo; Guan-Ying Tseng; I-Chen Sun; Yueh-Hsing Ou

    2004-01-01

    AIM: Helicobacter pyloricauses chronic gastritis, peptic ulcer,gastric cancer and MALT-lymphoma. Different genotypes of Helicobacter pylori are confirmed from diverse geographic areas. Its association with bleeding peptic ulcer remains controversial. The aim of this study was to investigate the Helicobacter pylori vac4 alleles, cagA and iceA in patients with bleeding peptic ulcer.METHODS: We enrolled patients with bleeding, nonbleeding peptic ulcers and chronic gastritis. Biopsy specimens were obtained from the antrum of the stomach for rapid urease test, bacterial culture and PCR assay. DNA extraction and polymerase chain reaction were used to detect the presence or absence of cagA and to assess the polymorphism of vac4 and iceA.RESULTS: A total of 168 patients (60.4%) (25 patients with chronic gastritis, 26 patients with bleeding gastric ulcer,51 patients with non-bleeding gastric ulcer, 26 patients with bleeding duodenal ulcer, and 40 patients with non-bleeding duodenal ulcer) were found to have positive PCR results between January 2001 and December 2002. Concerning genotypes, we found cagA (139/278, 50%), vacA s1a (127/278, 45.7%), and iceA1 (125/278, 45%) predominated in all studied patients. In patients with bleeding peptic ulcers,vac4 s1a and m1T were fewer than those in patients with non-bleeding peptic ulcers (37/106 vs69/135, P=0.017, and 4/106 vs21/135, P=0.002).CONCLUSION: In patients with peptic ulcers, Hpylori vacA s1a and m1T prevent bleeding complication.

  17. Non-specific binding in solid phase immunoassays for autoantibodies correlates with inflammation markers.

    Science.gov (United States)

    Güven, Esin; Duus, Karen; Lydolph, Magnus Christian; Jørgensen, Charlotte Sværke; Laursen, Inga; Houen, Gunnar

    2014-01-31

    Enzyme-linked immunosorbent assay (ELISA) is a validated and sensitive method for detection of human autoantibodies, but may have problems with specificity. Non-specific binding is a well-known problem often observed in tests for autoantibodies, when sera are incubated on plastic surfaces, e.g. an ELISA plate. To understand the mechanisms underlying non-specific immunoglobulin deposition, we here analyse the phenomenon in detail and we propose means of reducing false positive test results caused by non-specific binding. The level of non-specific binding, in sera with suspected autoreactivity, was analysed in non-coated and autoantigen-coated ELISA wells and 4-32% of sera showed a high level of non-specific binding depending on the assay conditions and serum properties. Non-specifically binding sera were found to contain increased concentrations of IgG and other inflammatory mediators. Moreover, non-specific binding could be induced in serum by increasing the concentration of IgG and incubating the serum at 40 °C. This suggests that non-specific binding immunoglobulins can be formed during inflammation with high immunoglobulin levels and elevated temperature. We show that the level of non-specific binding correlates with the IgG concentration and therefore propose that non-specific binding may be interpreted as an informative finding indicative of elevated IgG and inflammation.

  18. Determinants of change in perceived disability of patients with non-specific chronic low back pain

    NARCIS (Netherlands)

    Hodselmans, A.P.; Dijkstra, P.U.; Geertzen, J.H.B.; Preuper, H.R.S.; van der Schans, C.P.

    2010-01-01

    Objective: Change in psychophysical capacity, calculated as the ratio between physical capacity and perceived effort, may be a determinant of change in perceived disability. The aim of this study was to identify determinants for change in perceived disability, as measured with the Roland Morris Disa

  19. Invasive mucormycosis in benign gastric ulcer.

    Science.gov (United States)

    Al-Rikabi, A C; Al-Dohayan, A D; Al-Boukai, A A

    2000-03-01

    Fungal elements are frequently noted overlying the base of chronic peptic ulcers of the stomach and it has been suggested that the fungi enhance the degree of necrosis and that these cases have protracted disease and deeper ulcers with more perforations. It has also been postulated that the number of fungal elements might be increased in the stomach of patients who are receiving potent medications such as H2-receptor antagonists to reduce gastric acidity, but there have not been adequate control studies, and the deleterious effects from the presence of the fungi in these cases have not been substantiated. We present a very rare case of invasive mucormycosis (phycomycosis) occurring in the base of a chronic gastric ulcer in a 55 years old diabetic male. This case was clinically and radiologically been mistaken for a gastric carcinoma. In addition, the ulcer was complicated by perforation and fungal septicemia with subsequent fatal outcome. The clinical, radiological and histopathological features are described together with a literature review of other reported fungal gastric ulcers.

  20. Observation of therapeutic effect of SilverCare nanometer silver antimicrobial gel on chronic ulcers%斯丽凯纳米银抗菌凝胶治疗慢性溃疡的临床观察

    Institute of Scientific and Technical Information of China (English)

    张龙; 崔正军; 韩兆峰; 周健; 张树堂

    2011-01-01

    Objective To observe the therapeutic effect of SilverCare nanometer silver antimicrobial gel on Chronic ulcers. Methods Trial group: To select 50 patients with chronic ulcer,and take silvercare nanometer silver gel to change dressings. Control group: Self-contral observation was used on the same patient with chronic ulcer,which scattered on adjacent or symmetrical parts of bodies,and taked sulfadiazine silver cream. Data was collected at different time points on wound pain,wound exudate,wound edema,wound effective rate,bacterial culture rate,and adverse drug reactions. Results Wound painand wound edema in trial group were significantly lower than those of control group at different time pionts (P<0.05); wound exudate in trial group was not significantly lower than those of control group at different time pionts (P>0.05); wound effective rate of trial group was obviously higher than those of control group (P< 0.05);and bacterial culture rate of trial group was evidently lower than those of control group (P<0.05);the obvious adverse reactions were not observed in trial group. Conclusions SilverCare nanometer silver antimicrobial gel has better antibacterial activity, promotes wound management,and decreases the healing time,comparing with sulfadiazine silver cream.%目的:观察斯丽凯纳米银抗菌凝胶治疗慢性溃疡的临床疗效.方法:试验组:选取慢性溃疡患者50例进行临床试验,应用斯丽凯纳米银抗菌凝胶进行创面换药.对照组:设自身同体对照,慢性溃疡面积相近、相邻或部位对称,应用磺胺嘧啶银乳膏换药.观测记录各组病例不同时相点的创面疼痛程度、创面渗出液、创面水肿程度、创面有效率、细菌培养率和药物不良反应.结果:试验组不同时相点的创面疼痛程度和创面渗出液明显小于对照组(P0.05);试验组不同时相点的创面有效率明显高于对照组(P<0.05);试验组不同时相点的细菌检出率明显低于对照组(P<0

  1. The Effect of Wound Bed Preparation in the Treatment of Chronic Surface Ulcer%创面床准备在治疗体表慢性溃疡中的作用

    Institute of Scientific and Technical Information of China (English)

    史振玉

    2012-01-01

      Objective:To observe the effect of wound bed preparation in the treatment of chronic surface ulcer.Method:To randomize 98 chronic surface ulcer patients into a treatment group and a control group,49 in each.The treatment group will be classified into four types according to the color of the base of wound:Black Phase,Yellow Phase,Red Phase,and Pink Phase.Take different measures of treatment at different phases while the control group will use the conventional dressing therapy.Result:Compared with the control group,the various points during the evolution time of the treatment group was significantly shortened(P<0.05),Black Phase → Yellow Phase(3.9±1.6) d VS.(6.0±2.6) d,Yellow Phase → Red Phase(12.5±4.8) d VS.(19.5±6.6) d,Red Phase → Pink Phase(11.8±6.2) d VS.(20.5±8.3) d,Pink Phase → Wound Healing(10.5±5.0) d VS.(16.5±6.9) d,the corresponding cure coefficient 28:12,which shows that the effect of the subsequent surgical treatment in the treatment group is better than the one in the control group.Conclusion:The application of wound bed preparation in the treatment of chronic surface ulcers can improve the cure rate and the power of the surgical repair.%  目的:观察应用“创面床准备”方案治疗体表慢性溃疡的疗效.方法:选择98例体表慢性溃疡患者随机分为治疗组及对照组,每组各49例,治疗组按“创面床准备”方案将创面分为黑、黄、红、粉四期,对处于不同时期的创面采取不同的治疗措施,对照组创面采用常规换药治疗.结果:治疗组较对照组,黑期→黄期(3.9±1.7)d VS.(6.0±2.4)d、黄期→红期(12.5±4.9)d VS.(19.5±6.5)d、红期→粉期(11.8±6.3)d VS.(20.5±8.2)d、粉期→创面愈合(10.5±5.0)d VS.(16.5±6.9)d,各分期间演进时间明显缩短(P<0.05),自愈例数28:12,后续手术治疗效果治疗组明显优于对照组.结论:应用创面床准备方案治疗体表慢性溃疡能提高自愈率及手术修复率.

  2. Choledochoduodenal fistula of ulcer etiology

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2010-01-01

    Full Text Available Introduction Choledochoduodenal fistulas are very rare and in most cases are caused by a long-lasting and poorly treated chronic duodenal ulcer. They may be asymptomatic or followed by symptoms of ulcer disease, by attacks of cholangitis or bleeding or vomiting in cases of ductoduodenal stenosis. The diagnosis is simple and safe, however treatment is still controversial. If surgery is the choice of treatment, local findings should be taken into consideration. As a rule, intervention involving closure of fistula is not recommended. Case Outline The authors present a 60-year-old woman with a long history of ulcer disease who developed attacks of cholangitis over the last three years. Ultrasonography and CT showed masive pneumobilia due to a choledochoduodenal fistula. . As there was no duodenal stenosis or bleeding, at operation the common bile duct was transected and end-to-side choledochojejunostomy was performed using a Roux-en Y jejunal limb. From the common bile duct, multiple foreign bodies of herbal origin causing biliary obstruction and cholangitis were removed. After uneventful recovery the patient stayed symptom free for four years now. Conclusion The performed operation was a simple and good surgical solution which resulted in complication-free and rapid recovery with a long-term good outcome. .

  3. Current treatment of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Johannes Meier; Andreas Sturm

    2011-01-01

    Ulcerative colitis (UC) is a chronic disease featuring recurrent inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complications of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice- orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.

  4. Current treatment of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    JohannesMeier; AndreasSturm

    2011-01-01

    Ulcerative colitis (UC) is a chronic disease featuring re- current inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complica- tions of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice-orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.

  5. Spectrum of bacteria associated with diabetic foot ulcer and biofilm formation: A prospective study

    Directory of Open Access Journals (Sweden)

    Asima Banu

    2015-09-01

    The organisms causing chronic diabetic foot ulcers were commonly multidrug-resistant; this was also observed among biofilm formers. Therefore, screening for biofilm formation, along with the usual antibiogram, needs to be performed as a routine procedure in chronic diabetic ulcers to formulate effective treatment strategies for these patients.

  6. Assessment of the influence of the inflammatory process on the activation of blood platelets and morphological parameters in patients with ulcerative colitis (colitis ulcerosa

    Directory of Open Access Journals (Sweden)

    Beata Polińska

    2011-04-01

    Full Text Available Ulcerative colitis (colitis ulcerosa is a non-specific inflammatory bowel disease of unknown etiology. Thesymptoms which are observed in the course of ulcerative colitis are: an increase in the number of leukocytes andblood platelets, an increase in the concentration of IL-6 and anemia. Blood platelets are the key element, linkingthe processes of hemostasis, inflammation and the repair of damaged tissues. Activation of blood platelets is connectedwith changes in their shape and the occurrence of the reaction of release. P-selectin appears on the surfacesof activated blood platelets and the concentration level of soluble P-selectin increases in the blood plasma. The aimof this study was to define whether the increased number of blood platelets in patients with ulcerative colitisaccompanies changes in their activation and morphology. A total of 16 subjects with ulcerative colitis and 32healthy subjects were studied. Mean platelet count, morphological parameters of platelets and MPC were measuredusing an ADVIA 120 hematology analyzer. Concentrations of sP-selectin and IL-6 in serum were marked byimmunoassay (ELISA. MPC, concentration of sP-selectin and IL-6 were significantly higher in subjects with ulcerativecolitis compared to those in the healthy group. There was a decrease of MPV in patients with ulcerativecolitis, which is statistically significant. Chronic inflammation in patients with ulcerative colitis causes an increase inthe number of blood platelets, a change in their morphology and activation. Decreased MPV value reflects activationand the role blood platelets play in the inflammatory process of the mucous membrane of the colon. A highconcentration of sP-selectin, which is a marker of blood platelet activation, demonstrates their part in the inflammatoryprocess. The increase in the concentration of sP-selectin correlated positively with the increase in concentrationof IL-6. This is why it may be a useful marker of the activity of

  7. Histiocytic ulcerative colitis in a French bulldog.

    Science.gov (United States)

    Tanaka, Hiroshi; Nakayama, Masanari; Takase, Katsuaki

    2003-03-01

    A 9-month-old French bulldog was referred for signs of chronic large bowel diarrhea. The dog had an increased frequency of defecation, tenesmus and hematochezia. Flexible colonoscopy showed hyperemia, irregularities and ulcerations with multifocal hemorrhages in the mucosa from the descending colon to the proximal rectum. Multiple colonic biopsies were characterized by infiltrations of PAS positive histiocytes in the lamina propria. A diagnosis of histiocytic ulcerative colitis (HUC) was made, and the animal showed only minimal improvement, although it was treated with nutritional and medical therapies. This is the second case of HUC in French bulldog, a breed which has ancestral relations to Boxer dogs.

  8. Duration of wound fluid secretion from chronic venous leg ulcers is critical for interleukin-1α, interleukin-1β, interleukin-8 levels and fibroblast activation

    DEFF Research Database (Denmark)

    Zillmer, Rikke; Trøstrup, Hannah; Karlsmark, Tonny

    2011-01-01

    Wound fluid collected from chronic wounds may be used as a simple gauge of the processes taking place in the tissue. There is lack of information on the optimal conditions for wound fluid procurement. We have studied possible diurnal variations and duration of wound fluid accumulation using reten...

  9. Cushing's ulcer: Further reflections

    OpenAIRE

    Kemp, William J.; Bashir, Asif; Dababneh, Haitham; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Brain tumors, traumatic head injury, and other intracranial processes including infections, can cause increased intracranial pressure and lead to overstimulation of the vagus nerve. As a result, increased secretion of gastric acid may occur which leads to gastro-duodenal ulcer formation known as Cushing's ulcer. Methods: A review of original records of Dr. Harvey Cushing's patients suffering from gastro-duodenal ulcers was performed followed by a discussion of the available litera...

  10. Helicobacter pylori infection analysis in chronic hepatitis B and hepatitis B cirrhosis complicated with peptic ulcer patients%慢性乙型肝炎及乙肝肝硬化合并消化性溃疡患者幽门螺杆菌感染分析

    Institute of Scientific and Technical Information of China (English)

    张武汉; 罗雪兵; 马爱霞

    2015-01-01

    目的:分析慢性乙型肝炎及乙肝肝硬化合并消化性溃疡患者幽门螺杆菌(Hp)感染情况。方法对67例慢性乙型肝炎合并消化性溃疡患者(设为观察组)与48例乙肝肝硬化合并消化性溃疡患者(设为对照组)分别实施胃镜检查、快速尿素酶测定和14C呼气试验,比较两组的Hp感染情况。结果观察组的Hp阳性率为70.15%(47/67),胃溃疡21例,其中Hp感染4例, Hp阳性率占19.05%,十二指肠溃疡46例, Hp感染43例, Hp阳性率占93.48%。对照组患者中,胃溃疡18例,其中Hp感染3例, Hp阳性率占16.67%,十二指肠溃疡30例, Hp感染13例, Hp阳性率占43.33%。结论慢性乙型肝炎十二指肠溃疡与Hp感染有显著的相关性,慢性乙型肝炎胃溃疡、乙肝肝硬化胃溃疡与Hp感染相关性则不明显。%ObjectiveTo analyze helicobacter pylori (Hp) infection in chronic hepatitis B and hepatitis B cirrhosis complicated with peptic ulcer patients.MethodsGastroscopy, rapid urease test assay, and14C breath test were applied in 67 chronic hepatitis B complicated with peptic ulcer patients (as observation group) and 48 hepatitis B cirrhosis complicated with peptic ulcer patients (as control group) for comparison of their Hp infection condition.ResultsThe observation group had Hp positive rate as 70.15% (47/67). Among 21 cases with gastric ulcer, there were 4 cases of them with Hp infection, with the Hp positive rate as 19.05%. Among 46 cases with duodenal ulcer, there were 43 cases with Hp infection, with the Hp positive rate as 93.48%. In the control group, there were 18 cases with gastric ulcer, and 3 cases among them had Hp infection, with the Hp positive rate as 16.67%. Among 30 cases with duodenal ulcer, there were 13 cases with Hp infection, with the Hp positive rate as 43.33%.ConclusionChronic hepatitis B duodenal ulcer has significant correlation with Hp infection, while chronic hepatitis B gastric ulcer and hepatitis B cirrhosis

  11. Buruli Ulcer (Mycobacterium ulcerans Infection)

    Science.gov (United States)

    ... leishmaniasis, extensive ulcerative yaws and ulcers caused by Haemophilus ducreyi 1 . Early nodular lesions are occasionally confused with ... been made. References 1 Mitjà, O et al. Haemophilus ducreyi as a cause of skin ulcers in children ...

  12. Non-specific Effects of Vaccines and Stunting: Timing May Be Essential

    Directory of Open Access Journals (Sweden)

    Mike L.T. Berendsen

    2016-06-01

    Conclusions: We found a general time-dependent pattern of non-specific effects of vaccination, with positive associations for vaccinations given early in life and negative associations for vaccinations given later in infancy. If confirmed in further research, our findings may provide a new perspective on the non-specific effects of vaccination.

  13. Recurrent lower gastrointestinal bleeding secondary to cytomegalovirus-associated colonic ulcer in a non human immunodeficiency virus infected patient: timely diagnosis and treatment averted surgery.

    Science.gov (United States)

    Lim, L-G; Rajnakova, A; Yan, B; Salto-Tellez, M; Lim, L-L

    2009-11-01

    Mr C, a 68-year-old Chinese male with diabetes mellitus, previous stroke and ischaemic cardiomyopathy on clopidogrel, presented with haematochezia. Colonoscopy showed a sigmoid ulcer, which was treated endoscopically. Histology of the biopsy from the ulcer revealed non-specific changes. However, he presented with recurrent bleeding from this non-healing sigmoid ulcer. A review of the histologic specimen revealed CMV intranuclear inclusion bodies. He was treated with intravenous ganciclovir, with no further hematochezia.

  14. Mucosal polymerase chain reaction for diagnosing Helicobacter pylori infection in patients with bleeding peptic ulcers

    Institute of Scientific and Technical Information of China (English)

    Hwai-Jeng Lin; Wen-Ching Lo; Chin-Lin Perng; Guan-Ying Tseng; Anna Fen-Yau Li; Yueh-Hsing Ou

    2005-01-01

    AIM: Helicobacter pylori(Hpylori) has been linked to chronic gastritis, peptic ulcers, gastric cancer and MALT-lymphoma.Conventional invasive tests are less sensitive than noninvasive tests in diagnosing H pylori infection in patients with bleeding peptic ulcers. Polymerase chain reaction is a sensitive and accurate method for diagnosing H pylori infection. The aim of this study was to evaluate the diagnostic role of mucosal polymerase chain reaction for H pylori infection in patients with bleeding peptic ulcers.METHODS: In patients with bleeding, non-bleeding peptic ulcers and chronic gastritis, we checked rapid urease test,histology, bacterial culture and mucosal polymerase chain reaction for detecting H pylori infection. Positive H pylori infection was defined as positive culture or both a positive histology and a positive rapid urease test. For mucosal polymerase chain reaction of Hpylori, we checked vacA (s1a, s1b, s1c, s2, m1, m1T, m2),iceA1,iceA2 and cag A.RESULTS: Between October 2000 and April 2002, 88 patients with bleeding peptic ulcers (males/females: 60/28, gastric ulcers/duodenal ulcers: 55/33), 81 patients with non-bleeding peptic ulcers (males/females: 54/27, gastric ulcers/duodenal ulcers: 45/36) and 37 patients with chronic gastritis (males/females: 24/13) were enrolled in this study. In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, 45 patients (51%), 71 patients (88%)and 20 patients (54%) respectively were found to have positive H pylori infection (P<0.001). In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, polymerase chain reaction for H pylori infection was positive in 54 patients (61%), 70 patients (86%) and 20 patients (54%) respectively (P<0.001). The sensitivity,positive predictive value and diagnostic accuracy of mucosal polymerase reaction for Hpylori infection were significantly lower in patients with bleeding peptic ulcers (84%, 79%and 81%) than in

  15. Neonatal Pressure Ulcer Prevention.

    Science.gov (United States)

    Scheans, Patricia

    2015-01-01

    The incidence of pressure ulcers in acutely ill infants and children ranges up to 27 percent in intensive care units, with a range of 16-19 percent in NICUs. Anatomic, physiologic, and developmental factors place ill and preterm newborns at risk for skin breakdown. Two case studies illustrate these factors, and best practices for pressure ulcer prevention are described.

  16. The stress ulcer syndrome

    NARCIS (Netherlands)

    H.A. van Essen

    1986-01-01

    textabstractThe stress ulcer syndrome is described in this thesis. This syndrome is seen in patients admitted to intensive care departments or being treated in field hospitals, in disaster areas, or battle fields. Acute mucosal lesions associated with burns (Curling's ulcers) and central nervous sys

  17. Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection

    Directory of Open Access Journals (Sweden)

    Richard F. Guo

    2015-01-01

    Full Text Available Cytomegalovirus (CMV infection rarely manifests with skin ulcerations. We describe a case report of a 64-year-old woman with chronic immunosuppression for treatment of mixed connective tissue disease, presenting with new onset leg ulcerations after a recent change in immunosuppressive regimen. She subsequently developed fulminant hepatitis, encephalopathy, and pancytopenia and was found to have severe systemic CMV viremia. Skin ulcer biopsy was positive by immunohistochemical staining for CMV infected endothelial cells. Both systemic disease and skin ulcer rapidly improved after stopping immunosuppression and administering intravenous ganciclovir. New onset skin ulcers in an immunosuppressed individual, especially with recent changes in immunosuppressive regimen, should raise the suspicion of reactivation of CMV.

  18. Diabetes Foot Ulcers: A novel Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Golnaz Namazi

    2008-05-01

    Full Text Available Foot ulcers are common in 12-25 percent of diabetic patients. Preventing, controlling and treating of these kind chronic wounds are of the major clinical challenges.Evidence based documents revealed that DFU (Diabetic Foot ulcer is a chronic wound type originating from disturbed cellular and molecular mechanisms that have to be in its functional form to overcome its problem. In diabetes and some other chronic based diseases, harmonized acting machine causes chronic phases that result in conditions as foot ulceration and related complications seen commonly in diabetes.DFU needs to be transformed into acute phase in order to be healed in a physiological manner. Disturbed mechanisms have to be corrected reversely and to achieve such a goal it is essential to better understanding of disturbing factors responsible for biological abnormalities. Factors associated with DFU are as cellular and molecular recruitment and function impairments and there is need to repair these mechanisms. For this, we believe that the activated Th-1 cells (T helper-1 Cells might have a critical role in regulation of the several effector functions of the cellular and molecular mechanisms essential to the body to act the best. Evidences and our successful results urge us to suggest this regulatory role for effector cells and molecules generated through activation of Th-1 cells as a treatment strategy.

  19. Peptic ulcer disease today.

    Science.gov (United States)

    Yuan, Yuhong; Padol, Ireneusz T; Hunt, Richard H

    2006-02-01

    Over the past few decades, since the introduction of histamine H(2)-receptor antagonists, proton-pump inhibitors, cyclo-oxygenase-2-selective anti-inflammatory drugs (coxibs), and eradication of Helicobacter pylori infection, the incidence of peptic ulcer disease and ulcer complications has decreased. There has, however, been an increase in ulcer bleeding, especially in elderly patients. At present, there are several management issues that need to be solved: how to manage H. pylori infection when eradication failure rates are high; how best to prevent ulcers developing and recurring in nonsteroidal anti-inflammatory drug (NSAID) and aspirin users; and how to treat non-NSAID, non-H. pylori-associated peptic ulcers. Looking for H. pylori infection, the overt or surreptitious use of NSAIDs and/or aspirin, and the possibility of an acid hypersecretory state are important diagnostic considerations that determine the therapeutic approach. Combined treatment with antisecretory therapy and antibiotics for 1-2 weeks is the first-line choice for H. pylori eradication therapy. For patients at risk of developing an ulcer or ulcer complications, it is important to choose carefully which anti-inflammatory drugs, nonselective NSAIDs or coxibs to use, based on a risk assessment of the patient, especially if the high-risk patient also requires aspirin. Testing for and eradicating H. pylori infection in patients is recommended before starting NSAID therapy, and for those currently taking NSAIDs, when there is a history of ulcers or ulcer complications. Understanding the pathophysiology and best treatment strategies for non-NSAID, non-H. pylori-associated peptic ulcers presents a challenge.

  20. Activated protein C to heal pressure ulcers.

    Science.gov (United States)

    Wijewardena, Aruna; Lajevardi, Sepehr S; Vandervord, Elle; Vandervord, John; Lang, Thomas C; Fulcher, Gregory; Jackson, Christopher J

    2016-10-01

    Pressure ulcers present a major clinical challenge, are physically debilitating and place the patient at risk of serious comorbidities such as septic shock. Recombinant human activated protein C (APC) is an anticoagulant with anti-inflammatory, cytoprotective and angiogenic effects that promote rapid wound healing. Topical negative pressure wound therapy (TNP) has become widely used as a treatment modality in wounds although its efficacy has not been proven through randomised controlled trials. The aim of this study was to determine the preliminary efficacy and safety of treatment with APC for severe chronic pressure sores with and without TNP. This case presentation describes the history, management and outcome of two patients each with a severe chronic non-healing pressure ulcer that had failed to respond to conventional therapy. TNP was added to conservative management of both ulcers with no improvement seen. Then local application of small doses of APC was added to TNP and with conservative management, resulted in significant clinical improvement and rapid healing of both ulcers, displaying rapid growth of vascular granulation tissue with subsequent epithelialisation. Patients tolerated the treatment well and improvements suggested by long-term follow-up were provided. Randomised placebo-controlled double blind trials are needed to quantify the efficacy, safety, cost-effectiveness, optimal dose and quality of life changes seen from treatment with APC.

  1. A new non-specificity measure in evidence theory based on belief intervals

    Institute of Scientific and Technical Information of China (English)

    Yang Yi; Han Deqiang; Jean Dezert

    2016-01-01

    In the theory of belief functions, the measure of uncertainty is an important concept, which is used for representing some types of uncertainty incorporated in bodies of evidence such as the discord and the non-specificity. For the non-specificity part, some traditional measures use for reference the Hartley measure in classical set theory;other traditional measures use the simple and heuristic function for joint use of mass assignments and the cardinality of focal elements. In this paper, a new non-specificity measure is proposed using lengths of belief intervals, which represent the degree of imprecision. Therefore, it has more intuitive physical meaning. It can be proved that our new measure can be rewritten in a general form for the non-specificity. Our new measure is also proved to be a strict non-specificity measure with some desired properties. Numerical examples, simulations, the related analyses and proofs are provided to show the characteristics and good properties of the new non-specificity definition. An example of an application of the new non-specificity measure is also presented.

  2. Peptic Ulcer Disease Different Pathogenesis of Duodenal and Gastric Ulcer

    Directory of Open Access Journals (Sweden)

    Hendra Koncoro

    2015-12-01

    Full Text Available Despite decrease frequency of Helicobacter pylori (H. pylori due to eradication therapy, peptic ulcer disease as a manifestation of this infection is still remain a health burden. Understanding the physiology of gastric acid secretion and its alteration by H. pylori induced inflammation will aid physician in differentiating peptic ulcer disease based on its location. Duodenal ulcer and gastric ulcer disease are two common condition that usually found in peptic ulcer. Recognition of symptoms and its pathogenesis may lead physician to understand the fate of each condition in the future. This article reviews concept of peptic ulcer pathogenesis according to ulcer etiology.

  3. Unna Boot in Venous Ulcer Treatment: Evaluation of 30 patients

    OpenAIRE

    Acıpayam, Mehmet; Zor, M. Hakan; Altınay, Levent; Uncu, Hasan; Halıcı, Ümit

    2013-01-01

    Aim: We aim to evaluate the results of the Unna boot practice with this prospective study. Material and Methods: This study included a total of 30 patients (1 female, 29 male; ages 23–56, mean 33.5) admitted to outpatient clinic with chronic venous leg ulcers. All patients were treated with Unna's boot. This treatment combined with oral calcium dobesilat 500 mg tabletorally twice a day. As the ulcer was healing, the treatment continued with calcium dobesilate tablets and compres...

  4. Diagnostics of pressure ulcer risk and pressure ulcers

    OpenAIRE

    Kottner, Jan

    2011-01-01

    Pressure ulcers are serious health problems and they develop in every healthcare setting. Pressure ulcer risk scales aim to support practitioners in determining individual pressure ulcer risk and in starting preventive activities. Study results indicate validity problems inherent in pressure ulcer risk scale scores. Since risk scores are too imprecise for individual clinical decision making, it is questionable whether the standardized pressure ulcer risk assessments improve resident and patie...

  5. Peptic Ulcer Disease Different Pathogenesis of Duodenal and Gastric Ulcer

    OpenAIRE

    Hendra Koncoro; I Dewa Nyoman Wibawa

    2015-01-01

    Despite decrease frequency of Helicobacter pylori (H. pylori) due to eradication therapy, peptic ulcer disease as a manifestation of this infection is still remain a health burden. Understanding the physiology of gastric acid secretion and its alteration by H. pylori induced inflammation will aid physician in differentiating peptic ulcer disease based on its location. Duodenal ulcer and gastric ulcer disease are two common condition that usually found in peptic ulcer. Recognition of symptoms ...

  6. Connective tissue ulcers.

    Science.gov (United States)

    Dabiri, Ganary; Falanga, Vincent

    2013-11-01

    Connective tissue disorders (CTD), which are often also termed collagen vascular diseases, include a number of related inflammatory conditions. Some of these diseases include rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), localized scleroderma (morphea variants localized to the skin), Sjogren's syndrome, dermatomyositis, polymyositis, and mixed connective tissue disease. In addition to the systemic manifestations of these diseases, there are a number of cutaneous features that make these conditions recognizable on physical exam. Lower extremity ulcers and digital ulcers are an infrequent but disabling complication of long-standing connective tissue disease. The exact frequency with which these ulcers occur is not known, and the cause of the ulcerations is often multifactorial. Moreover, a challenging component of CTD ulcerations is that there are still no established guidelines for their diagnosis and treatment. The morbidity associated with these ulcerations and their underlying conditions is very substantial. Indeed, these less common but intractable ulcers represent a major medical and economic problem for patients, physicians and nurses, and even well organized multidisciplinary wound healing centers.

  7. Assessment of the influence of the inflammatory process on the activation of blood platelets and morphological parameters in patients with ulcerative colitis (colitis ulcerosa

    Directory of Open Access Journals (Sweden)

    Halina Kemona

    2011-04-01

    Full Text Available Ulcerative colitis (colitis ulcerosa is a non-specific inflammatory bowel disease of unknown etiology. The symptoms which are observed in the course of ulcerative colitis are: an increase in the number of leukocytes and blood platelets, an increase in the concentration of IL-6 and anemia. Blood platelets are the key element, linking the processes of hemostasis, inflammation and the repair of damaged tissues. Activation of blood platelets is connected with changes in their shape and the occurrence of the reaction of release. P-selectin appears on the surfaces of activated blood platelets and the concentration level of soluble P-selectin increases in the blood plasma. The aim of this study was to define whether the increased number of blood platelets in patients with ulcerative colitis accompanies changes in their activation and morphology. A total of 16 subjects with ulcerative colitis and 32 healthy subjects were studied. Mean platelet count, morphological parameters of platelets and MPC were measured using an ADVIA 120 hematology analyzer. Concentrations of sP-selectin and IL-6 in serum were marked by immunoassay (ELISA. MPC, concentration of sP-selectin and IL-6 were significantly higher in subjects with ulcerative colitis compared to those in the healthy group. There was a decrease of MPV in patients with ulcerative colitis, which is statistically significant. Chronic inflammation in patients with ulcerative colitis causes an increase in the number of blood platelets, a change in their morphology and activation. Decreased MPV value reflects activation and the role blood platelets play in the inflammatory process of the mucous membrane of the colon. A high concentration of sP-selectin, which is a marker of blood platelet activation, demonstrates their part in the inflammatory process. The increase in the concentration of sP-selectin correlated positively with the increase in concentration of IL-6. This is why it may be a useful marker

  8. Challenges in the management of oral ulceration in elderly patients

    Directory of Open Access Journals (Sweden)

    Nanan Nur'aeny

    2015-12-01

    Full Text Available Background: Oral ulceration can be experienced by anyone, including those who are elderly. Various trigger factors can occur in elderly patient, but the main thing to consider is the degenerative factors that affect the occurrence of some medical problems. Handling oral ulceration in elderly patients should be done carefully and holistically otherwise the improvement is only temporary and can reappear or even be worse. Purpose: In this paper we will discuss two different case reports of elderly female patients and both having some oral ulceration. Cases: First case of recurrent oral ulceration experienced by 58 years old patient, and second case is concerning a 77 years old patient with chronic oral ulceration and also having some medical problems. Aphthous like ulcers (ALU is a diagnosis for recurrent oral ulceration associated with systemic condition, and usually started after adolescent age. Elderly or geriatric condition itself is a special condition that contribute to the degree of a disease. Cases management: Both patients given non pharmacology and pharmacology therapies. The non pharmacology therapy includes communication, information, and education, also oral hygiene instruction. Steroid as anti-inflammatory drugs had an important role in healing process, beside other medication. Conclusion: Oral ulceration in elderly patients with or without a medical problems becomes a challenging thing to handle due to the complexity of their condition. As a dentist we have more careful to arrange the treatment plans for elderly patients when combine with some therapy related systemic disease.

  9. Zinc compounds, a new treatment in peptic ulcer.

    Science.gov (United States)

    Escolar, G; Bulbena, O

    1989-01-01

    Effects of zinc in gastric ulcer have been reviewed through investigations carried out on zinc acexamate (ZAC). ZAC is an organic compound that has been shown to possess an experimental antiulcer effect and a wide therapeutic index, making it a useful drug in the treatment of peptic ulcer disease. ZAC protects from ulceration in several experimental models such as pylorus occlusion, reserpine-induced ulcer, necrotizing agents, PAF-induced ulcer and cold-restraint stress. ZAC first reduces the gastric acid output by inhibiting the mast cell degranulation, an action likely to be mediated through a membrane stabilizing action. Secondly, it enhances the mucosal protection factors by increasing mucus secretion, inhibiting the H+ retrodiffusion and improving microcirculation. ZAC is also effective in acetic acid-induced chronic ulcer, restoring the continuity of the damaged mucosa. Several clinical trials have shown the usefulness of ZAC in acute and maintenance treatment of both gastric and duodenal ulcers. Endoscopic studies showed that ZAC reduced the inflammatory processes (gastritis and duodenitis) associated with ulcer healing. This reduction was statistically significant and not observed with other comparative treatments (H2-antagonists). The observed side-effects were minimal and affected less than 2% of treated patients. The pharmacological profile, clinical effectiveness and good tolerance of ZAC suggest this compound as an interesting option in the treatment of peptic disease.

  10. [Guidelines of treatment for peptic ulcer disease in special conditions].

    Science.gov (United States)

    Kim, Ji Hyun; Moon, Jeong Seop; Jee, Sam Ryong; Shin, Woon Geon; Park, Soo-Heon

    2009-11-01

    The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion.

  11. Nonspecific genital ulcers.

    Science.gov (United States)

    Sehgal, Virendra N; Pandhi, Deepika; Khurana, Ananta

    2014-01-01

    Recent intervention of nonspecific genital ulcers has added refreshing dimensions to genital ulcer disease. It was considered pertinent to dwell on diverse clinical presentation and diagnostic strategies. It seems to possess spectrum. It includes infective causes, Epstein Bar Virus, tuberculosis, Leishmaniasis, HIV/AIDS related ulcers and amoebiasis. Noninfective causes are immunobullous disorders, aphthosis, Behcet's disease (BD), inflammatory bowel disease, lichen planus and lichen sclerosis et atrophicus, drug reactions, premalignant and malignant conditions, pyoderma gangrenosum, and hidradenitis suppurativa. The diagnostic features and treatment option of each disorder are succinctly outlined for ready reference.

  12. Corneal ulcers in horses.

    Science.gov (United States)

    Williams, Lynn B; Pinard, Chantale L

    2013-01-01

    Corneal ulceration is commonly diagnosed by equine veterinarians. A complete ophthalmic examination as well as fluorescein staining, corneal cytology, and corneal bacterial (aerobic) and fungal culture and sensitivity testing are necessary for all infected corneal ulcers. Appropriate topical antibiotics, topical atropine, and systemic NSAIDs are indicated for all corneal ulcers. If keratomalacia (melting) is observed, anticollagenase/antiprotease therapy, such as autologous serum, is indicated. If fungal infection is suspected, antifungal therapy is a necessity. Subpalpebral lavage systems allow convenient, frequent, and potentially long-term therapy. Referral corneal surgeries provide additional therapeutic options when the globe's integrity is threatened or when improvement has not been detected after appropriate therapy.

  13. Hemoglobinopathies and Leg Ulcers.

    Science.gov (United States)

    Alavi, Afsaneh; Kirsner, Robert S

    2015-09-01

    Major hemoglobinopathies, including sickle cell anemia, are becoming a global health issue. Leg ulcers are the most common cutaneous manifestation of sickle cell disease and an important contributor to morbidity burden in this population. Leg ulcers following sickling disorders are extremely painful, and hard to heal. The clinical evidence for the optimal management of these ulcers is limited. Treating the cause and the strategies to prevent sickling are the mainstay of treatment. The basic principles of wound bed preparation and compression therapy is beneficial in these patients.

  14. 慢性溃疡性结肠炎大鼠结肠黏膜异型增生模型探讨%Prolonged inflammation progresses to dysplasia in novel rat model of chronic ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    李燕舞; 巫燕莉

    2012-01-01

    Objective It is to establish a novel rat model of chronic ulcerative colitis( CUC ) which involve the inflammation progresses to dysplasia of colonic mucosa. Methods Two establish methods were used to establish the models. 1,2- dim-ethylhydrazine ( DMH ) reactivated method: trinitrobenzene sulfonic acid ( TNBS ) was used to induce colitis followed by a weekly s. c. dose of DMH. Prolonged reactivation of TNBS: inflammation was induced with TNBS, after 2 weeks, TNBS in saline was given i. v. via a tail vein. The period of above two methods was 10 weeks. Results Diarrhea, blood or mucous stool were observed in the early days of model group animals. At 10 weeks, all animal groups except for normal ones had scar, adhesions and an increase in colon thickness. There was a significant decrease in the average colon length of model animals compared with normal ones, and the concentration of TNF - a and IL - 6 in serum of model animals increased obviously. Pathologic changes in colonic mucosa including loss mucosal architecture, inflammatory cell infiltration, muscle thickening, goblet cell depletion, gland disorder and dysplasia were found. Conclusion The new model will be used as a tool to imitate the inflammation progresses to dysplasia of chronic ulcerative colitis.%目的 探讨慢性溃疡性结肠炎大鼠黏膜异型增生模型的建立方法.方法 采用2种方法 制备模型.二甲肼(DMH)刺激法:三硝基苯磺酸(TNBS)经直肠制备结肠炎模型后采用皮下注射DMH刺激造模;TNBS持续刺激法:TNBS经直肠诱导结肠炎2周后,采用尾静脉注射TNBS刺激,造模周期10周.结果 模型组动物前期均出现腹泻、脓血黏液便,造模10周后模型大鼠结肠黏膜可见瘢痕、粘连,结肠长度缩短;血清中TNF-α、IL-6浓度较正常组动物显著增高;病理观察可见模型大鼠结肠黏膜均有不同程度的炎症表现:上皮细胞结构改变,淋巴细胞浸润,血管充血;肌层增厚;杯状细胞消失,腺体排列

  15. Imaging of a Marjolin's Ulcer: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Jang Gyu; Paik, Sang Hyun; Hong, Hyun Sook; Lee, Hae Kyung [Dept. of Radiology, Soonchunhyang University Hospital, Bucheon (Korea, Republic of); Yoo, Jae Ho [Dept. of Orthopedics, Seoul SKY Hospital, Seoul (Korea, Republic of); Kim, Hee Kyung [Dept of Pathology, Soonchunhyang University Hospital, Bucheon (Korea, Republic of)

    2011-06-15

    A Marjolin's ulcer refers to malignancies that developed in chronic venous ulcers, scars, or sinuses. We report three-dimensional computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT findings in a patient who developed skin cancer from a chronic leg ulcer. Although rare, on MR, a Marjolin's ulcer should be considered when a well-enhanced soft-tissue mass with a broad based skin ulcer shows a mass effect and invasion of the adjacent bone. CT angiography and PET-CT complement MRI for evaluating the nature of Marjolin's ulcers and may provide essential anatomical information, enabling the physician to design the optimal surgical approach or determining cancer staging.

  16. Collagen types I and III propeptides as markers of healing in chronic leg ulcers. A noninvasive method for the determination of procollagen propeptides in wound fluid--influence of growth hormone

    DEFF Research Database (Denmark)

    Rasmussen, L H; Jensen, L T; Avnstorp, C;

    1992-01-01

    A noninvasive method allowing measurements of the propeptides of collagen type III (PIIINP) and type I (PICP) in ulcer washings was developed. The response to topical human growth hormone was examined. Fourteen patients with venous ulcers were treated sequentially with human growth hormone (0.1, 0.......25, and 1 IU/cm2/day), each dose for 1 week, followed by 1 week washout. On alternate days, three and two times during treatment and washout periods, respectively, the ulcers were washed and incubated for 30 minutes with sterile water. No changes in healing rates in relation to growth hormone application...

  17. A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers.

    Science.gov (United States)

    Chung, Chen-Shuan; Chiang, Tsung-Hsien; Lee, Yi-Chia

    2015-09-01

    An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk for complicated ulcer disease, a poorer response to gastric acid suppressants, and a higher recurrence rate after treatment. Risk factors associated with this disease may include genetic predisposition, older age, chronic mesenteric ischemia, smoking, concomitant diseases, a higher American Society of Anesthesiologists score, and higher stress. Therefore, the diagnosis and management of emerging disease should systematically explore all known causes and treat underlying disease, while including regular endoscopic surveillance to confirm ulcer healing and the use of proton-pump inhibitors on a case-by-case basis.

  18. Roxatidine in duodenal ulcer.

    OpenAIRE

    1995-01-01

    Roxatidine acetate is a new H2-receptor antagonist. A randomized double-blind clinical trial in fifty-three patients with endoscopically proven duodenal ulcers > 5 mm in diameter was undertaken to compare safety and efficacy of roxatidine with that of ranitidine. Twenty-six patients received roxatidine (75 mg bid) while 27 patients received ranitidine (150 mg bid) for 4 weeks. One patient in each group did not come for follow up. Roxatidine and ranitidine had comparable ulcer healing rates...

  19. Optimal management of peptic ulcer disease in the elderly.

    Science.gov (United States)

    Pilotto, Alberto; Franceschi, Marilisa; Maggi, Stefania; Addante, Filomena; Sancarlo, Daniele

    2010-07-01

    Recent data report that the incidence of peptic ulcer is decreasing in the general population; conversely, the rates of gastric and duodenal ulcer hospitalization and mortality remain very high in older patients. Two major factors that might explain this epidemiological feature in the elderly population are the high prevalence of Helicobacter pylori infection and the increasing prescriptions of gastroduodenal damaging drugs, including NSAIDs and/or aspirin (acetylsalicylic acid). The main goals for treating peptic ulcer disease in old age are to reduce recurrence of the disease and to prevent complications, especially bleeding and perforation. The available treatments for peptic ulcer are essentially based on gastric acid suppression with antisecretory drugs and the eradication of H. pylori infection. The aim of this article is to report the available data on clinical efficacy and tolerability of peptic ulcer treatments in elderly patients and provide recommendations for their optimal use in this special population. Proton pump inhibitor (PPI)-based triple therapies for 7 days are highly effective for the cure of H. pylori-positive peptic ulcers as well as for reducing ulcer recurrence. Antisecretory drugs are also the treatment of choice for NSAID- or aspirin-related peptic ulcers and are useful as preventive therapy in chronic users of NSAIDs and low-dose aspirin as antiplatelet therapy. Antisecretory PPI therapy has a favourable tolerability profile in geriatric patients; however, monitoring is suggested in older patients with frequent pulmonary infections, gastrointestinal malabsorption, unexplained chronic diarrhoea, osteoporosis or those taking concomitant cytochrome P450 2C19-metabolized medications. The overall approach to the geriatric patient should include a comprehensive geriatric assessment that ensures multidimensional evaluation of the patient in order to better define the clinical risk of adverse outcomes in the older patient with peptic ulcer and

  20. Enterobacter cloacae ulceration in a failed corneal graft: a case report.

    OpenAIRE

    Gross, N D; Meyer, R F

    1985-01-01

    A 70-year-old female developed a bacterial ulcer in a previously rejected corneal graft. Cultures identified the pathogen as Enterobacter cloacae. Intensive topical antibiotic therapy arrested the progress of the ulcer, and the epithelial defect healed in one week; there was no resultant stromal thinning. Factors which may have predisposed the cornea to ulceration by this organism of relatively low virulence include chronic oedema following graft rejection, topical corticosteroid therapy, and...

  1. Pressure Ulcers in Trauma Patients with Preventive Spinal Immobilization : Incidence, characteristics and risk factors

    OpenAIRE

    Ham, H.W.

    2016-01-01

    Introduction To protect the (possibly) injured spine, trauma patients are immobilized on a backboard, with an extrication collar, lateral headblocks, and straps. Although pressure ulcers are typically associated with older adults and chronic illness, of all patients in a hospital environment, these trauma patients may be particularly at risk for developing (device-related) pressure ulcers. Pressure ulcers are a serious health complication that develop as a result of pressure alone or pressure...

  2. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  3. Desulfovibrio bacterial species are increased in ulcerative colitis.

    LENUS (Irish Health Repository)

    Rowan, Fiachra

    2012-02-01

    BACKGROUND: Debate persists regarding the role of Desulfovibrio subspecies in ulcerative colitis. Combined microscopic and molecular techniques enable this issue to be investigated by allowing precise enumeration of specific bacterial species within the colonic mucous gel. The aim of this study was to combine laser capture microdissection and quantitative polymerase chain reaction to determine Desulfovibrio copy number in crypt-associated mucous gel in health and in acute and chronic ulcerative colitis. METHODS: Colonic mucosal biopsies were harvested from healthy controls (n = 19) and patients with acute (n = 10) or chronic (n = 10) ulcerative colitis. Crypt-associated mucous gel was obtained by laser capture microdissection throughout the colon. Pan-bacterial 16S rRNA and Desulfovibrio copy number\\/mm were obtained by polymerase chain reaction at each locus. Bacterial copy numbers were interrogated for correlation with location and disease activity. Data were evaluated using a combination of ordinary linear methods and linear mixed-effects models to cater for multiple interactions. RESULTS: Desulfovibrio positivity was significantly increased in acute and chronic ulcerative colitis at multiple levels within the colon, and after normalization with total bacterial signal, the relative Desulfovibrio load was increased in acute colitis compared with controls. Desulfovibrio counts did not significantly correlate with age, disease duration, or disease activity but interlevel correlations were found in adjacent colonic segments in the healthy control and chronic ulcerative colitis groups. CONCLUSION: The presence of Desulfovibrio subspecies is increased in ulcerative colitis and the data presented suggest that these bacteria represent an increased percentage of the colonic microbiome in acute ulcerative colitis.

  4. Shewanella alga bacteremia in two patients with lower leg ulcers

    DEFF Research Database (Denmark)

    Domínguez, H.; Vogel, Birte Fonnesbech; Gram, Lone;

    1996-01-01

    The first Danish cases of Shewanella alga bacteremia in two patients with chronic lower leg ulcers are reported. Both patients were admitted to the hospital during the same month of a very warm summer and had been exposed to the same marine environment, thereby suggesting the same source of infec......The first Danish cases of Shewanella alga bacteremia in two patients with chronic lower leg ulcers are reported. Both patients were admitted to the hospital during the same month of a very warm summer and had been exposed to the same marine environment, thereby suggesting the same source......'Etoile, France), but further genetic and physiological analyses identified them as Shewanella alga....

  5. Ulcerative Colitis associated with Sclerosing Cholangitis and Autoimmune Hepatitis

    Directory of Open Access Journals (Sweden)

    Hoduț Andrei

    2013-04-01

    Full Text Available Introduction: Ulcerative colitis is a chronic intestinal inflammation, part of inflammatory bowel disease, which also includes Crohn’s disease. Both have extraintestinal manifestations, but those that tend to occur more commonly with ulcerative colitis include chronic active hepatitis, pyoderma gangrenosum and ankylosing spondylitis. Many individuals present with overlapping non-diagnostic features of more than one of these conditions that is referred to in the literature as autoimmune overlap syndrome. Sclerosing cholangitis associated with IBD is often referred to as overlap syndrome.

  6. [Anesthesia for non-specific surgery in a post-transplantation patient].

    Science.gov (United States)

    Steib, A; Freys, G; Otteni, J C

    1993-01-01

    The increase of non specific surgeries in transplanted patients may be related to the better survival achieved by the efficacy of immunosuppressive therapy and improved surgical and intensive care conditions. Therefore, the anaesthetist may be mandated to give anaesthesia in such patients, treated in hospitals which are not involved in transplantation procedures. The ignorance of the main physiologic and pharmacological changes in the new grafted organ as well as the knowledge of high risks of rejection or infection contribute to the anxiety often encountered in front of these patients. The denervated heart is unable to respond to stimulations requiring the integrity of autonomic neural mechanisms. Modulation of cardiac output depends on intrinsic activity (Frank-Starling mechanism) and therefore of end diastolic volume (preload). The denervated transplanted lung shows inability to elicit cough reflex; the latter is totally abolished in case of tracheal anastomosis. These physiologic changes have no deleterious effects on early cardiac and pulmonary functions following transplantation. In the same way, renal, liver or pancreatic functions are restored after respective replacement. However chronic rejection occurs frequently in 50% of patients in a mean time of 5 years following surgery except for liver transplanted patients which seem to be better protected. It results in a progressive decrease in organ function tests. The preoperative assessment requires primary contact with the transplant center. This communication should give precious information about the last biological and functional results as well as about the immunosuppressive therapy. Standard preoperative investigations include measurements of haemoglobin, urea, electrolyte and creatinine concentrations, liver tests, ECG, chest X-ray and coagulation pattern. Previsible difficult intubation should be detected in case of previous pancreas transplantation. Immunosuppressive therapy and other treatments

  7. Aloe Vera and Infected Leg Ulcers

    Directory of Open Access Journals (Sweden)

    Asima Banu

    2012-06-01

    Full Text Available Background Infected leg ulcers are major health problems resulting in morbidity and disability and are usually chronic and refractory to antimicrobial treatment. Aims The present study is aimed at determining the bacteria involved in leg ulcers and their resistance patterns to commonly used antibiotics as well as to determine whether Aloe Vera has antibacterial activity against multi-drug resistant organisms and promotes wound healing. Method A total of 30 cases with leg ulcers infected with multi-drug resistant organisms were treated with topical aloe vera gel and 30 age and sex-matched controls were treated with topical antibiotics. Culture and sensitivity was done from the wounds on alternate days and the ulcer was clinically and microbiologically assessed after 10 days. The results were compiled and statistically analysed. Results Cultures of the study group who were using aloe vera dressings showed no growth by the fifth day in 10 (33.3% cases, seventh day in another 16 (53.3% and ninth day in two of the remaining four cases (6.7% while in two (6.7% cases there was no decrease in the bacterial count. This means that of the 30 cases, 28 showed no growth by the end of 11 days while two cases showed no decrease in bacterial count. Growth of bacteria in study group is decreased from 100% (30 cases to 6.7% (2 cases by day 11 with P

  8. Microcirculation and venous ulcers: a review.

    Science.gov (United States)

    Pascarella, Luigi; Schönbein, Geert W Schmid; Bergan, John J

    2005-11-01

    Recent histological and immunocytochemical analyses of venous leg ulcers suggest that lesions observed in the different stages of chronic venous insufficiency (CVI) may be related to an inflammatory process. This inflammatory process leads to fibrosclerotic remodeling of the skin and then to ulceration. The vascular network of the most superficial layers of the skin appears to be the target of the inflammatory reaction. Hemodynamic forces such as venous hypertension, circulatory stasis, and modified conditions of shear stress appear to play an important role in an inflammatory reaction accompanied by leukocyte activation which clinically leads to CVI: venous dermatitis and venous ulceration. The leukocyte activation is accompanied by the expression of integrins and by synthesis and release of many inflammatory molecules, including proteolytic enzymes, leukotrienes, prostaglandin, bradykinin, free oxygen radicals, cytokines, and possibly other classes of inflammatory mediators. The inflammatory reaction perpetuates itself, leading to liposclerotic skin and subcutaneous tissue remodeling. In light of the mechanisms of venous ulcer formation cited above, therapy in the future might be directed against leukocyte activation in order to diminish the magnitude of the inflammatory response. With this in mind, the attention of many investigators has been drawn to two different drugs with an anti-inflammatory effect: pentoxifylline and flavonoids.

  9. The Role of Non-specific and Specific Immune Systems in Poultry against Newcastle Disease

    Directory of Open Access Journals (Sweden)

    Dyah Ayu Hewajuli

    2015-09-01

    Full Text Available Newcastle disease (ND is caused by avian paramyxovirus-1 which belong to Avulavirus genus and Paramyxoviridae family. The birds have abnormalities in humoral (bursa fabricius and cellular (thymus and spleen lymphoid organs. Lesions decrease the immune system. Immune system consists of non-specific and specific immune systems. The main components of non-specific immunity are physical and chemical barrier (feather and skin or mucosa, phagocytic cells (macrophages and natural killer, protein complement and the mediator of inflammation and cytokines. Interferons (IFNs belong to a group of cytokines that play a major role in the nonspecific or innate (natural immunity. The virulent ND virus encodes protein of V gene can be suppressed IFN type I. This leads to non-specific immune system fail to respond to the virulent strains resulting in severe pathogenicity. The defense mechanism of the host is replaced by specific immunity (adaptive immunity when natural immunity fails to overcome the infection. The specific immune system consists of humoral mediated immunity (HMI and cell-mediated immunity (CMI. The cells of immune system that react specifically with the antigen are B lymphocytes producing the antibodies, T lymphocytes that regulate the synthesis of antibodies and T cells as effector or the direct cytotoxic cells. Both non-specific and specific immunities are complementary against the invasion of ND virus in the birds. The objective of this article is to discuss the role of non specific and specific immune system in ND.

  10. Surgery for Crohn's Disease and Ulcerative Colitis

    Science.gov (United States)

    ... Crohn's Disease & Ulcerative Colitis Go Back Surgery for Crohn's Disease & Ulcerative Colitis Email Print + Share ( Disclaimer: Surgery information ... helps you to learn what to expect. About Crohn’s disease and ulcerative colitis Crohn’s disease and ulcerative colitis ...

  11. 美沙拉嗪联合灌肠综合治疗慢性溃疡性结肠炎的疗效观察%Clinical observation of Mesalazine combined with enema in the treatment of chronic ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    陈跃

    2012-01-01

    目的 观察美沙拉嗪结合灌肠治疗慢性溃疡性结肠炎的临床疗效.方法 将40例患者随机分为两组,每组各20例.对照组给予柳氮磺吡啶1 g/次,4次/d;治疗组给予美沙拉嗪口服,1 g/次,3次/d,同时配合灌肠(将庆大霉素16万U、思密达6 g及地塞米松5 mg加入60 mL生理盐水),保留灌肠40 min,2次/d,2周为1个疗程.共观察2个疗程.结果 两组疗效比较,对照组总有效率为60.0%,治疗组达85.0%,差异有统计学意义(P < 0.05).两组患者治疗前后结肠镜下评分比较,治疗组较对照组明显改善(P < 0.05).不良反应情况观察,对照组高达45.0%,治疗组为15.0%,较对照组明显降低(P < 0.05).结论美沙拉嗪结合灌肠综合治疗慢性溃疡性结肠炎有较好的临床疗效,毒副作用小,患者依从性好,值得进一步研究推广.%Objective To observe the clinical efficacy of Mesalazine combined with enema in the treatment of chronic ul-cerative colitis. Methods 40 patients were randomly assigned to two groups, with 20 cases in each group. Patients in the control group were given Sulfasalazine 1 g every time, 4 times a day; patients in the treatment group were given oral administration of Mesalazine (1 g every time, 3 times a day), in conjunction with enema (gentamicin 160 000 U, Smectite up to 6 g and Dexamethasone 5 mg added to 60 mL of normal saline). Enema was retained 2 times a day, 40 min each time and 2 weeks each treatment course. The two groups were observed for two courses. Results Total effective rate was 60.0% in the control group and 85.0% in the treatment group, showing significantly differences (P < 0.05). Colonoscopy score improvement was significantly better in the treatment group than in the control group (P < 0.05). Treatment group showed significantly lower adverse reactions rate (45.0%) than seen in the control group (15.0%)(P < 0.05). Conclusion Mesalamine combined with enema shows good treatment efficacy in the treatment of

  12. Primary sclerosing cholangitis in patients with ulcerative colitis: two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Se Hwan; Lee, Dong Ho; Choi, Dong Sik; Ko, Young Tae [Kyunghee University Hospital, Seoul (Korea, Republic of)

    1999-02-01

    Primary sclerosing cholangitis, a chronic cholestatic liver disease, is uncommon and is characterized by inflammation and fibrosis of the bile ducts. It frequently occurs in association with ulcerative colitis. We describe two cases of primary sclerosing cholangitis in patients with ulcerative colitis.

  13. Do We Eradicate Helicobacter pylori in Hospitalized Patients with Peptic Ulcer Disease?

    Directory of Open Access Journals (Sweden)

    Frank Wong

    2013-01-01

    Full Text Available BACKGROUND: Helicobacter pylori infection is the most common chronic infection in humans. It is a major contributor to the cause of duodenal and gastric ulcers worldwide. Its eradication has been shown to reduce rates of H pylori-related ulcers as well as other complications such as gastric cancer.

  14. The local immune response in ulcerative lesions of Buruli disease

    Science.gov (United States)

    Kiszewski, A E; Becerril, E; Aguilar, L D; Kader, I T A; Myers, W; Portaels, F; Hernàndez Pando, R

    2006-01-01

    Buruli disease (BU) is a progressive necrotic and ulcerative disease of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. BU is considered the third most common mycobacterial disease after tuberculosis and leprosy. Three clinical stages of the cutaneous lesions have been described in BU: pre-ulcerative, ulcerative and healed lesions. In this study we used immunohistochemistry and automated morphometry to determine the percentage of macrophages and of CD4/CD8 lymphocytes and their expression of interferon (IFN)-γ, interleukin (IL)-10, tumour necrosis factor (TNF)-α and transforming growth factor (TGF)-β. Expression of these cytokines was correlated with the inflammatory response evaluated by histopathology. All the studied BU ulcerative cases showed extensive necrosis and chronic inflammation. The most important feature was the presence or absence of granulomas co-existing with a mixed pro-inflammatory/anti-inflammatory cytokine balance. When granulomas were present significantly higher expression of IFN-γ was seen, whereas in ulcerative lesions without granulomas there was increased expression of IL-10 and significantly higher bacillary counts. These features correlated with the chronicity of the lesions; longer-lasting lesions showed granulomas. Thus, granulomas were absent from relatively early ulcerative lesions, which contained more bacilli and little IFN-γ, suggesting that at this stage of the disease strong suppression of the protective cellular immune response facilitates proliferation of bacilli. PMID:16487243

  15. Correlation between the levels of non-specific physical symptoms and pressure pain thresholds measured by algometry in patients with temporomandibular disorders.

    Science.gov (United States)

    Ramalho, D; Macedo, L; Goffredo Filho, G; Goes, C; Tesch, R

    2015-02-01

    Recent studies showed that patients with chronic TMD pain also feature increased sensitivity in other craniofacial regions, and even in remote peripheral areas, suggesting that nociceptive processing is centrally facilitated in this patient population. The aim of this study was to investigate the existence of a negative correlation between the levels of non-specific physical symptoms and pressure pain thresholds measured by algometry at sites distant from the chief complaint of oro-facial pain in patients with TMD. A total of 20 female patients were evaluated comprising 11 patients diagnosed with myofascial pain (Group I of RDC/TMD) and 9 patients with arthralgia (Group III of RDC/TMD), with both reporting chronic TMD pain for at least 3 months. Patients were tested by the pressure algometry technique, and, in the same visit, clinical diagnosis and levels of non-specific physical symptoms, including pain-related issues or not, were obtained. The raw scores were then standardised into a T-score. The possible correlation between the dependent variable levels of non-specific physical symptoms and pressure pain thresholds measured by algometry at sites distant from the chief complaint of oro-facial pain was assessed with Spearman's correlation coefficient. Results were considered statistically significant, which stood a lower than 5% probability of occurring by chance (P pain-related symptoms, and experimental pressure pain thresholds in patients with painful TMD.

  16. CASE STUDY OF LEECH APPLICATION IN DIABETIC FOOT ULCER

    Directory of Open Access Journals (Sweden)

    Amarprakash P. Dwivedi

    2012-10-01

    Full Text Available In diabetes, slight injury to the glucose laden tissue may cause chronic infection and ulcer formation. About 15% of all diabetic patients develops foot ulcer in their life time. The etiological factors include increased sugar level, diabetic micro angiopathy and peripheral neuropathy.Mainstay of treatment includes antibiotics, debridement, and local wound care and footwear improvisation. In spite of all advances in health sciences, statistics reveals that about 3% patients yet have to undergo lower limb amputation.In Sushrut samhita, we get the most scientific description of wound and its management. Similarly, Sushrut has given the utmost importance to Bloodletting therapy and considered Leech as the most unique and effective method of bloodletting even in infected wounds and abscesses.Aforesaid description led us to try Leech therapy in Diabetic foot ulcer. Patient with Diabetic foot ulcer was advised to continue anti diabetic medicine along with weekly application of Leech around the ulcer which was followed by dressing with Nimb-Haridra oil.This Leech therapy proved very effective and the ulcer healed completely within 30 days.However, further evaluation is required to be done by taking a large sample size to prove its significance in treating Diabetic foot ulcer and avoiding lower limb amputation.

  17. Topical application of amelogenin extracellular matrix protein in non-healing venous ulcers

    Directory of Open Access Journals (Sweden)

    Burçin Abud

    2014-12-01

    Full Text Available Background and Design: Treatment of chronic venous ulcers of the lower extremity is still an important difficulty. The principal treatment of these ulcers includes compression therapy, local wound care and surgery. Unresponsiveness to these standard treatments is a frequent situation with negative effects on life quality and reductions in personal productivity. Therefore, there is a need for new applications to increase the effectiveness of treatment in treatment-resistant cases. In the present study, we retrospectively evaluated the results of topical application of amelogenin extracellular matrix protein in resistant venous ulcers. Materials and Methods: We analyzed the records of patients with treatment-resistant venous ulceration who were treated with amelogenin extracellular matrix protein between June 2011 and December 2012.. Results: 26 patients (21 male and 5 female with a total number of 28 ulcers (24 patients with 1 ulcer, 2 patients with two ulcers were evaluated. The patients were treated with topically applied amelogenin extracellular matrix protein and regional four bandage compression. Bandages were changed weekly. Each cure continued for six weeks. In fourteen patients (15 ulcers, we observed a complete healing by the end of the first cure. In another twelve cases (13 ulcers, the same period resulted with a reduction in wound diameter. We continued to the second cure for these patients. By the end of the second cure, complete healing was achieved in five cases (6 ulcers. Conclusion: Topical application of amelogenin extracellular matrix protein may be considered as an effective therapeutic choice for refractory venous ulcers.

  18. Quality of healing of gastric ulcers: Natural products beyond acid suppression.

    Science.gov (United States)

    Kangwan, Napapan; Park, Jong-Min; Kim, Eun-Hee; Hahm, Ki Baik

    2014-02-15

    Gastric ulcer is a chronic disease featured with unexpected complications, including bleeding, stenosis and perforation, as well as a high incidence of recurrence. Clinical treatments for gastric ulcer have allowed the rapid development of potent anti-ulcer drugs during the last several decades. Gastric ulcer healing is successful with conventional treatments including H2-receptor antagonists, and proton pump inhibitors (PPIs) have been essential for ulcer healing and prevention of complications. Additionally, Helicobacter pylori eradication therapy is effective in reducing ulcer recurrence and leads to physiological changes in the gastric mucosa which affect the ulcer healing process. However, in spite of these advancements, some patients have suffered from recurrence or intractability in spite of continuous anti-ulcer therapy. A new concept of the quality of ulcer healing (QOUH) was initiated that considers the reconstruction of the mucosal structure and its function for preventing ulcer recurrence. Although several gastroprotection provided these achievements of the QOUH, which PPI or other acid suppressants did not accomplish, we found that gastroprotection that originated from natural products, such as a newer formulation from either Artemisia or S-allyl cysteine from garlic, were very effective in the QOUH, as well as improving clinical symptoms with fewer side effects. In this review, we will introduce the importance of the QOUH in ulcer healing and the achievements from natural products.

  19. Management of parastomal ulcers

    Institute of Scientific and Technical Information of China (English)

    Heather Yeo; Farshad Abir; Walter E Longo

    2006-01-01

    Management of surgically placed ostomies is an important aspect of any general surgical or colon and rectal surgery practice. Complications with surgically placed ostomies are common and their causes are multifactorial. Parastomal ulceration, although rare, is a particularly difficult management problem. We conducted a literature search using MD Consult, Science Direct,OVID, Medline, and Cochrane Databases to review the causes and management options of parastomal ulceration. Both the etiology and treatments are varied.Different physicians and ostomy specialists have used a large array of methods to manage parastomal ulcers;these including local wound care; steroid creams;systemic steroids; and, when conservative measures fail, surgery. Most patients with parastomal ulcers who do not have associated IBD or peristomal pyoderma gangrenosum (PPG) often respond quickly to local wound care and conservative management. Patients with PPG,IBD,or other systemic causes of their ulceration need both systemic and local care and are more likely to need long term treatment and possibly surgical revision of the ostomy. The treatment is complicated, but improved with the help of ostomy specialists.

  20. Prediction of Pressure Ulcer by Combination of Braden Scale Score and Acute Physiology and Chronic Health EvaluationⅡ Score%Braden 量表评分联合急性生理学与慢性健康状况评分系统Ⅱ评分预测压疮发生的价值

    Institute of Scientific and Technical Information of China (English)

    郝娜; 张建波; 高冰洁; 周平

    2016-01-01

    Background Pressure ulcer assessment is a crucial step in the nursing of pressure ulcer. Braden Scale is a widely used evaluation tool in current assessment of pressure ulcer,but there are limitations in the risk prediction of pressure ulcer in clinic. Objective To evaluate the value of Braden Scale score combined with acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in pressure ulcer prediction. Methods 310 patients reported by clinic departments(including ICU,CCU,Department of Cardiovascular Disease, Liver Disease, Oncology, Nephrology, Orthopaedics, Emergency, etc. ) from Traditional Chinese Medicine Hospital in Chongqing from June 2014 to June 2015 were selected as the research objects. Patients'scores of Braden Scale and APACHE Ⅱ were collected. The patients scored not more than 12 in Braden Scale were predicted as high - risk pressure ulcer,while those who scored greater than 12 were low - risk pressure ulcer;the patients scored not more than 12 in Braden Scale and not less than 15 in APACHE Ⅱ were predicted as high - risk pressure ulcer,otherwise they would be taken as low - risk pressure ulcer. The receiver operating characteristic(ROC)curve was predicted by Braden Scale or Braden Scale score combined with APACHE Ⅱ score. The areas under curve ( AUC) of ROC,sensibility,specificity,positive predictive value and negative predictive value were also calculated. Results 57 patients developed pressure ulcer,and 253 patients didn't among the 310 inpatients. The 310 patients were predicted as high - risk pressure ulcer and 0 patients were low -risk pressure ulcer by Braden Scale score. The AUC of the occurrence of pressure ulcer predicted by Braden Scale score was 0. 326,95% CI( 0. 241,0. 410 );with 12 as the critical value,the sensitivity,specificity,positive predictive value, negative predictive value,and Youden's index of predicting the occurrence of pressure ulcer were 100% ,0,18. 4% ,0, 18. 4% ,0,and 0 respectively. 63 high - risk

  1. RECURRENT MARJOLIN’S ULCER WITH REGIONAL LYMPH NODE METASTASIS

    Directory of Open Access Journals (Sweden)

    Anjali

    2012-11-01

    Full Text Available ABSTRACT: Marjolin’s ulcer is a malignant tumour developing in a chronic skin lesion (burn scar, vaccination scar, non-healing wound etc.. Th e majority of cases reported are squamous cell carcinoma. Surgery remains the first treatment of choice (resection with 2cms. safety margin of healthy skin for primary squamous cell car cinoma Marjolin ulcers and 2.5cms. safety margin for recurrent cases. Recurrence after surge ry and regional lymph node metastasis are not uncommon (17% & 30% respectively.We presents a c ase report and literature review of Recurrent Marjolin’s Ulcer with regional Lymph Node Metastasis. Marjolin's ulcer should be considered as a significant post-burn complication; i t should be treated with full emphasis on adequate local clearance and regular follow up for m any years; if not treated adequately, it may lead to complicated recurrence.

  2. Brunner's glands of the rat during cysteamine ulceration

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1981-01-01

    in the histologic appearance of the duodenal glands of Brunner during ulcer formation. The secretory cells became extremely flattened without mucus content and the lumina of the acini dilated. Changes became most pronounced between 4 and 8 h after administration of cysteamine. Repeated injections of pentagastrin...... in a dosage inducing an acid response equivalent to the one induced by cysteamine did not produce any histologic changes in Brunner's glands or any ulcerations. When cysteamine was administered to rats with chronic gastric fistulas draining the gastric secretions, no duodenal ulcerations were produced......, but Brunner's glands still became depleted of mucus. These findings suggest that the histologic changes in Brunner's glands are not secondary either to the increased acid secretion induced by cysteamine or to ulcer formation. Together with our previous demonstration of a marked reduction duodenal secretion...

  3. Biofilms in chronic wounds.

    Science.gov (United States)

    James, Garth A; Swogger, Ellen; Wolcott, Randall; Pulcini, Elinor deLancey; Secor, Patrick; Sestrich, Jennifer; Costerton, John W; Stewart, Philip S

    2008-01-01

    Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. It has been speculated that bacteria colonizing chronic wounds exist as highly persistent biofilm communities. This research examined chronic and acute wounds for biofilms and characterized microorganisms inhabiting these wounds. Chronic wound specimens were obtained from 77 subjects and acute wound specimens were obtained from 16 subjects. Culture data were collected using standard clinical techniques. Light and scanning electron microscopy techniques were used to analyze 50 of the chronic wound specimens and the 16 acute wound specimens. Molecular analyses were performed on the remaining 27 chronic wound specimens using denaturing gradient gel electrophoresis and sequence analysis. Of the 50 chronic wound specimens evaluated by microscopy, 30 were characterized as containing biofilm (60%), whereas only one of the 16 acute wound specimens was characterized as containing biofilm (6%). This was a statistically significant difference (p<0.001). Molecular analyses of chronic wound specimens revealed diverse polymicrobial communities and the presence of bacteria, including strictly anaerobic bacteria, not revealed by culture. Bacterial biofilm prevalence in specimens from chronic wounds relative to acute wounds observed in this study provides evidence that biofilms may be abundant in chronic wounds.

  4. Microsurgical Treatment of Mooren's Ulcer

    Institute of Scientific and Technical Information of China (English)

    Hanping Xie; Jiaqi Chen; Xiangming Gong; Chunmao Feng; Longshan Chen; Yuesheng Lin

    2000-01-01

    Objective: To evaluate effect of microsurgery of lamellar keratoplasty (LKP) on Mooren's corneal ulcer.Methods: The effect, postoperative astigmatism, postoperative vision, ulcer recurrence of postoperation, and surgical complications of two groups of consecutive Mooren's ulcer inpatients treated respectively by non-microsurgery of LKP and microsurgery of LKP were analyzed.Results:There were significant differences of the effect, postoperative astigmatism,postoperative vision, ulcer recurrence of postoperation, and surgical complications between the two groups. The effect and postoperative vision of the microsurgery-treated groupwerebetterthanthoseofthenon-microsurgery-treatedgroup. The postoperative astigmatism, ulcer recurrence of postoperation, and surgical complications of the microsurgery-treated group were less than those of the nonmicrosurgery-treated group.Conclusion: Microsurgery of LKP of Mooren's corneal ulcer can greatly improve the ulcer healing and postoperative vision, and reduce the surgical complication and the ulcer recurrence of postoperation. Eye Science 2000; 16:56 ~ 60.

  5. Prognostic stratification of ulcerated melanoma

    DEFF Research Database (Denmark)

    Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib J

    2014-01-01

    OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We...... stratification of ulcerated lesions. METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma. RESULTS: The presence...... of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal...

  6. Treatment for Peptic Ulcer Disease

    Science.gov (United States)

    ... Protectants Protectants coat ulcers and protect them against acid and enzymes so that healing can occur. Doctors only prescribe one protectant— sucralfate (Carafate) —for peptic ulcer disease. Tell your doctor if the medicines make you ...

  7. 回阳生肌膏对慢性皮肤溃疡形态变化的初步研究%A preliminary study on Huiyang Shengji Ointment to chronic skin ulcers of the morphological changes

    Institute of Scientific and Technical Information of China (English)

    王广宇; 王伏声; 丁毅; 康煜冬; 李勇; 王雨; 董雨; 徐旭英

    2014-01-01

    目的:探讨回阳生肌膏治疗慢性皮肤溃疡腐肉、肉芽、脓液及组织HE染色形态变化规律。方法收集首都医科大学附属北京中医医院2012年11月~2013年11月40例局部辨证为寒湿凝滞证慢性疮面患者,随机分为两组,治疗组应用回阳生肌膏纱条,对照组按照常规方法进行。观察两组治疗前后疮面形态评分和治疗前后皮下组织HE染色变化情况。结果对照组总的评分治疗前为(29.1±5.7)分,治疗组为(28.4±6.1)分,差异无统计学意义(P>0.05);对照组治疗后为(25.7±5.4)分,与治疗前比较,差异有统计学意义(P 0.05); the total score of the control group was (25.7±5.4) scores after the treatment, compared with the control group, the difference was statistically significant (P<0.05). The total score of the treatment group was (22.9±6.8) scores, compared with the treat-ment group, the difference was statistically significant (P < 0.05). The comparison between the control group and the treatment group showed that, the difference was statistically significant (P<0.05). The subcutaneous tissue HE staining showed that there were more inflammatory cells before treatment, endothelial cells and fibroblasts were less and thin, and they sprawled out in some areas, collagen fibers were dyed pale; there were less inflammatory cells after treatment, endothelial cells and fibroblasts were more and well-stacked, they distribute regularly, ollagen fibers were dyed dark. Healing trend was better in the treatment group than in the control group. Conclusion Warming Yang and Invigorating Qi, the main effect of Huiyang Shengji Ointment, can make chronic skin ulcer w ound turn "Yin" into "Yang", and turn "Static" into "Dynamic", so that the speed of wound healing will be accelerated.

  8. [Peripheral ulcerative keratitis].

    Science.gov (United States)

    Stamate, Alina-cristina; Avram, Corina Ioana; Malciolu, R; Oprea, S; Zemba, M

    2014-01-01

    Ulcerative keratitis is frequently associated with collagen vascular diseases and presents a predilection for peripheral corneal localization, due to the distinct morphologic and immunologic features of the limbal conjunctiva, which provides access for the circulating immune complexes to the peripheral cornea via the capillary network. Deposition of immune complexes in the terminal ends of limbal vessels initiates an immune-mediated vasculitis process, with inflammatory cells and mediators involvement by alteration of the vascular permeability. Peripheral ulcerative keratitis generally correlates with exacerbations of the background autoimmune systemic disease. Associated sceritis, specially the necrotizing form, is usually observed in severe cases, which may evolve in corneal perforation and loss of vision. Although the first-line of treatment in acute phases is represented by systemic administration of corticosteroids, immunosuppressive and cytotoxic agents are necessary for the treatment of peripheral ulcerative keratitis associated with systemic diseases.

  9. Ulcer disease of trout

    Science.gov (United States)

    Fish, F.F.

    1934-01-01

    During the summer of 1933, lesions of a disease were noted among some fingerling brook, rainbow, blackspotted, and lake trout at the Cortland (New York) trout hatchery. Although these lesions bore a marked superficial resemblance to those of furunculosis, they were sufficiently atypical to warrant further investigation. A more detailed examination of the lesions proved them to be of a distinct disease, which for lack of a better name is herein called "ulcer disease," for the lesions closely resemble those described by Calkins (1899) under this name. Because of the marked resemblance to furunculosis, ulcer disease has not been generally recognized by trout culturists, and any ulcer appearing on fish has been ascribed by them to furunculosis without further question.

  10. Local administration of autologous platelet-rich plasma in a female patient with skin ulcer defect

    Directory of Open Access Journals (Sweden)

    S M Noskov

    2011-01-01

    Full Text Available The paper describes a clinical observation of the efficiency of local therapy with autologous platelet-rich plasma for .skin ulcer defect in a female with chronic lymphocytic leukemia

  11. Intestinal Behcet's disease with esophageal ulcers and colonic longitudinal ulcers

    Institute of Scientific and Technical Information of China (English)

    Soichiro Fujiwara; Ichiro Shimizu; Momoko Ishikawa; Kohzo Uehara; Hirofumi Yamamoto; Michiyo Okazaki; Takahiro Horie; Arata Iuchi; Susumu Ito

    2006-01-01

    Intestinal Behcet's disease in a 38-year-old woman was diagnosed because of the history of recurrent oral aphthous ulcers, erythema nodosum-like eruptions,genital ulcer, and endoscopic findings of esophageal and ileocolonic punched-out ulcers with colonic longitudinal ulcers. Esophageal lesions and colonic longitudinalulcers are rarely seen in intestinal Behcet's disease. The ulcers of esophagus and ileocolon healed with 3 wk of treatment with prednisolone and mesalazine without any adverse effect. Mesalazine may decrease the total dose of prednisolone required to treat the disease.

  12. Ileal pouch surgery for ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Simon P Bach; Neil J Mortensen

    2007-01-01

    Ulcerative colitis (UC) is a relapsing and remitting disease characterised by chronic mucosal and submucosal inflammation of the colon and rectum.Treatment may vary depending upon the extent and severity of inflammation. Broadly speaking medical treatments aim to induce and then maintain remission.Surgery is indicated for inflammatory disease that is refractory to medical treatment or in cases of neoplastic transformation. Approximately 25% of patients with UC ultimately require colectomy. Ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis who ultimately require colectomy. This review will examine indications for IPAA, patient selection, technical aspects of surgery,management of complications and long term outcome following this procedure.

  13. Applying mixture toxicity modelling to predict bacterial bioluminescence inhibition by non-specifically acting pharmaceuticals and specifically acting antibiotics.

    Science.gov (United States)

    Neale, Peta A; Leusch, Frederic D L; Escher, Beate I

    2017-04-01

    Pharmaceuticals and antibiotics co-occur in the aquatic environment but mixture studies to date have mainly focused on pharmaceuticals alone or antibiotics alone, although differences in mode of action may lead to different effects in mixtures. In this study we used the Bacterial Luminescence Toxicity Screen (BLT-Screen) after acute (0.5 h) and chronic (16 h) exposure to evaluate how non-specifically acting pharmaceuticals and specifically acting antibiotics act together in mixtures. Three models were applied to predict mixture toxicity including concentration addition, independent action and the two-step prediction (TSP) model, which groups similarly acting chemicals together using concentration addition, followed by independent action to combine the two groups. All non-antibiotic pharmaceuticals had similar EC50 values at both 0.5 and 16 h, indicating together with a QSAR (Quantitative Structure-Activity Relationship) analysis that they act as baseline toxicants. In contrast, the antibiotics' EC50 values decreased by up to three orders of magnitude after 16 h, which can be explained by their specific effect on bacteria. Equipotent mixtures of non-antibiotic pharmaceuticals only, antibiotics only and both non-antibiotic pharmaceuticals and antibiotics were prepared based on the single chemical results. The mixture toxicity models were all in close agreement with the experimental results, with predicted EC50 values within a factor of two of the experimental results. This suggests that concentration addition can be applied to bacterial assays to model the mixture effects of environmental samples containing both specifically and non-specifically acting chemicals.

  14. Depression Is Associated with Repeat Emergency Department Visits in Patients with Non-specific Abdominal Pain

    Directory of Open Access Journals (Sweden)

    Andrew Charles Meltzer

    2014-05-01

    Full Text Available Introduction: Patients with abdominal pain often return multiple times despite no definitive diagnosis. Our objective was to determine if repeat emergency department (ED use among patients with non-specific abdominal pain might be associated with a diagnosis of moderate to severe depressive disorder. Methods: We screened 987 ED patients for major depression during weekday daytime hours from June 2011 through November 2011 using a validated depression screening tool, the PHQ-9. Each subject was classified as either no depression, mild depression or moderate/ severe depression based on the screening tool. Within this group, we identified 83 patients with non-specific abdominal pain by either primary or secondary diagnosis. Comparing depressed patients versus non-depressed patients, we analyzed demographic characteristics and number of prior ED visits in the past year. Results: In patients with non-specific abdominal pain, 61.9% of patients with moderate or severe depression (PHQ9≥10 had at least one visit to our ED for the same complaint within a 365-day period, as compared to 29.2% of patients with no depression (PHQ9<5, (p=0.013. Conclusion: Repeat ED use among patients with non-specific abdominal pain is associated with moderate to severe depressive disorder. Patients with multiple visits for abdominal pain may benefit from targeted ED screening for depression.

  15. Optimization of the BLASTN substitution matrix for prediction of non-specific DNA microarray hybridization

    DEFF Research Database (Denmark)

    Eklund, Aron Charles; Friis, Pia; Wernersson, Rasmus;

    2010-01-01

    DNA microarray measurements are susceptible to error caused by non-specific hybridization between a probe and a target (cross-hybridization), or between two targets (bulk-hybridization). Search algorithms such as BLASTN can quickly identify potentially hybridizing sequences. We set out to improve...

  16. The characteristics and clinical manifestation of subjects with non-specific pattern of pulmonary function tests

    Institute of Scientific and Technical Information of China (English)

    周德训

    2014-01-01

    Objective To analyze the characteristics of pulmonary function and the clinical significance of non-specific pattern(NSP).Methods A total of 1 933 pulmonary function tests of adult patients were analyzed,and those with NSP were selected.The pulmonary function test results,clinical diagnosis and radiological manifestations were

  17. An unusual case of spontaneous Mycobacterium chelonae corneal ulcer in a healthy middle-aged adult

    OpenAIRE

    Bhandari V; Sriganesh R; Relekar K

    2016-01-01

    Vipul Bhandari, R Sriganesh, Kirti RelekarDepartment of Cornea, Nethradhama Eye Hospital, Bengaluru, IndiaBackground: To report a rare presentation of culture-positive Mycobacterium chelonae corneal ulcer and its management.Findings: We report a rare case of a patient with a history of chronic pain and blurriness of vision. Examination revealed a chronic nonhealing paracentral corneal ulcer inferiorly at the 5–7 o'clock meridian with anterior chamber reaction unresponsive to...

  18. A chronic ulcerative colitis model in rats

    Institute of Scientific and Technical Information of China (English)

    Li Zheng; Zhen Qiang Gao; Shu Xian Wang

    2000-01-01

    @@ INTRODUCTION In recent years, there have been many reports about animal model to investigate drugs for inflammatory bowel diseases (IBD). The experimental animal model often used is acetic acid-induced damage of colonic muscosa. In the present study, this animal model was investigated by administering various concentrations of TNBS.

  19. Hydrophobic fluorescent probes introduce artifacts into single molecule tracking experiments due to non-specific binding.

    Science.gov (United States)

    Zanetti-Domingues, Laura C; Tynan, Christopher J; Rolfe, Daniel J; Clarke, David T; Martin-Fernandez, Marisa

    2013-01-01

    Single-molecule techniques are powerful tools to investigate the structure and dynamics of macromolecular complexes; however, data quality can suffer because of weak specific signal, background noise and dye bleaching and blinking. It is less well-known, but equally important, that non-specific binding of probe to substrates results in a large number of immobile fluorescent molecules, introducing significant artifacts in live cell experiments. Following from our previous work in which we investigated glass coating substrates and demonstrated that the main contribution to this non-specific probe adhesion comes from the dye, we carried out a systematic investigation of how different dye chemistries influence the behaviour of spectrally similar fluorescent probes. Single-molecule brightness, bleaching and probe mobility on the surface of live breast cancer cells cultured on a non-adhesive substrate were assessed for anti-EGFR affibody conjugates with 14 different dyes from 5 different manufacturers, belonging to 3 spectrally homogeneous bands (491 nm, 561 nm and 638 nm laser lines excitation). Our results indicate that, as well as influencing their photophysical properties, dye chemistry has a strong influence on the propensity of dye-protein conjugates to adhere non-specifically to the substrate. In particular, hydrophobicity has a strong influence on interactions with the substrate, with hydrophobic dyes showing much greater levels of binding. Crucially, high levels of non-specific substrate binding result in calculated diffusion coefficients significantly lower than the true values. We conclude that the physic-chemical properties of the dyes should be considered carefully when planning single-molecule experiments. Favourable dye characteristics such as photostability and brightness can be offset by the propensity of a conjugate for non-specific adhesion.

  20. Hydrophobic fluorescent probes introduce artifacts into single molecule tracking experiments due to non-specific binding.

    Directory of Open Access Journals (Sweden)

    Laura C Zanetti-Domingues

    Full Text Available Single-molecule techniques are powerful tools to investigate the structure and dynamics of macromolecular complexes; however, data quality can suffer because of weak specific signal, background noise and dye bleaching and blinking. It is less well-known, but equally important, that non-specific binding of probe to substrates results in a large number of immobile fluorescent molecules, introducing significant artifacts in live cell experiments. Following from our previous work in which we investigated glass coating substrates and demonstrated that the main contribution to this non-specific probe adhesion comes from the dye, we carried out a systematic investigation of how different dye chemistries influence the behaviour of spectrally similar fluorescent probes. Single-molecule brightness, bleaching and probe mobility on the surface of live breast cancer cells cultured on a non-adhesive substrate were assessed for anti-EGFR affibody conjugates with 14 different dyes from 5 different manufacturers, belonging to 3 spectrally homogeneous bands (491 nm, 561 nm and 638 nm laser lines excitation. Our results indicate that, as well as influencing their photophysical properties, dye chemistry has a strong influence on the propensity of dye-protein conjugates to adhere non-specifically to the substrate. In particular, hydrophobicity has a strong influence on interactions with the substrate, with hydrophobic dyes showing much greater levels of binding. Crucially, high levels of non-specific substrate binding result in calculated diffusion coefficients significantly lower than the true values. We conclude that the physic-chemical properties of the dyes should be considered carefully when planning single-molecule experiments. Favourable dye characteristics such as photostability and brightness can be offset by the propensity of a conjugate for non-specific adhesion.

  1. Peptic Ulcer Disease

    Science.gov (United States)

    ... include:Protein pump inhibitors, like esomeprazole (Nexium) or lansoprazole (Prevacid).Histamine receptor blockers, like famotidine (Pepcid) or ranitidine (Zantac).Protectants, like sucralfate (Carafate).If using NSAIDs caused your peptic ulcer and there’s no H. pylori infection, you may ...

  2. Perforated peptic ulcer

    DEFF Research Database (Denmark)

    Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M

    2015-01-01

    Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacte...

  3. Chronic gastritis.

    Science.gov (United States)

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-06-01

    Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understanding of the bizarre epidemiology and course of the disease. A life-long and aggressive inflammation in gastritis results in destruction (atrophic gastritis) of stomach mucosa with time (years and decades). The progressive worsening of atrophic gastritis results subsequently in dysfunctions of stomach mucosa. Atrophic gastritis will finally end up in a permanently acid-free stomach in the most extreme cases. Severe atrophic gastritis and acid-free stomach are the highest independent risk conditions for gastric cancer known so far. In addition to the risks of malignancy and peptic ulcer, acid-free stomach and severe forms of atrophic gastritis may associate with failures in absorption of essential vitamins, like vitamin B12, micronutrients (like iron, calcium, magnesium and zinc), diet and medicines.

  4. Transversal escharotomies: a new surgical technique adjuvant in the treatment of chronic ulcers with non-arterial etiology in the lower limbs Escarotomias transversais: uma nova opção cirúrgica adjuvante no tratamento de úlceras crônicas de etiologia não arterial em membros inferiores

    Directory of Open Access Journals (Sweden)

    Mário Augusto Silva Freitas

    2006-01-01

    Full Text Available PURPOSE: Propose a new and alternative surgical procedure in order to aid on treatments of chronic ulcers with non-arterial etiology in the lower limbs, especially those that reoccurs and accomplish of dermatosclerosis and skin contractures determining ankle and foot limits. METHODS: It describes a medical case regarding a female, 54 years old, with a pre-existing ulcer (sixteen years on her left leg. Despite of conventional treatments such as curatives, compressive therapy and surgeries, the ulcer on her leg was not cured for three years. The skin dermatosclerosis on her foot and ankle limited her mobility tremendously. The surgery involved the debridement of the ulcers, local phlebectomies and the correction of her scar contraction by a transversal escharotomies. Conventional procedures were applied in pre and post-surgery. RESULTS: After twelve weeks, the ulcer was completely healed by second intention. Despite the odds, she regained sustainable mobility in her foot and ankle, allowing this patient to wear medical elastic socks. Reoccurrences of the ulcer did not occur during the two years post-surgery. CONCLUSION: The transversal escharotomies may favor the healing of non-arterial chronic ulcers in the lower limbs, impeding perpetual mechanisms of this sort. For example, the ankle and foot limitation determinates in secondary scars, skin contractures, dermatosclerosis that produce the failure in the muscular calf-pump with deterioration in the ascending venous propulsion.OBJETIVO: Apresentar uma nova alternativa cirúrgica para auxiliar o tratamento de úlceras crônicas de etiologia não arterial em membros inferiores, especialmente aquelas com recidivas e complicadas por contraturas de pele, limitando movimentos do pé e tornozelo. MÉTODOS: Descrição de caso de uma paciente portadora de úlcera em perna esquerda com dezesseis anos de evolução, múltiplas recidivas, sem cicatrização há três anos apesar de curativos convencionais

  5. Arteriovenous shunt graft ulceration with sinus and graft epithelialization

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2015-03-01

    Full Text Available Arteriovenous fistula and grafts are used as access sites for patients with chronic kidney disease and are prone for complications. Stent grafts are used to treat access site complications. We report a rare and unusual finding of epithelialization of the sinus tract and the lumen of a polytetrafluoroethylene graft, following ulceration of the overlying skin.

  6. [Cultured epidermis in the treatment of leg ulcer: "edge effect" and correlation with keratinocyte proliferation index].

    Science.gov (United States)

    Giannotti, V; Pimpinelli, N; Mariotti, V; Borgognoni, L; Reali, U M

    1990-04-01

    Cultured keratinocyte grafting (KG) of chronic leg ulcers produces an impressive stimulation of host epithelization by an effect on the edge of the ulcer, which starts to grow in rapidly ("edge effect"). In 5 patients with chronic leg ulcers treated by KG, we have studied the proliferation index of the epidermis of the edge and of the graft area and that of secondary culture keratinocytes. The aim of the study was to correlate this parameter with the clinical evolution of the treated lesions. We found a significant correlation between the proliferation index of the edge epidermis and the clinical evidence of "edge effect".

  7. THALIDOMIDE: A THERAPEUTIC BOON IN THE MANAGEMENT OF RECURRENT GENITAL APHTHOUS ULCERATION IN AN IMMUNOCOMPROMISED INDIVIDUAL

    Directory of Open Access Journals (Sweden)

    Madhubabu

    2016-06-01

    Full Text Available Genital lesions are common in Human Immunodeficiency Virus (HIV positive patients. Aetiology of the genital lesions are mainly due to Herpes Simplex Virus (HSV, Human Papilloma Virus (HPV and non-specific genital ulcers. They usually respond to the antiviral and antibacterial agents. We are presenting a young unmarried HIV positive and Hepatitis-B positive patient who presented with non-healing genital ulcer lesions while on antiretroviral therapy and showed variable response and challenges to treatment with antivirals, steroids, antibacterials and change of ART and finally dramatic response with Thalidomide therapy which is rarely described in the literature.

  8. Marjolin's ulcers: theories, prognostic factors and their peculiarities in spina bifida patients

    Directory of Open Access Journals (Sweden)

    Nthumba Peter M

    2010-12-01

    Full Text Available Abstract Background Due to improved care, more and more children born with spina bifida in rural Kenya are surviving into adulthood. This improved survival has led to significant challenges in their lifestyles, especially the need to ensure pressure ulcer prevention and treatment. Malignant degeneration of pressure ulcers in spina bifida patients is very rare. The author describes the clinical presentation of two pressure ulcer carcinomas that are at variance from classical descriptions. Materials and methods An internet/Medline/PubMed search of English literature for theories on Marjolin's ulcer evolution and prognostic features of Marjolin's ulcers was performed. A chart review of two young adults with spina bifida who had presented to the author's hospital between 2004 and August 2010 with chronic pressure ulcers found to be Marjolin's ulcers on histo-pathological examination was performed, and the clinical features are reported. Results The two ulcers appeared clinically benign: one was a deep ulcer, while the other was shallow; both had normal, benign-appearing edges, and a foul smelling discharge. The two ulcers were surrounded by induration and multiple communicating sinuses, with no evidence of chronic osteomyelitis. The internet search revealed a total of nine theories on Marjolin's ulcer development, as well as seven clinical and four histological prognostic features. Discussion The multifactorial theory, a coalescence of a number of proposed theories, best explains the evolution of Marjolin's ulcers. Poor prognostic features include pressure ulcer carcinomas, lesions and location in the lower limbs/trunks, all present in the two patients making their prognosis dim: this is despite the surgical margins being clear of tumor. Benign appearance, induration and presence of multiple communicating sinuses are features that have not been previously described as presenting features of pressure ulcers carcinomas. Conclusion There is need for

  9. Anti-ulcer effects of Lycium barbarum polysaccharide in rats

    Institute of Scientific and Technical Information of China (English)

    YE Rui-dong; YANG Qian-zi; XIAO Wei; LIU Fang-e; CHEN Jian-kang

    2005-01-01

    Objective: To investigate the effects of Lycium barbarum polysaccharide (LBP) on experimental gastric ulcers in rats. Methods: The ulcers were induced by water-immersion restraint stress, acetic acid and pylorus-ligation in rats. In each model, animals were divided randomly into 4 groups and administrated with LBP of 100 mg/kg and 300 mg/kg, ranitidine 100 mg/kg (as a reference standard) and saline respectively. Mucosal lesions were scored as ulcer index. In the pylorus-ligation model, we also compared the gastric juice volume, total acidity, acid output and pepsin activity among groups. Results: Oral administration of LBP inhibited the formation of the acute gastric lesions induced by physical stress such as water-immersion restraint (P<0.05), and accelerated the healing of chronic gastric ulcer model induced by acetic acid (P<0.05 to P<0.01). In the pylorus-ligated rats, significant decrease was also seen in ulcer index (P<0.05 to P<0.01), total acidity (P<0.05), acid output (P<0.05 to P<0.01). LBP 300 mg/kg even showed marked reduction of the volume (P<0.05) and pepsin activity (P<0.05) in the gastric juice. These effects were in a dose-dependent manner. Conclusion: LBP has protective effects on treating gastric ulcer and this action may relate to the reduction of acid output and pepsin activity in the gastric juice.

  10. Vascular leg ulcers: histopathologic study of 293 patients.

    Science.gov (United States)

    Misciali, Cosimo; Dika, Emi; Baraldi, Carlotta; Fanti, Pier Alessandro; Mirelli, Michele; Stella, Andrea; Bertoncelli, Marco; Patrizi, Annalisa

    2014-12-01

    Vascular leg ulcers remain a challenge for the modern health care, and a systematic pathological study on this kind of lesions has not been reported so far. A total of 293 consecutive white patients with chronic leg ulcers (present for a minimum of 6 months and up to several years) referred to the Wound Care Unit (Dermatology, University of Bologna) between March 2008 and June 2011. Thirty-four patients affected by other than vascular ulcers, neoplastic or inflammatory conditions, were excluded. The remaining 259 patients affected by vascular leg ulcers were enrolled in this study. Assessment of the patients general health, skin biopsy, and vascular Doppler of the lower limbs were performed to determine the etiology and to formulate an appropriate management plan, whereas 2 punch biopsies of 3 mm were performed on the border and on the bed of each ulcer. Doppler evaluation showed the presence of vascular hemodynamic impairment in 259 patients. Of these, 181 (69.9%) patients were affected by venous insufficiency, 58 (22.4%) by venous and arterial insufficiency, and 20 (7.7%) by arterial insufficiency. Histopathologic features revealed significant differences, thus, reflecting the clinicopathologic correlation with the underlying hemodynamic impairments. In conclusion, histopathologic and hemodynamic data correlation could provide the basis for future analysis of leg ulcers pathogenesis and may improve treatment protocols. We should underline that this observational study represents a single-institute experience and that larger series are needed to confirm our observations.

  11. Gastroretentive drug delivery systems for therapeutic management of peptic ulcer.

    Science.gov (United States)

    Garg, Tarun; Kumar, Animesh; Rath, Goutam; Goyal, Amit K

    2014-01-01

    A peptic ulcer, stomach ulcer, or gastric ulcer, also known as peptic ulcer disease (PUD), is a very common chronic disorder of the stomach which is mainly caused by damage or impairment of the stomach lining. Various factors such as pepsin, gastric acid, H. pylori, NSAIDs, prostaglandins, mucus, bicarbonate, and blood flow to mucosa play an important role in causing peptic ulcers. In this review article, our main focus is on some important gastroretentive drug delivery systems (GRDDS) (floating, bioadhesive, high density, swellable, raft forming, superporous hydrogel, and magnetic systems) which will be helpful in gastroretention of different dosage forms for treatment of peptic ulcer. GRDDS provides a mean for controlled release of compounds that are absorbed by active transport in the upper intestine. It also enables controlled delivery for paracellularly absorbed drugs without a decrease in bioavailability. The above approaches are specific for targeting and leading to a marked improvement in the quality of life for a large number of patients. In the future, it is expected that they will become of growing significance, finally leading to improved efficiencies of various types of pharmacotherapies.

  12. Venous ulcers of the lower limb: Where do we stand?

    Directory of Open Access Journals (Sweden)

    Chatterjee S Sasanka

    2012-01-01

    Full Text Available Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  13. Venous ulcers of the lower limb: Where do we stand?

    Science.gov (United States)

    Chatterjee, Sasanka S

    2012-05-01

    Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  14. Vaccination with lipid core peptides fails to induce epitope-specific T cell responses but confers non-specific protective immunity in a malaria model.

    Directory of Open Access Journals (Sweden)

    Simon H Apte

    Full Text Available Vaccines against many pathogens for which conventional approaches have failed remain an unmet public health priority. Synthetic peptide-based vaccines offer an attractive alternative to whole protein and whole organism vaccines, particularly for complex pathogens that cause chronic infection. Previously, we have reported a promising lipid core peptide (LCP vaccine delivery system that incorporates the antigen, carrier, and adjuvant in a single molecular entity. LCP vaccines have been used to deliver several peptide subunit-based vaccine candidates and induced high titre functional antibodies and protected against Group A streptococcus in mice. Herein, we have evaluated whether LCP constructs incorporating defined CD4(+ and/or CD8(+ T cell epitopes could induce epitope-specific T cell responses and protect against pathogen challenge in a rodent malaria model. We show that LCP vaccines failed to induce an expansion of antigen-specific CD8(+ T cells following primary immunization or by boosting. We further demonstrated that the LCP vaccines induced a non-specific type 2 polarized cytokine response, rather than an epitope-specific canonical CD8(+ T cell type 1 response. Cytotoxic responses of unknown specificity were also induced. These non-specific responses were able to protect against parasite challenge. These data demonstrate that vaccination with lipid core peptides fails to induce canonical epitope-specific T cell responses, at least in our rodent model, but can nonetheless confer non-specific protective immunity against Plasmodium parasite challenge.

  15. Non-specific SIRT inhibition as a mechanism for the cytotoxicity of ginkgolic acids and urushiols.

    Science.gov (United States)

    Ryckewaert, Lucie; Sacconnay, Lionel; Carrupt, Pierre-Alain; Nurisso, Alessandra; Simões-Pires, Claudia

    2014-09-02

    Ginkgolic acids and urushiols are natural alkylphenols known for their mutagenic, carcinogenic and genotoxic potential. However, the mechanism of toxicity of these compounds has not been thoroughly elucidated so far. Considering that the SIRT inhibitory potential of anacardic acids has been hypothesized by in silico techniques, we herein demonstrated through both in vitro and computational methods that structurally related compounds such as ginkgolic acids and urushiols are able to modulate SIRT activity. Moreover, their SIRT inhibitory profile and cytotoxicity were comparable to sirtinol, a non-specific SIRT inhibitor (SIRT1 and SIRT2), and different from EX-527, a SIRT1 specific inhibitor. This is the first report on the SIRT inhibition of ginkgolic acids and urushiols. The results reported here are in line with previously observed effects on the induction of apoptosis by this class of compounds, and the non-specific SIRT inhibition is suggested as a new mechanism for their in vitro cytotoxicity.

  16. Specific and non-specific symptoms of colorectal cancer and contact to general practice

    DEFF Research Database (Denmark)

    Rasmussen, Sanne; Larsen, Pia Veldt; Søndergaard, Jens;

    2015-01-01

    , were randomly selected in the general population and invited to participate in an internet-based survey. Items regarding experience of specific and non-specific alarm symptoms of colorectal cancer within the preceding 4 weeks and contact to GP were included. RESULTS: A total of 49706 subjects completed......BACKGROUND: To improve survival rates for colorectal cancer, referral guidelines have been implemented. First step in the diagnostic process is for the individual to recognize the symptoms and contact his/her general practitioner (GP) for evaluation. OBJECTIVES: To determine (i) the prevalence...... of specific and non-specific symptom experiences indicative of colorectal cancer, (ii) the proportion of subsequent contacts to GPs, (iii) to explore the possible differences in symptom experience and contact to GPs between age and sex. METHODS: A nationwide study of 100000 adults, aged 20 years and older...

  17. Non-specific cellular uptake of surface-functionalized quantum dots

    CERN Document Server

    Kelf, T A; Sun, J; Kim, E J; Goldys, E M; Zvyagin, A V; 10.1088/0957-4484/21/28/285105

    2010-01-01

    We report a systematic empirical study of nanoparticle internalization into cells via non-specific pathways. The nanoparticles were comprised of commercial quantum dots (QDs) that were highly visible under a fluorescence confocal microscope. Surface-modified QDs with basic biologically-significant moieties, e.g. carboxyl, amino, streptavidin were used, in combination with the surface derivatization with polyethylene glycol (PEG) in a range of immortalized cell lines. Internalization rates were derived from image analysis and a detailed discussion about the effect of nanoparticle size, charge and surface groups is presented. We find that PEG-derivatization dramatically suppresses the non-specific uptake while PEG-free carboxyl and amine functional groups promote QD internalization. These uptake variations displayed a remarkable consistency across different cell types. The reported results are important for experiments concerned with cellular uptake of surface-functionalized nanomaterials, both when non-specifi...

  18. Recurrent activity in higher order, modality non-specific brain regions

    DEFF Research Database (Denmark)

    Lou, Hans Olav Christensen; Joensson, Morten; Biermann-Ruben, Katja

    2011-01-01

    in the visual system as a response to visual stimulation. In contrast recurrent activity has never been demonstrated before in higher order modality non-specific regions. Using magneto-encephalography and Granger causality analysis, we tested in a paralimbic network the hypothesis that stimulation may enhance...... causal recurrent interaction between higher-order, modality non-specific regions. The network includes anterior cingulate/medial prefrontal and posterior cingulate/medial parietal cortices together with pulvinar thalami, a network known to be effective in autobiographic memory retrieval and self......-awareness. Autobiographic memory retrieval of previous personal judgments of visually presented words was used as stimuli. It is demonstrated that the prestimulus condition is characterized by causal, recurrent oscillations which are maximal in the lower gamma range. When retrieving previous judgments of visually presented...

  19. Tissue Non-Specific Genes and Pathways Associated with Diabetes: An Expression Meta-Analysis.

    Science.gov (United States)

    Mei, Hao; Li, Lianna; Liu, Shijian; Jiang, Fan; Griswold, Michael; Mosley, Thomas

    2017-01-21

    We performed expression studies to identify tissue non-specific genes and pathways of diabetes by meta-analysis. We searched curated datasets of the Gene Expression Omnibus (GEO) database and identified 13 and five expression studies of diabetes and insulin responses at various tissues, respectively. We tested differential gene expression by empirical Bayes-based linear method and investigated gene set expression association by knowledge-based enrichment analysis. Meta-analysis by different methods was applied to identify tissue non-specific genes and gene sets. We also proposed pathway mapping analysis to infer functions of the identified gene sets, and correlation and independent analysis to evaluate expression association profile of genes and gene sets between studies and tissues. Our analysis showed that PGRMC1 and HADH genes were significant over diabetes studies, while IRS1 and MPST genes were significant over insulin response studies, and joint analysis showed that HADH and MPST genes were significant over all combined data sets. The pathway analysis identified six significant gene sets over all studies. The KEGG pathway mapping indicated that the significant gene sets are related to diabetes pathogenesis. The results also presented that 12.8% and 59.0% pairwise studies had significantly correlated expression association for genes and gene sets, respectively; moreover, 12.8% pairwise studies had independent expression association for genes, but no studies were observed significantly different for expression association of gene sets. Our analysis indicated that there are both tissue specific and non-specific genes and pathways associated with diabetes pathogenesis. Compared to the gene expression, pathway association tends to be tissue non-specific, and a common pathway influencing diabetes development is activated through different genes at different tissues.

  20. Quality of ulcer healing in gastrointestinal tract: Its pathophysiology and clinical relevance

    Institute of Scientific and Technical Information of China (English)

    Tetsuo Arakawa; Toshio Watanabe; Tetsuya Tanigawa; Kazunari Tominaga; Yasuhiro Fujiwara; Ken'ichi Morimoto

    2012-01-01

    In this paper,we review the concept of quality of ulcer healing (QOUH) in the gastrointestinal tract and its role in the ulcer recurrence.In the past,peptic ulcer disease (PUD) has been a chronic disease with a cycle of repeated healing/remission and recurrence.The main etiological factor of PUD is Helicobacter pylori (H.pylori),which is also the cause of ulcer recurrence.However,H.pylori-negative ulcers are present in 12%-20% of patients; they also recur and are on occasion intractable.QOUH focuses on the fact that mucosal and submucosal structures within ulcer scars are incompletely regenerated.Within the scars of healed ulcers,regenerated tissue is immature and with distorted architecture,suggesting poor QOUH.The abnormalities in mucosal regeneration can be the basis for ulcer recurrence.Our studies have shown that persistence of macrophages in the regenerated area plays a key role in ulcer recurrence.Our studies in a rat model of ulcer recurrence have indicated that proinflammatory cytokines trigger activation of macrophages,which in turn produce increased amounts of cytokines and chemokines,which attract neutrophils to the regenerated area.Neutrophils release proteolytic enzymes that destroy the tissue,resulting in ulcer recurrence.Another important factor in poor QOUH can be deficiency of endogenous prostaglandins and a deficiency and/or an imbalance of endogenous growth factors.Topically active mucosal protective and antiulcer drugs promote high QOUH and reduce inflammatory cell infiltration in the ulcer scar.In addition to PUD,the concept of QOUH is likely applicable to inflammatory bowel diseases including Crohn's disease and ulcerative colitis.

  1. Non-specific immune response of bullfrog Rana catesbeiana to intraperitoneal injection of bacterium Aeromonas hydrophila

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Non-specific immune response of bullfrog Rana catesbeiana to pathogenic Aeromonas hydrophila was studied to 60 individuals in two groups. Each bullfrog in bacterium-injected group was injected intraperitoneally (i.p.) with 0.2 ml bacterial suspension at a density of 5.2 × 106 CFU/ml, while each one in control group injected i.p. with 0.2 ml sterile saline solution (0.85%, w/v). Three bullfrogs in both groups were sampled at 0, 1, 3, 7, 11, 15 and 20 days post-injection (dpi) for the evaluation of non-specific immune parameters. It was observed that intraperitoneal injection of A. hydrophila significantly increased the number of leucocytes and that of NBT-positive cells in peripheral blood. Significant increases in serum bactericidal activity and serum acid phosphatase activity were also observed in the bacterium-injected frogs when compared with those in the control group. However, a significant reduction was detected in vitro in phagocytosis activity of peripheral blood phagocytes. No significant difference in changes in the number of peripheral erythrocytes, serum superoxide dismutase (SOD) activity, and lysozyme activity was detected between the two groups. It is suggested that bullfrogs may produce a series of non-specific immune reactions in response to the A. hydrophila infection.

  2. Specific and non-specific interactions of ParB with DNA: implications for chromosome segregation.

    Science.gov (United States)

    Taylor, James A; Pastrana, Cesar L; Butterer, Annika; Pernstich, Christian; Gwynn, Emma J; Sobott, Frank; Moreno-Herrero, Fernando; Dillingham, Mark S

    2015-01-01

    The segregation of many bacterial chromosomes is dependent on the interactions of ParB proteins with centromere-like DNA sequences called parS that are located close to the origin of replication. In this work, we have investigated the binding of Bacillus subtilis ParB to DNA in vitro using a variety of biochemical and biophysical techniques. We observe tight and specific binding of a ParB homodimer to the parS sequence. Binding of ParB to non-specific DNA is more complex and displays apparent positive co-operativity that is associated with the formation of larger, poorly defined, nucleoprotein complexes. Experiments with magnetic tweezers demonstrate that non-specific binding leads to DNA condensation that is reversible by protein unbinding or force. The condensed DNA structure is not well ordered and we infer that it is formed by many looping interactions between neighbouring DNA segments. Consistent with this view, ParB is also able to stabilize writhe in single supercoiled DNA molecules and to bridge segments from two different DNA molecules in trans. The experiments provide no evidence for the promotion of non-specific DNA binding and/or condensation events by the presence of parS sequences. The implications of these observations for chromosome segregation are discussed.

  3. The effects of non-specific and specific concepts on tactical creativity in team ball sports.

    Science.gov (United States)

    Memmert, Daniel; Roth, Klaus

    2007-10-01

    The main aim of this study was to examine the efficacy of various training approaches in team ball sports for the development of tactical creativity. Altogether, 135 children aged about 7 years took part in a 15-month field-based study. They participated either in non-specific treatment groups, a specific handball, soccer or field hockey group, or a control group. General and game-oriented tactical creativity were chosen as outcome measures. Our analysis of treatment-related effects showed that the non-specific groups displayed improvements in general creativity, whereas the specific groups showed improvements in the game-oriented creativity in which they were trained. Furthermore, clear transfer-related effects were observed. The analysis of group-related effects indicated no differences between the approaches. Only the soccer-specific group performed better in nearly all creative values. In conclusion, a non-specific concept appears to be a promising alternative to traditional specific treatments. This is further substantiated by several pedagogical, psychological, and medical arguments.

  4. Non-specific immune response of bullfrog Rana catesbeiana to intraperitoneal injection of bacterium Aeromonas hydrophila

    Science.gov (United States)

    Zhang, Junjie; Zou, Wenzheng; Yan, Qingpi

    2008-08-01

    Non-specific immune response of bullfrog Rana catesbeiana to pathogenic Aeromonas hydrophila was studied to 60 individuals in two groups. Each bullfrog in bacterium-injected group was injected intraperitoneally (i.p.) with 0.2 ml bacterial suspension at a density of 5.2 × 106 CFU/ml, while each one in control group injected i.p. with 0.2 ml sterile saline solution (0.85%, w/v). Three bullfrogs in both groups were sampled at 0, 1, 3, 7, 11, 15 and 20 days post-injection (dpi) for the evaluation of non-specific immune parameters. It was observed that intraperitoneal injection of A. hydrophila significantly increased the number of leucocytes and that of NBT-positive cells in peripheral blood. Significant increases in serum bactericidal activity and serum acid phosphatase activity were also observed in the bacterium-injected frogs when compared with those in the control group. However, a significant reduction was detected in vitro in phagocytosis activity of peripheral blood phagocytes. No significant difference in changes in the number of peripheral erythrocytes, serum superoxide dismutase (SOD) activity, and lysozyme activity was detected between the two groups. It is suggested that bullfrogs may produce a series of non-specific immune reactions in response to the A. hydrophila infection.

  5. Non-specific cellular uptake of surface-functionalized quantum dots

    Energy Technology Data Exchange (ETDEWEB)

    Kelf, T A; Sreenivasan, V K A; Sun, J; Goldys, E M; Zvyagin, A V [MQ Photonics Centre, Faculty of Science, Macquarie University, Sydney (Australia); Kim, E J, E-mail: azvyagin@science.mq.edu.au [Department of Science Education-Chemical Education Major, Daegu University, Gyeonbuk (Korea, Republic of)

    2010-07-16

    We report a systematic empirical study of nanoparticle internalization into cells via non-specific pathways. The nanoparticles were comprised of commercial quantum dots (QDs) that were highly visible under a fluorescence confocal microscope. Surface-modified QDs with basic biologically significant moieties, e.g. carboxyl, amino, and streptavidin, were used, in combination with surface derivatization with polyethylene glycol (PEG) for a range of immortalized cell lines. Internalization rates were derived from image analysis and a detailed discussion about the effect of nanoparticle size, charge and surface groups is presented. We find that PEG derivatization dramatically suppresses the non-specific uptake while PEG-free carboxyl and amine functional groups promote QD internalization. These uptake variations displayed a remarkable consistency across different cell types. The reported results are important for experiments concerned with cellular uptake of surface-functionalized nanomaterials, both when non-specific internalization is undesirable and when it is intended for material to be internalized as efficiently as possible.

  6. Dominant cagA/vacA genotypes and coinfection frequency of H. Pylori in peptic ulcer or chronic gastritis patients in Zhejiang Province and correlations among different genotypes, coinfection and severity of the diseases

    Institute of Scientific and Technical Information of China (English)

    CHEN Xue-jun; YAN Jie; SHEN Yue-fang

    2005-01-01

    Background Almost half of the world's population suffer from the Helicobacter pylori (H. Pylori) infection, but only some individuals develop gastric diseases with clinical symptoms. One reason for the phenomenon may be the different pathogenicity of infected H. Pylori strains. The presence of cytotoxin-associated gene A (cagA) and expression of vacuolating cytotoxin activity encoded by vacuolating cytotoxin gene A (vacA) are considered the two major virulent markers of H. Pylori. The aim of this study was to detect dominant cagA/vacA genotypes and coinfection frequency of H. Pylori in patients with peptic ulceration (PU) or chronic gastritis (CG), and to determine correlations among different cagA/vacA genotypes, coinfection and severity of the diseases. Methods For each of 139 patients in Zhejiang Province who had been diagnosed as PU or CG based on clinical symptoms and gastroscopy, two gastric biopsy specimens (one from antrum and the other from corpus) for H. Pylori isolation were taken by two different disinfected biopsy forceps. One hundred and fifty-six H. Pylori strains were isolated from both the antrum and corpus biopsy specimens of 78 patients (36 PU and 42 CG). PCRs were performed to detect cagA genes, and signal (s) and middle (m) regions of vacA genes in the H. Pylori isolates. The amplified fragments of dominant vacA gene s and m subtypes from representative H. Pylori isolates were sequenced after TA cloning. Dominant cagA/vacA genotypes of the H. Pylori isolates, coinfection frequency and correlations among the different genotypes, coinfection and severity of the diseases were determined.Results Of the H. Pylori strains isolated from the antrum specimens, 96.2% were cagA gene positive, as were 97.4% of the H. Pylori strains isolated from the corpus specimens. Only one s region subtype (s1a) and four m region subtypes m1, m2, m1b and m1b-m2 of vacA gene were found. The proportions of vacA gene subtypes s1a/m1, s1a/m2, s1a/m1b and s1a/m1b-m2 in the

  7. Roxatidine in duodenal ulcer.

    Directory of Open Access Journals (Sweden)

    Habibullah C

    1995-07-01

    Full Text Available Roxatidine acetate is a new H2-receptor antagonist. A randomized double-blind clinical trial in fifty-three patients with endoscopically proven duodenal ulcers > 5 mm in diameter was undertaken to compare safety and efficacy of roxatidine with that of ranitidine. Twenty-six patients received roxatidine (75 mg bid while 27 patients received ranitidine (150 mg bid for 4 weeks. One patient in each group did not come for follow up. Roxatidine and ranitidine had comparable ulcer healing rates (22/25 vs 22/26; roxatidine, however, resulted in greater reduction in the number and severity of night time pain episodes (p < 0.05. No adverse event was reported during 4 weeks of treatment with roxatidine. Thus roxatidine achieves the primary therapeutic goal of relief of pain better than ranitidine.

  8. Roxatidine in duodenal ulcer.

    Science.gov (United States)

    Habibullah, C M; Habeeb, M A; Singh, S P

    1995-01-01

    Roxatidine acetate is a new H2-receptor antagonist. A randomized double-blind clinical trial in fifty-three patients with endoscopically proven duodenal ulcers > 5 mm in diameter was undertaken to compare safety and efficacy of roxatidine with that of ranitidine. Twenty-six patients received roxatidine (75 mg bid) while 27 patients received ranitidine (150 mg bid) for 4 weeks. One patient in each group did not come for follow up. Roxatidine and ranitidine had comparable ulcer healing rates (22/25 vs 22/26); roxatidine, however, resulted in greater reduction in the number and severity of night time pain episodes (p roxatidine. Thus roxatidine achieves the primary therapeutic goal of relief of pain better than ranitidine.

  9. Another 'Cushing ulcer'.

    Science.gov (United States)

    Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

    2011-04-09

    The authors describe the case of a 39-year-old man who presented to our hospital with easy fatigability and malaise. On physical examination, hypertension was noted without any cushingoid appearance. Laboratory testing revealed normochromic-normocytic anaemia with positive results of occult blood in the stool, hyperglycaemia and hypokalemia. Upper endoscopy revealed active gastric ulcer with Helicobacter pylori infection, likely causing gastrointestinal bleeding. Endocrine examinations showed that both serum adrenocorticotropic hormone and cortisol were elevated with loss of diurnal variation. A diagnosis of Cushing's disease secondary to pituitary adenoma was made as results of brain MRI and blood sampling from inferior petrosal sinus. In a patient with peptic ulcer disease, physician should be alert to the possible endocrine background.

  10. The interest of the {sup 13}C urea breath test for the diagnostic and monitoring of chronic duodenal ulcer; Interet du test respiratoire a l`uree {sup 13}C dans le diagnostic et le suivi de l`ulcere duodenal chronique

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau-Tsangaris, M. [INBIOMED, 69 - Lyon (France); Centarti, M.; Mion, F.; Minaire, Y. [Hopital Edouard-Herriot, 69 - Lyon (France); Brazier, J.L. [Faculte de Pharmacie, 69 - Lyon (France)

    1994-12-31

    Duodenal ulcer is very frequently associated with Helicobacter pylori (Hp) present in the gastric mucous membrane. Breath tests with {sup 13}C-labelled urea have been carried out for the detection of Hp; these tests could be more sensitive than gastric biopsies, because of the heterogenous distribution of the bacteria in the mucous membrane. This breath test may be used repetitively and allows for a non-intrusive monitoring of the Hp eradication after treatment. 12 refs.

  11. Venous Leg Ulcers.

    Science.gov (United States)

    Vivas, Alejandra; Lev-Tov, Hadar; Kirsner, Robert S

    2016-08-02

    This issue provides a clinical overview of venous leg ulcers, focusing on prevention, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  12. Secretin-stimulated MR cholangio-pancreatography in the evaluation of asymptomatic patients with non-specific pancreatic hyperenzymemia

    Energy Technology Data Exchange (ETDEWEB)

    Donati, Francescamaria, E-mail: fra.donati@katamail.co [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy); Boraschi, Piero; Gigoni, Roberto; Salemi, Simonetta [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy); Faggioni, Lorenzo; Bertucci, Cristina; Cecchi, Claudia; Bartolozzi, Carlo [Diagnostic and Interventional Radiology, University of Pisa, Via Rome 67, I-56126 Pisa (Italy); Falaschi, Fabio [2nd Department of Radiology, Pisa University-Hospital, Via Paradisa 2, I-56124 Pisa (Italy)

    2010-08-15

    Purpose: To assess the diagnostic value of secretin-stimulated MRCP (SS-MRCP) compared with conventional MRCP in asymptomatic patients with mild elevations of pancreatic enzymes. Materials and methods: Eighty asymptomatic patients with pancreatic hyperenzymemia underwent MR imaging at 1.5 T-device (Signa EXCITE, GE Healthcare). After the acquisition of axial T1w,T2w sequences, and conventional MRCP, SS-MRCP was performed using a single-slice coronal breath-hold, thick-slab, SSFSE T2w sequence, repeated every 30 s up to 15 min following intravenous injection of secretin (Secrelux, Sanochemia). Results: On the basis of the standards of reference, our final diagnoses were: negative findings (n = 23), pancreas divisum (n = 22), mild chronic pancreatitis (n = 14), inflammatory ampullary stenosis (n = 3), juxtapapillary duodenal diverticulum (n = 1), small cystic lesions (<1 cm) (n = 22; 5/22 cases associated with pancreas divisum). The image quality of SS-MRCP was significantly higher than that of conventional MRCP (p < 0.0001). Standards of reference did not differ significantly from of SS-MRCP findings (p = 0.5), while was statistically different from those of conventional MRCP (p < 0.0001). A significant difference was found between conventional MRCP and SS-MRCP findings (p < 0.0001). Conclusion: In asymptomatic patients with non-specific pancreatic hyperenzymemia SS-MRCP may represent the best non-invasive diagnostic technique, since it gives morphological and functional information.

  13. Effect of therapeutic infra-red in patients with non-specific low back pain: a pilot study.

    Science.gov (United States)

    Ansari, Noureddin Nakhostin; Naghdi, Soofia; Naseri, Nasrin; Entezary, Ebrahim; Irani, Shahnur; Jalaie, Shohreh; Hasson, Scott

    2014-01-01

    The purpose of this study was to investigate the effect of infra-red (IR) in patients with chronic non-specific low back pain (NSLBP). Ten patients with NSLBP (5 men and 5 women) and disease duration of 21.7 ± 11.50 months participated in this pilot study. Patients had a mean age of 36.40 ± 10.11 years (range = 25-55). Patients were treated with infra-red (IR) for 10 sessions, each for 15 min, 3 days per week, for a period of 4 weeks. Outcome measures were the Numerical Rating Scale (NRS), the Functional Rating Index (FRI), the Modified-Modified Schober Test (MMST), and the Biering-Sorensen test to assess pain severity, disability, lumbar flexion and extension range of motion (ROM), and back extensor endurance, respectively. Data were collected at: baseline - study entry (T0); end of 5th treatment session after 2 weeks (T1); and end of the treatment after 4 weeks (T2). The results of the ANOVA demonstrated a statistically significant main effect of IR on all outcomes of pain, function, lumbar flexion-extension ROM, and back extensor endurance. The treatment effect sizes ranged from large to small. IR was effective in improving pain, function, lumbar ROM, and back extensor endurance in a sample of patients with NSLBP. Treatment effect sizes ranged from large to small indicating clinically relevant improvements primarily in pain and function for patients with NSLBP.

  14. Ulcerative lupus vulgaris over nose, leading to cosmetic deformity.

    Science.gov (United States)

    Nair, Pragya A; Mehta, Malay J; Patel, Bhumi B

    2015-01-01

    Lupus vulgaris (LV), is a chronic and progressive form of secondary cutaneous tuberculosis. In India, it is commonly seen over buttocks, thighs, and legs whereas involvement of nose is quite rare. Ulcerative variant particularly over nose causes destruction of cartilage, leading to irreversible deformities and contracture. High-index of suspicion is required for early diagnosis and prevention of cosmetic deformity. A case of LV over nose in a young male with ulceration is reported who responded well to anti-tubercular therapy, but left with scarring of nose, which could have been prevented if adequate awareness regarding extra-pulmonary cases would have been practiced.

  15. Microcirculatory remodeling in marginal zone of duodenal ulcer after bleeding

    Directory of Open Access Journals (Sweden)

    Sulayeva О.N.

    2009-01-01

    Full Text Available To estimate objectively vessels network remodeling in duodenal mucosa after ulcer bleeding the morphometric analysis of marginal ulcer zone biopsies was performed in 32 patients. It was shown that reparation is accompanied with chronic inflammation and acute alteration of microcirculation. Injection hemostasis led to enhancement of microcirculation, development of edema and ischemic alteration of mucosal tissues. Acute neutrophilic infiltration during 1 day was changed on 3 day with granular tissue development and angiogenesis stimulation. Intensification and prolongation of angiogenesis paral-leled with lymphocytes infiltration after 7 days resulted to villi dysmorphogenesis and changes in cellular content of intestinal epithelium.

  16. Management of venous ulcers: State of the art.

    Science.gov (United States)

    Marola, Silvia; Ferrarese, Alessia; Solej, Mario; Enrico, Stefano; Nano, Mario; Martino, Valter

    2016-09-01

    Venous ulceration is a complex and serious problem that affects 1-2% of the global elderly population (>65 years), and its incidence is constantly increasing. The population group with higher risk of development of venous ulceration is the elderly. These lesions have a significant negative impact on patients' quality of life. Our aim was to analyze the state of the art, starting with the medical literature review. The evidence supports that managing chronic wounds with a multidisciplinary wound care team significantly increases wound healing and reduces the severity of wound-associated pain and the required daily wound treatments compared with persons who are not managed by such a team.

  17. Somatic pain sensitivity during formation and healing of acetic acid-induced gastric ulcers in conscious rats.

    Science.gov (United States)

    Yarushkina, Natalya; Bogdanov, Anatoly; Filaretova, Ludmila

    2006-06-30

    A classical feature of visceral pain is its referring to somatic locations. Gastric ulcer is a source of visceral pain. In the present study we investigated whether gastric ulcers may trigger the changes in somatic nociception. For this aim somatic pain sensitivity was estimated under conditions of gastric ulcer development and healing. Gastric ulcers were induced by luminal application of 60% acetic acid under surgical conditions. Control rats were subjected to the same surgical procedure, but with the application of saline instead of the acid. Somatic pain sensitivity (tail flick latency), plasma corticosterone level, adrenal and thymus weight were investigated under conditions of the formation and the healing of gastric ulcers. The application of the acid resulted in the formation of kissing gastric ulcers, the increase of somatic pain sensitivity (the decrease of tail flick latency) as well as the appearance of typical signs of chronic stress: long-lasting increase of plasma corticosterone level, adrenal gland hypertrophy and thymus gland involution. Natural healing of gastric ulcers was accompanied by restoration of pain sensitivity as well as attenuation of the signs of chronic stress. Delay of ulcer healing by the daily indomethacin administration (2 mg/kg, s.c.) prevented the restoration of somatic pain sensitivity. The results suggest that chronic gastric ulcers may trigger somatic hypersensitivity.

  18. 远程伤口治疗平台在偏远地区下肢慢性溃疡患者中的应用%Application of tele-wound treatment platform to patients with chronic lower limb ulcers in remote areas

    Institute of Scientific and Technical Information of China (English)

    楚婷; 陈正英; 吴冬琼; 刘细寒

    2012-01-01

    目的 探讨以手机彩信为平台的远程伤口治疗模式对偏远地区下肢慢性溃疡的治疗作用.方法 采取整群抽样方法收集湘西地区综合性医院就诊的37例农村下肢慢性溃疡患者,随机分为干预组25例和对照组12例,干预组进行彩信平台的远程伤口治疗,对照组按常规处理伤口,6个月后通过自制问卷调查评估.结果 干预6个月后,干预组伤口治疗评分、疼痛及症状管理评分显著高于对照组(均P<0.05).结论 基于彩信平台的远程伤口治疗有助于改善偏远地区下肢慢性溃疡患者的伤口治疗效果.%Objective To investigate the effect of a multimedia-message-based tele-wound treatment platform on chronic lower limb ulcers for patients living in remote areas. Methods Thirty seven cases with chronic lower limb ulcers from backwoods of west Hunan Province, and seeking medical service in a comprehensive hospital, were collected by cluster sampling. They were randomly divided into 2 groups: the intervention group (n = 25) were managed with a remote wound treatment platform via which medical staff sent multimedia messages to inctruct patients to care for the wounds, while the control group (n=12) were given routine intervention. Six months later, a self-designed questionaire was used to assess the effect of the interventions. Results Six months later, the wound treatment score, pain management score, symptom management score of the intervention group were significantly higher than those of the controls (P<0. 05 for all). Conclusion The multimedia-message-based tele-wound treatment platform helps improve therapeutic effect of wound care of backwoods residents with chronic lower limb ulcers.

  19. 下肢慢性静脉性溃疡病因学及治疗研究%Progress in the etiology and therapy of chronic venous leg ulcers

    Institute of Scientific and Technical Information of China (English)

    陈琉; 常李; 陈金鳌

    2012-01-01

    下肢慢性静脉性溃疡( CVLU)是下肢静脉功能不全的常见并发症.许多CVLU反复发作,久治不愈,形成难治性溃疡,成为临床治疗中的辣手问题.笔者就近年来CVLU病因学研究进展,分期疗法和个体化治疗方法进行评价及综述.%Chronic venous leg ulceration (CVLU) is a frequent complication of lower limb venous insufficiency. Many cases of CVLU, which are slow to heal and frequently recur, and finally develop into refractory ulcers, have become a difficult problem in clinical practice. This paper reviews the recent progress in the etiology of CVLU, and its staging and individualized treatment.

  20. Leg ulcers, a problem-based learning approach Leg ulcers, a problem-based learning approach Moya Morrison Christine Moffatt and Peter Franks Elsevier £39.95 0 7234 3311 9 0723433119 [Formula: see text].

    Science.gov (United States)

    2007-03-01

    This book explores the field of leg ulcer management. The authors suggest that although there has been a burgeoning of knowledge in this field in the past 20 years, the reality is that many leg ulcers become chronic and fail to heal.

  1. Effects of predictive nursing intervention on elderly patients with chronic diseases in community life quality and pressure ulcer%预见性护理干预对社区高龄慢性疾病患者生活质量及压疮的影响

    Institute of Scientific and Technical Information of China (English)

    杨莉

    2015-01-01

    目的:探讨预见性护理干预对社区高龄慢性疾病患者生活质量及压疮的影响。方法选取2013年2—10月于重庆市长寿区第三人民医院就诊的高龄慢性疾病患者170例,以随机抽样方法分为对照组(85例)和观察组(85例)。两组患者均行居家治疗,观察组患者在此基础上加用预见性护理干预。比较两组患者压疮发生率、生活质量综合评定问卷( GQO—LI)评分及护理满意度。结果对照组患者压疮发生率为17.65%(15/85),观察组为2.35%(2/85);观察组患者压疮发生率低于对照组,差异有统计学意义( P<0.05)。观察组患者GQO—LI量表各项指标评分均高于对照组,差异有统计学意义( P <0.05)。对照组患者护理满意度为75.29%(64/85),观察组为100.00%(85/85);观察组患者护理满意度高于对照组,差异有统计学意义( P<0.05)。结论预见性护理干预可有效改善社区高龄慢性疾病患者的生活质量,降低压疮发生风险。%Objective To investigate the effects of predictive nursing intervention on life quality and pressure ulcer of elderly patients with chronic diseases in community. Methods From February to October 2013 in the Third People's Hospital of Changshou District,Chongqing,170 elderly patients with chronic diseases were selected and divided into control group( n=85)and observation group(n=85)by random sampling method. Both groups given home treatment,patients of the observa-tion group given predictive nursing intervention based on the home treatment. The incidence of pressure ulcers,general quality of life inventory( GQO—LI) score and clinical nursing satisfaction were compared between the two groups. Results The inci-dence of pressure ulcer of the control group was 17. 65%(15/85),that of the observation group was 2. 35%(2/85);the in-cidence of pressure ulcer of observation group was lower than that of control group,the difference

  2. Golimumab in unresponsive ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Lippert E

    2014-05-01

    Full Text Available Elisabeth Lippert, Martina Müller, Claudia Ott University Hospital Regensburg, Department of Internal Medicine I, Regensburg, Germany Abstract: Ulcerative colitis (UC is a chronic inflammation mainly affecting the colon mucosa. It predominantly occurs in younger patients. Until recently, the main goals in the treatment of UC were to temper the symptoms, such as diarrhea, pain, and weight loss, by using mesalazine and steroids. With newer medications, such as immunomodulators (thiopurines and the biologics providing blockade of tumor necrosis factor (TNF, the goals of the therapy in UC have changed to long-term remission and mucosal healing. The first available anti-TNF therapy in UC included infusion therapy with infliximab every few weeks. In 2012, subcutaneously administered adalimumab gained approval for the treatment of UC in Germany. In patients with a mild disease, therapy with mesalazine, orally or topically, can be sufficient. In patients with moderate to severe disease, therapy with azathioprine or anti-TNF is often required to reach disease control; however, this is only efficient in about two-thirds of patients. Some patients either show no response or a lost response while on treatment. So, further medical options are warranted in the treatment of UC. With golimumab, a new approach in the treatment of mild to moderate UC recently became available in Germany and is a promising new option in the therapy regimen for patients with UC. Keywords: anti-TNF, biological therapy, inflammatory bowel disease

  3. [Peptic ulcer disease and stress].

    Science.gov (United States)

    Herszényi, László; Juhász, Márk; Mihály, Emese; Tulassay, Zsolt

    2015-08-30

    The discovery that Helicobacter pylori infection is the major cause of peptic ulcer disease revolutionised our views on the etiology and treatment of the disease. This discovery has tempted many experts to conclude that psychological factors and, specifically, stress are unimportant. However, Helicobacter pylori infection alone does not explain fully the incidence and prevalence of peptic ulcer disease. It has been demonstrated that stress can cause peptic ulcer disease even in the absence of Helicobacter pylori infection, supporting a multicausal model of peptic ulcer etiology. Psychological stress among other risk factors can function as a cofactor with Helicobacter pylori infection.

  4. Autologous stem cell-based therapy for sickle cell leg ulcer: a pilot study.

    Science.gov (United States)

    Meneses, José Válber L; Fortuna, Vitor; de Souza, Eliane Silva; Daltro, Gildasio Cerqueira; Meyer, Roberto; Minniti, Caterina P; Borojevic, Radovan

    2016-12-01

    Recurrent chronic leg ulcers are among the most severe vasculopathic complications of sickle cell disease (SCD). Their treatment remains a challenge. Stem cell therapy with bone marrow mononuclear cells (BMMC) is a promising new therapeutic option for other forms of chronic ulcers. This prospective pilot study was performed to evaluate safety and feasibility of BMMC implantation in patients with SCD and chronic leg ulcers (SCLU). Ulcer closure, recurrence and local pain were evaluated. BMMC were successfully administered to 23 SCLU patients and no serious adverse events occurred. During the 6-month follow-up period, 91·3% of patients had improved ulcer pain compared with baseline and 29·2% of the treated ulcers achieved total healing. The frequency of progenitor stem cells (CD34CD45(low) and fibroblast colony-forming units) in BMMC was found to be significantly reduced in SCLU patients and compared to SCD patients without ulcers (P < 0·004 and P < 0·01, respectively). No relationship was observed between treatment outcome and the number of implanted BM progenitor stem cells. In conclusion, BMMC implantation is a feasible and safe procedure, showing favourable outcomes for the treatment of SCLU, and encouraging further controlled clinical trials.

  5. Gastrointestinal symptoms resembling ulcerative proctitis caused by larvae of the drone fly Eristalis tenax.

    Science.gov (United States)

    Desoubeaux, Guillaume; Gaillard, Julien; Borée-Moreau, Diane; Bailly, Éric; Andres, Christian R; Chandenier, Jacques

    2014-04-01

    We report a case of facultative intestinal myiasis due to larvae of the drone fly Eristalis tenax, also named the rat-tailed maggots. The development of larvae in the lower bowel was responsible for non-specific gastrointestinal symptoms that resembled ulcerative proctitis. The diagnosis was established upon the observation of four spontaneously excreted mobile larvae. The definite identification of the E. tenax species was made possible by scanning electron microscopy. The clinical outcome was satisfactory.

  6. Retrospective Evaluation of Cases Diagnosed with Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Gülseren Şahin

    2012-04-01

    Full Text Available In­tro­duc­ti­on: Inflammatory bowel disease (IBD is a chronic inflammatory disease of the gastrointestinal canal characterised by remissions and exacerbations. This study aimed to make a retrospective evaluation of clinical and laboratory findings of patients being monitored with a diagnosis of IBD.Materials and Methods: Medical records of 18 patients with a diagnosis of IBD and 7 years of follow-up at our pediatric gastroenterology departments were investigated with respect to demographic data, complaints on presentation and accompanying diseases. Unusual findings from physical examination, endoscopic findings, histopathological findings and the applied treatments were examined.Results: The 18 patients (10 female, 8 male included in this study had a mean age of 13.6±2.9 years and the mean time from onset of symptoms to diagnosis was 6.9±4.5 months. Seventeen patients were diagnosed with ulcerative colitis and 1 patient with intermediate colitis. There was a positive family history of the disease in 2 patients (11%. At the time of diagnosis, the most common complaints on presentation were found to be abdominal pain (100%, bloody diarrhea (94.5% and tenesmus (44.4%. The most frequent laboratory findings were CRP positivity (89%, increased sedimentation rate (83.3% and iron-deficient anaemia (77.7%. On colonoscopy, pancolitis involvement (66.6% was most frequently encountered. Accompanying diseases to IBD were found to be familial Mediterranean fever (FMF (11%, celiac disease (5.5% and Heliobacter pylori gastritis (5.5%. One patient (5.5% who did not respond to medical treatment for pancolitis involvement underwent a colectomy. Discussion: The number of diagnoses of IBD in childhood is gradually increasing. Nonetheless, it can be difficult to define diseases with non-specific symptoms and this may cause a delay in diagnosis. Because of the association of autoimmune diseases with IBD, despite appropriate therapy, diseases with no remission

  7. Non-specific immunological effects of selected routine childhood immunisations: systematic review

    Science.gov (United States)

    Voysey, Merryn; McQuaid, Fiona; de Nie, Karlijn; Ryan, Rebecca; Orr, Olivia; Uhlig, Ulrike; Sande, Charles; O’Connor, Daniel; Pollard, Andrew J

    2016-01-01

    Objective To identify and characterise non-specific immunological effects after routine childhood vaccines against BCG, measles, diphtheria, pertussis, and tetanus. Design Systematic review of randomised controlled trials, cohort studies, and case-control studies. Data sources Embase, PubMed, Cochrane library, and Trip searched between 1947 and January 2014. Publications submitted by a panel of experts in the specialty were also included. Eligibility criteria for selecting studies All human studies reporting non-specific immunological effects after vaccination with standard childhood immunisations. Studies using recombinant vaccines, no vaccine at all, or reporting only vaccine specific outcomes were excluded. The primary aim was to systematically identify, assemble, and review all available studies and data on the possible non-specific or heterologous immunological effects of BCG; measles; mumps, measles, and rubella (MMR); diphtheria; tetanus; and pertussis vaccines. Results The initial search yielded 11 168 references; 77 manuscripts met the inclusion criteria for data analysis. In most included studies (48%) BCG was the vaccine intervention. The final time point of outcome measurement was primarily performed (70%) between one and 12 months after vaccination. There was a high risk of bias in the included studies, with no single study rated low risk across all assessment criteria. A total of 143 different immunological variables were reported, which, in conjunction with differences in measurement units and summary statistics, created a high number of combinations thus precluding any meta-analysis. Studies that compared BCG vaccinated with unvaccinated groups showed a trend towards increased IFN-γ production in vitro in the vaccinated groups. Increases were also observed for IFN-γ measured after BCG vaccination in response to in vitro stimulation with microbial antigens from Candida albicans, tetanus toxoid, Staphylococcus aureas, lipopolysaccharide, and

  8. Identification of fluorescent compounds with non-specific binding property via high throughput live cell microscopy.

    Directory of Open Access Journals (Sweden)

    Sangeeta Nath

    Full Text Available INTRODUCTION: Compounds exhibiting low non-specific intracellular binding or non-stickiness are concomitant with rapid clearing and in high demand for live-cell imaging assays because they allow for intracellular receptor localization with a high signal/noise ratio. The non-stickiness property is particularly important for imaging intracellular receptors due to the equilibria involved. METHOD: Three mammalian cell lines with diverse genetic backgrounds were used to screen a combinatorial fluorescence library via high throughput live cell microscopy for potential ligands with high in- and out-flux properties. The binding properties of ligands identified from the first screen were subsequently validated on plant root hair. A correlative analysis was then performed between each ligand and its corresponding physiochemical and structural properties. RESULTS: The non-stickiness property of each ligand was quantified as a function of the temporal uptake and retention on a cell-by-cell basis. Our data shows that (i mammalian systems can serve as a pre-screening tool for complex plant species that are not amenable to high-throughput imaging; (ii retention and spatial localization of chemical compounds vary within and between each cell line; and (iii the structural similarities of compounds can infer their non-specific binding properties. CONCLUSION: We have validated a protocol for identifying chemical compounds with non-specific binding properties that is testable across diverse species. Further analysis reveals an overlap between the non-stickiness property and the structural similarity of compounds. The net result is a more robust screening assay for identifying desirable ligands that can be used to monitor intracellular localization. Several new applications of the screening protocol and results are also presented.

  9. Non-specific Effects of Vaccines and Stunting: Timing May Be Essential

    OpenAIRE

    2016-01-01

    Background: Bacillus Calmette-Guérin (BCG) vaccination possesses effects on health beyond its target disease, the so called “non-specific effects”. We evaluate these effects, as well as the effect of timing of BCG and other vaccinations, on stunting in Sub-Saharan African (SSA) children under five. Methods: We use a Big Data design, including cross-sectional data for 368,450 children from 33 SSA countries. Logistic regression analysis is used with control factors at child, mother, househol...

  10. [Circumannular features of non-specific resistance in patients with osteoarthrosis in mid-lattitudes].

    Science.gov (United States)

    Titskaia, E V; Barabash, L V; Levitskiĭ, E F; Khon, V B

    2011-01-01

    Modified cosinor-analysis was used to calculate biorhythmologic characteristics (period, amplitude, phase, mesor) of the circumannual rhythm of neuroendocrine regulation parameters, the state of bioradical hemostasis, and protein components of non-specific resistance in patients with osteoarthrosis living in moderate climates. Near-annual rhythms of these parameters are described. The chronological analysis indicates that strenuouos activity of the regulatory systems responsible for adaptive reactions of the organism falls within the periods from March to May and from August to October. Variability of the above parameters is shown to be related to the efficacy of osteoarthrosis therapy in different phases of the near-annual rhythm.

  11. Biotypes of Gardnerella vaginalis isolated from non-specific vaginitis patients in Bombay.

    Science.gov (United States)

    Pandit, D V; Barve, S M; Deodhar, L P

    1989-11-01

    The incidence and prevalent biotypes of G. vaginalis in patients with non-specific vaginitis from Bombay, was studied. Of 300 patients screened, 105 were diagnosed to have nonspecific vaginitis (NSV). G. vaginalis was isolated from 71 per cent patients with NSV; 34.6 and 29.3 per cent G. vaginalis were belonging to biotypes 5 and 1 respectively. In 55 per cent patient, G. vaginalis was associated with anaerobes. None of the isolated strains of G. vaginalis was sensitive to 5 micrograms metronidazole disc whereas 93 per cent of the strains were sensitive to 50 micrograms metronidazole disc.

  12. On the relationship between pain intensity and postural sway in patients with non-specific neck pain

    DEFF Research Database (Denmark)

    Ruhe, Alexander; Fejer, René; Walker, Bruce

    2013-01-01

    Increased center of pressure excursions are well documented in patients with non-specific neck pain. While a linear relationship between pain intensity and postural sway has been described in low back pain patients, no such investigation has been conducted in adults with non-specific neck pain....

  13. Photoletter to the editor: Oral ulceration in pyoderma gangrenosum.

    LENUS (Irish Health Repository)

    Verma, Saroj

    2012-02-01

    A 65-year-old woman presented with widespread necrotising cutaneous ulceration and oral involvement. Past history included rheumatoid arthritis, and a left nephrectomy.Examination revealed multiple violaceous undermined ulcers. Blood investigations showed an acute inflammatory response. Skin histopathology showed epidermal ulceration with acute and chronic inflammation. Direct immunofluorescence was negative. A diagnosis of pyoderma gangrenosum with oral involvement was made. Mycophenolate mofetil therapy resulted in complete resolution of her pyoderma gangrenosum. Her treatment was complicated by a left proteus mirabilis psoas abscess. This resolved following four weeks of antibiotics.Pyoderma gangrenosum with oral involvement is rare but has been linked with inflammatory bowel disease and hematological disorders. Oral pyoderma gangrenosum has not previously been described in rheumatoid arthritis. Primary psoas abscess is rare but can develop in immunocompromised patients. Proteus mirabilis has been reported in patients years after nephrectomy. This is a rare case of pyoderma gangrenosum with oral involvement.

  14. Management of the diabetic foot ulcer: exercising control.

    Science.gov (United States)

    Bentley, Jenny; Foster, Ali

    2008-03-01

    The incidence of diabetes is increasing and therefore patients with diabetic foot ulcers will become increasingly common in the community. The NHS model of Health and Social Care (Department of Health (DH), 2005) places a high emphasis on self care and disease management, and, as a long-term condition, diabetes mellitus requires efficient and effective management. The supervision and organization of the care of diabetic patients is multi-factorial and for this reason, a multi-disciplinary approach is essential for effective care, without which patients with diabetic foot ulcers are at high risk of complications. Diabetic wounds present differently to other chronic wounds; unless these are adequately assessed and treated, there may be devastating consequences for the patient--the most serious being major amputation and/or death. In the first article, accurate assessment was discussed; in this second article, the management of diabetic foot ulcers is explored.

  15. Cryptogenic Multifocal Ulcerous Stenosing Enteritis: An Exceptionally Rare Disease

    Directory of Open Access Journals (Sweden)

    Amandeep Kaur

    2016-01-01

    Full Text Available Cryptogenic Multifocal Ulcerous Stenosing Enteritis (CMUSE is a rare idiopathic disease of the small bowel. Its origin and pathophysiology has not been well described. Clinicopathologic features include unexplained ileal strictures with supercial ulceration. We present a case of a 31-year-old HIV positive lady who was admitted with complaints of recurrent abdominal pain and constipation. Laboratory investigations revealed iron deciency anemia. Ultrasonography of the abdomen showed dilated bowel loops and a subsequent barium follow through showed ve strictures in the ileum. Segmental small bowel resection with end-to-end anastomosis was performed. Grossly ileum showed ve ileal strictures. The diagnosis of CMUSE was made on histopathology after ruling out other causes of strictures. The present case highlights the importance of considering CMUSE in patients with chronic or recurrent episodes of intestinal obstruction with multiple small intestinal ulcers and strictures after other common causes have been ruled out.

  16. Large leg ulcers due to autoimmune diseases

    Science.gov (United States)

    Rozin, Alexander P.; Egozi, Dana; Ramon, Yehuda; Toledano, Kohava; Braun-Moscovici, Yolanda; Markovits, Doron; Schapira, Daniel; Bergman, Reuven; Melamed, Yehuda; Ullman, Yehuda; Balbir-Gurman, Alexandra

    2011-01-01

    Summary Background Large leg ulcers (LLU) may complicate autoimmune diseases. They pose a therapeutic challenge and are often resistant to treatment. To report three cases of autoimmune diseases complicated with LLU. Case Report Case 1. A 55-year old woman presented with long-standing painful LLU due to mixed connective tissue disease (MCTD). Biopsy from the ulcer edge showed small vessel vasculitis. IV methylprednisolone (MethP) 1 G/day, prednisolone (PR) 1mg/kg, monthly IV cyclophosphamide (CYC), cyclosporine (CyA) 100mg/day, IVIG 125G, ciprofloxacin+IV Iloprost+enoxaparin+aspirin (AAVAA), hyperbaric oxygen therapy (HO), maggot debridement and autologous skin transplantation were performed and the LLU healed. Case 2. A 45-year old women with MCTD developed multiple LLU’s with non-specific inflammation by biopsy. MethP, PR, hydroxychloroquine (HCQ), azathioprine (AZA), CYC, IVIG, AAVAA failed. Treatment for underlying the LLU tibial osteomyelitis and addition of CyA was followed by the LLU healing. Case 3. A 20-year-old man with history of polyarteritis nodosa (PAN) developed painful LLU’s due to small vessel vasculitis (biopsy). MethP, PR 1 mg/kg, CYC, CyA 100 mg/d, AAVAA failed. MRSA sepsis and relapse of systemic PAN developed. IV vancomycin, followed by ciprofloxacin, monthly IVIG (150 g/for 5 days) and infliximab (5 mg/kg) were instituted and the LLU’s healed. Conclusions LLU are extremely resistant to therapy. Combined use of multiple medications and services are needed for healing of LLU due to autoimmune diseases. PMID:21169912

  17. Combined with Traditional Chinese Medicine Formulations of Mesalamine Retention Enema Treatment of Chronic Recurrent Type Clinical Analysis of Ulcerative Colitis%美沙拉嗪联合中药制剂保留灌肠治疗慢性反复发作型溃疡性结肠炎的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    雷波; 伍平; 汪功华

    2012-01-01

      目的探讨美沙拉嗪联合中药制剂保留灌肠治疗慢性反复发作型溃疡性结肠炎的临床疗效.方法回顾性分析2005年7月~2012年7月在安徽省安庆市第一人民医院消化内科收治的59例慢性反复发作型溃疡性结肠炎的临床资料.将59例慢性反复发作型溃疡性结肠炎患者随机分为试验组和对照组,试验组31例,对照组28例.试验组予以美沙拉嗪(0.5g,4次/ d)联合中药制剂保留灌肠;对照组予以美沙拉嗪(0.5g,4次/ d)各治疗8周后观察其临床疗效.结果试验组31例患者治愈15例、显效12例、有效1例、无效3例,总有效率90.32%,对照组28例病人治愈11例、显效13例、有效0例、无效4例,总有效率85.71%.两组比较有统计学差异(P <005).结论美沙拉嗪联合中药制剂保留灌肠治疗慢性反复发作型溃疡性结肠炎具有疗效确切、治愈率高、不良反应少,且价格低廉.%  Objective To explore the the mesalazine joint Chinese medicine preparations retention enema clinical efficacy for the treatment of chronic ulcerative colitis relapse type. Method Retrospective analysis of clinical data from July 2005 to July 2012 in the Department of Gastroenterology, the First People's Hospital of Anqing City, Anhui Province admitted 59 patients with chronic recurrent type of ulcerative colitis. Repeated attack of the 59 patients with chronic ulcerative colitis patients were randomly divided into experimental and control groups, the test group (31 cases), 28 cases of the control group. Test group was treated with mesalamine (0.5g, 4 times / d) combined with traditional Chinese medicine preparations retention enema; clinical efficacy in the control group were given mesalamine (0.5g, 4 times / d) after eight weeks of each treatment.Result Test group of 31 patients, 15 cases were cured, 12 cases markedly effective one cases, 3 cases, the total effective rate was 90.32% in the control group of 28 patients, 11 cases were

  18. c-fos与c-jun癌蛋白在溃疡与增生性瘢痕创面联合表达的特征与意义%Expression of oncoproteins c-fos and c-jun in hypertrophic scars and chronic dermal ulcers and their regulation of basic fibroblast growth factor

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    目的探讨c-fos与c-jun两种原癌基因产物在溃疡与增生性瘢痕创面表达的特征与规律以及与不同组织修复结局发生的关系。 方法 16例标本均取自于外科手术患者,其中增生性瘢痕8例,溃疡创面8例,另有正常对照皮肤5例取自增生性瘢痕患者作为对照。用免疫组化法(ABC法)检测c-fos与c-jun两种癌蛋白以及bFGF在三种组织切片的分布特征。 结果在正常皮肤c-fos与c-jun的阳性表达主要见于表皮基底细胞和少量皮下成纤维细胞,但在相应部位c-jun的表达较c-fos为弱。在增生性瘢痕,c-fos与c-jun均出现强阳性表达,主要见于成纤维细胞。在溃疡组织,c-fos与c-jun的联合表达多见于毛细血管内皮细胞、部分炎症细胞以及成纤维细胞胞浆。 结论增生性瘢痕与溃疡创面c-fos与c-jun表达量与部位同正常皮肤存在显著差异,提示这两种原癌基因产物在影响和调控组织修复中有重要作用。%Objective To explore the characteristics of oncoprotein expression of c-fos and c-jun in hypertrophic scars and chronic dermal ulcers and their regulation of basic fibroblast growth factor (bFGF). Methods Tissues of hypertrophic scars (n=8), chronic dermal ulcers (n=8) and normal skin (n=5) were taken from 21 patients with burns and chronic dermal ulcers in operation. The ABC immunohistochemical method was used to characterize the gene product expression of c-fos, c-jun and bFGF in the above tissues. Results In normal skin, both c-fos and c-jun protein expression and bFGF protein expression were observed. The signals of both oncoproteins were localized mainly in subcutaneous fibroblasts, but, positive expression of the bFGF protein was mainly in keratinocytes. In hypertrophic scars, positive expression of both oncoproteins could be found mainly in fibroblasts, but bFGF was mainly in fibroblasts and endothelial cells. In chronic dermal ulcers, endothelial cells, some

  19. Application of BurnCalc 3D Body Scanning System in Measurement of the Area of Chronic Skin Ulcers%三维人体扫描系统在慢性皮肤溃疡面积测量中的应用

    Institute of Scientific and Technical Information of China (English)

    鲁晋; 王亮; 万燕; 姚砺; 唐洪泰; 夏照帆

    2016-01-01

    目的:研究BurnCalc扫描系统在慢性皮肤溃疡创面测量中的效果。方法选取2014年6月~2014年12月于我院就诊的皮肤慢性溃疡患者30例,分别采用无菌薄膜勾边法、NIH ImageJ方法和BurnCalc扫描方法对患者创面进行测量,使用统计学方法分析3种检测方法测量结果的一致性。结果随机区组方差分析显示3种方法测得创面面积无统计学差异(F=2.57,P=0.085);独立t检验分析B法与A法创面面积差值,无统计学差异(t=-0.728,P=0.472);独立t检验分析C法与A法创面面积差值,无统计学差异(t=2.010,P=0.054)。结论 BurnCalc扫描系统可以精确测量慢性皮肤溃疡创面面积,可作为临床评估慢性皮肤溃疡创面的新方法。%Objective To study the effectiveness of application of BurnCalc 3D body scanning system in measurement of the wound areas of chronic skin ulcers. Methods Altogether 30 cases of chronic skin ulcer patients who were treated in Changhai Hospital from June 2014 to December 2014 was involved in this study. Their wounds were measured by using the transparency tracing method (Method A), NIH ImageJ method (Method B) and BurnCalc scanning method (Method C) respectively. The statistical approach was applied to analyze the consistency among the results acquired by using three methods. Results According to the randomized block analysis of variance, no statistically significant difference was found among wound areas acquired by using three measurement methods (F=2.569, P=0.085). The results of independent t-test analysis showed that the difference between wound areas acquired by using Method B, Method A and Method C, Method A had no statistical significance respectively [(t=-0.728, P=0.472), (t=2.010, P=0.054)]. Conclusion The BurnCalc 3D body scanning system proved its effectiveness in accurate measurement of the wound areas of chronic skin ulcers, which could be considered a new method for the clinical

  20. Analysis of treatment of 126 cases of chronic gastritis and peptic ulcer with positive helicobacter pylori%慢性胃炎、消化性溃疡、幽门螺杆菌阳性治疗分析126例

    Institute of Scientific and Technical Information of China (English)

    孟定德

    2014-01-01

    Chronic gastritis and peptic ulcer are common digestive system diseases in clinic.The treatment of the disease is mainly the eradication of helicobacter pylori infection.The treatment options are diverse.In this paper,2 kinds of treatment regimen for helicobacter pylori are compared to guide the clinical work.%慢性胃炎以及消化性溃疡在临床上是较为常见的消化系统疾病,在针对该病的治疗上主要是根除幽门螺杆菌感染,其治疗方案多种多样。本文就两种治疗幽门螺杆菌方案进行比较,以期望对临床工作有所指导。

  1. Importance of luminal and mucosal zinc in the mechanism of experimental gastric ulcer healing.

    Science.gov (United States)

    Opoka, W; Adamek, D; Plonka, M; Reczynski, W; Bas, B; Drozdowicz, D; Jagielski, P; Sliwowski, Z; Adamski, P; Brzozowski, T

    2010-10-01

    Zinc has been reported to exert a gastroprotective action against various experimental gastric lesions suggesting that this trace element is involved in the integrity of the gastric mucosa. Compounds containing zinc, such as polaprezinc, were developed in Japan and used as an antiulcer drugs in the treatment of human peptic ulcer disease. However, the precise mechanism of Zn(2+) containing compounds and their effects on mucosal integrity, gastroprotection and ulcer healing remain unclear. We have determined the efficacy of zinc hydroaspartate, a compound containing Zn(2+), in the mechanism of gastric secretion and ulcer healing in rats with chronic gastric ulcers induced by acetic acid (initial ulcer area = 28 mm(2)). Rats with gastric ulcers were randomized into two groups: A) with gastric fistulas (GF) and B) without gastric fistulas and received a daily treatment with zinc hydroaspartate (32-130 mg/kg-d i.g.) for 3, 7 and 14 days. At the termination of each treatment, the area of gastric ulcers were examined by planimetry, the gastric blood flow (GBF) at ulcer margin was assessed by laser Doppler flowmetry and H(2)-gas clearance methods. The venous blood was withdrawn for a measurement of plasma gastrin levels by radioimmunoassay (RIA). The concentration of Zn(2+) in the gastric juice and mucosa at the ulcer margin were determined by differential pulse anodic stripping voltammetry (DPASV) and flame atomic absorption spectrometry (FAAS) methods and the gastric biopsy samples were taken for histopathological assessment of the quality of ulcer healing. The ulcers healed gradually, with the ulcer area in the vehicle control rats being diminished by 15%, 48% and 78% upon ulcer induction at 3, 7 and 14 days, respectively. Zinc hydroaspartate dose-dependently inhibited the area of gastric ulcer, the dose reducing this area by 50% (ID(50)) being about 60 mg/kg-d. The mucosal concentration of Zn(2+) significantly was unchanged from the baseline immediately after ulcer

  2. Refractory peptic ulcer disease.

    Science.gov (United States)

    Napolitano, Lena

    2009-06-01

    Refractory PUD is a diagnostic and therapeutic challenge. Optimal management of severe or refractory PUD requires a multidisciplinary team approach, using primary care providers, gastroenterologists, and general surgeons. Medical management has become the cornerstone of therapy. Identification and eradication of H pylori infection combined with acid reduction regimens can heal ulceration and also prevent recurrence. Severe, intractable or recurrent PUD and associated complications mandates a careful and methodical evaluation and management strategy to determine the potential etiologies and necessary treatment (medical or surgical) required.

  3. Helicobacter pylori and Peptic Ulcers

    Centers for Disease Control (CDC) Podcasts

    2010-08-17

    In this podcast, CDC's Dr. David Swerdlow discusses the relationship between Helicobacter pylori and peptic ulcer disease and trends in hospitalization rates for peptic ulcer disease in the United States between 1998 and 2005.  Created: 8/17/2010 by National Center for Emerging and Zoonotic Infectious Diseases.   Date Released: 8/17/2010.

  4. Characterization of a novel non-specific nuclease from thermophilic bacteriophage GBSV1

    Directory of Open Access Journals (Sweden)

    Zhang Xiaobo

    2008-04-01

    Full Text Available Abstract Background Thermostable enzymes from thermophiles have attracted extensive studies. In this investigation, a nuclease-encoding gene (designated as GBSV1-NSN was obtained from a thermophilic bacteriophage GBSV1 for the first time. Results After recombinant expression in Escherichia coli, the purified GBSV1-NSN exhibited non-specific nuclease activity, being able to degrade various nucleic acids, including RNA, single-stranded DNA and double-stranded DNA that was circular or linear. Based on sequence analysis, the nuclease shared no homology with any known nucleases, suggesting that it was a novel nuclease. The characterization of the recombinant GBSV1-NSN showed that its optimal temperature and pH were 60°C and 7.5, respectively. The results indicated that the enzymatic activity was inhibited by enzyme inhibitors or detergents, such as ethylene diamine tetraacetic acid, citrate, dithiothreitol, β-mercaptoethanol, guanidine hydrochloride, urea and SDS. In contrast, the nuclease activity was enhanced by TritonX-100, Tween-20 or chaps to approximately 124.5% – 141.6%. The Km of GBSV1-NSN nuclease was 231, 61 and 92 μM, while its kcat was 1278, 241 and 300 s-1 for the cleavage of dsDNA, ssDNA and RNA, respectively. Conclusion Our study, therefore, presented a novel thermostable non-specific nuclease from thermophilic bacteriophage and its overexpression and purification for scientific research and applications.

  5. Non-specificity of Pitstop 2 in clathrin-mediated endocytosis

    Directory of Open Access Journals (Sweden)

    Anna K. Willox

    2014-04-01

    Full Text Available Small molecule inhibitors of clathrin-mediated endocytosis are highly desired for the dissection of membrane trafficking pathways in the lab and for potential use as anti-infectives in the clinic. One inhibition strategy is to prevent clathrin from contacting adaptor proteins so that clathrin-mediated endocytosis cannot occur. “Pitstop” compounds have been developed that block only one of the four functional interaction sites on the N-terminal domain of clathrin heavy chain. Despite this limitation, Pitstop 2 causes profound inhibition of clathrin-mediated endocytosis. In this study, we probed for non-specific activity of Pitstop 2 by examining its action in cells expressing clathrin heavy chain harbouring mutations in the N-terminal domain interaction sites. We conclude that the inhibition observed with this compound is due to non-specificity, i.e. it causes inhibition away from its proposed mode of action. We recommend that these compounds be used with caution in cells and that they should not be used to conclude anything of the function of clathrin's N-terminal domain.

  6. Non-specificity of Pitstop 2 in clathrin-mediated endocytosis.

    Science.gov (United States)

    Willox, Anna K; Sahraoui, Yasmina M E; Royle, Stephen J

    2014-04-04

    Small molecule inhibitors of clathrin-mediated endocytosis are highly desired for the dissection of membrane trafficking pathways in the lab and for potential use as anti-infectives in the clinic. One inhibition strategy is to prevent clathrin from contacting adaptor proteins so that clathrin-mediated endocytosis cannot occur. "Pitstop" compounds have been developed that block only one of the four functional interaction sites on the N-terminal domain of clathrin heavy chain. Despite this limitation, Pitstop 2 causes profound inhibition of clathrin-mediated endocytosis. In this study, we probed for non-specific activity of Pitstop 2 by examining its action in cells expressing clathrin heavy chain harbouring mutations in the N-terminal domain interaction sites. We conclude that the inhibition observed with this compound is due to non-specificity, i.e. it causes inhibition away from its proposed mode of action. We recommend that these compounds be used with caution in cells and that they should not be used to conclude anything of the function of clathrin's N-terminal domain.

  7. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

    NARCIS (Netherlands)

    M. van Middelkoop (Marienke); S.M. Rubinstein (Sidney); T. Kuijpers (Ton); A.P. Verhagen (Arianne); R.W.J.G. Ostelo (Raymond); B.W. Koes (Bart); M.W. van Tulder (Maurits)

    2010-01-01

    textabstractLow back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of

  8. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

    NARCIS (Netherlands)

    M. van Middelkoop (Marienke); S.M. Rubinstein (Sidney); T. Kuijpers (Ton); A.P. Verhagen (Arianne); R.W.J.G. Ostelo (Raymond); B.W. Koes (Bart); M.W. van Tulder (Maurits)

    2011-01-01

    textabstractLow back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of

  9. Cysteamine-induced duodenal ulcer and acid secretion in the rat

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1980-01-01

    Duodenal ulcers can be produced in rats within 24 h by a single subcutaneous administration of cysteamine. To determine the role of gastric acid secretion in the pathogenesis of these ulcers, secretory and pathoanatomic studies were performed in chronic fistula rats ater an ulcerogenic dose...... of cysteamine. A prolonged increase of acid secretion was seen after cysteamine, reaching fourfold the basal level after 5 h. The acid response lasted for 10 to 11 h. After vagotomy cysteamine-induced acid secretion was markedly reduced. Ulcer formation was prevented by vagotomy and by drainage of the gastric...... for ulcer formation, the hypersecretion of acid induced by cysteamine is not the only factor responsible for the development of duodenal ulcer....

  10. [Non-Helicobacter pylori, Non-nonsteroidal Anti-inflammatory Drug Peptic Ulcer Disease].

    Science.gov (United States)

    Chang, Young Woon

    2016-06-25

    Non-Helicobacter pylori, non-NSAID peptic ulcer disease (PUD), termed idiopathic PUD, is increasing in Korea. Diagnosis is based on exclusion of common causes such as H. pylori infection, infection with other pathogens, surreptitious ulcerogenic drugs, malignancy, and uncommon systemic diseases with upper gastrointestinal manifestations. The clinical course of idiopathic PUD is delayed ulcer healing, higher recurrence, higher re-bleeding after initial ulcer healing, and higher mortality than the other types of PUD. Genetic predisposition, older age, chronic mesenteric ischemia, cigarette smoking, concomitant systemic diseases, and psychological stress are considered risk factors for idiopathic PUD. Diagnosis of idiopathic PUD should systematically explore all possible causes. Management of this disease is to treat underlying disease followed by regular endoscopic surveillance to confirm ulcer healing. Continuous proton pump inhibitor therapy is an option for patients who respond poorly to the standard ulcer regimen.

  11. Association between venous leg ulcers and sex chromosome anomalies in men.

    Science.gov (United States)

    Gattringer, Cornelia; Scheurecker, Christine; Höpfl, Reinhard; Müller, Hansgeorg

    2010-11-01

    We report here two cases of men, aged 46 and 23 years, with refractory chronic venous leg ulcers in association with sex chromosome aberrations: one with a 47,XXY/48,XXXY karyotype (Klinefelter syndrome) and the other with a 47,XYY karyotype (Jacob syndrome). In both patients, the occurrence of leg ulcers was the reason for seeking medical care; their medical history was other-wise unremarkable. Chromosomal analyses were performed due to the unusually young age for development of venous leg ulcers. The pathophysiology behind the occurrence of venous leg ulcers in patients with numerical aberrations of the sex chromosomes is incompletely understood. Involvement of elevated plasminogen activator inhibitor-1 levels in the pathogenesis of venous leg ulcers has been reported in patients with Klinefelter syndrome. Notably, our patient with 47,XXY/48,XXXY presented with androgen deficiency but normal plasminogen activator inhibitor-1 activity.

  12. Pharmacotherapy of recurrent aphthous ulcers

    Directory of Open Access Journals (Sweden)

    J P Angeline Archana

    2011-01-01

    Full Text Available Aphthous ulcer is the most common type of ulcer affecting the oral cavity and is considered to be one of the most painful conditions. Treatment is often unsatisfactory. Newer treatment modalities are therefore being tried. Amlexanox and rebamipide are the approved drugs for painful aphthous ulcers and have been used in painful symptoms of acid peptic disease as prostaglandin enhancers. Safety and efficacy of the drugs used in the treatment of recurrent aphthous ulcers were evaluated and being used widely by most of the treating physicians choosing a modality of treatment of their experience. There is no proper treatment modality available till date. Various drugs and their efficacy with least adverse drug effects while treating the various aphthous ulcers are discussed.

  13. The treatment of skin ulcers in patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    M. Matucci- Cerinic

    2011-09-01

    Full Text Available Systemic Sclerosis (Ssc is a complex disease of the connective tissue, characterized by progressive thickening and fibrosis of the skin and the internal organs and by diffused damage of the microvascular system. The fibrosis ones of the skin associated to the characteristic vascular alterations lead to the genesis of ulcers, more or less extended, often multiple, peripheral localization, chronic course, painful, able to influence patient’s quality of life. Indeed, immunity reactivity, the thinning and the loss of elasticity of the skin, the peripheral neurological damage and the eventual drug assumption that can reduce regenerative/reparative abilities, can easy chronicizzate an ulcer and become infected complicating still more the patient disease, rendering more difficult the cure often, ulcer evolves to gangrene, and in some cases, in amputation too. For all these reasons, we have begun to study ulcers therapy (local and systemic, considering this activity it leave integrating of the charitable distance of the sclerodermico patient, putting to point on strategy both diagnostic and therapeutic, but above all with the primary scope, if possible, is to prevent ulcers, in contrary case, to alleviate the pain and to render the quality of the life of the patient better.

  14. An integrated approach in the treatment of varicose ulcer

    Directory of Open Access Journals (Sweden)

    Deepa Patil

    2013-01-01

    Full Text Available Venous ulcers (stasis ulcers, varicose ulcers are the wounds occurring due to inappropriate functioning of venous valves, usually of the legs. It is one of the most serious chronic venous insufficiency complications. The overall incidence rate is 0.76% in men and 1.42% in women. When a venous valve gets damaged, it prevents the backflow of blood, which causes pressure in the veins that leads to hypertension and, in turn, venous ulcers. These are mostly along the medial distal leg, which is often very painful, can bleed, and get infected. Treating varicose ulcers is a difficult task to the physician and a nightmare to the suffering patients, though a good number of the treatment principles are mentioned and practiced in allied sciences. In Ayurveda, this condition is considered as dus.t.a vran.a. It can be managed with the specific s′odhana therapy. So, the same treatment protocol was used to treat the case discussed here, i.e. with Nitya virecana and by Basti karma. The wound was successfully treated and, therefore, is discussed in detail.

  15. Transdermal deferoxamine prevents pressure-induced diabetic ulcers.

    Science.gov (United States)

    Duscher, Dominik; Neofytou, Evgenios; Wong, Victor W; Maan, Zeshaan N; Rennert, Robert C; Inayathullah, Mohammed; Januszyk, Michael; Rodrigues, Melanie; Malkovskiy, Andrey V; Whitmore, Arnetha J; Walmsley, Graham G; Galvez, Michael G; Whittam, Alexander J; Brownlee, Michael; Rajadas, Jayakumar; Gurtner, Geoffrey C

    2015-01-06

    There is a high mortality in patients with diabetes and severe pressure ulcers. For example, chronic pressure sores of the heels often lead to limb loss in diabetic patients. A major factor underlying this is reduced neovascularization caused by impaired activity of the transcription factor hypoxia inducible factor-1 alpha (HIF-1α). In diabetes, HIF-1α function is compromised by a high glucose-induced and reactive oxygen species-mediated modification of its coactivator p300, leading to impaired HIF-1α transactivation. We examined whether local enhancement of HIF-1α activity would improve diabetic wound healing and minimize the severity of diabetic ulcers. To improve HIF-1α activity we designed a transdermal drug delivery system (TDDS) containing the FDA-approved small molecule deferoxamine (DFO), an iron chelator that increases HIF-1α transactivation in diabetes by preventing iron-catalyzed reactive oxygen stress. Applying this TDDS to a pressure-induced ulcer model in diabetic mice, we found that transdermal delivery of DFO significantly improved wound healing. Unexpectedly, prophylactic application of this transdermal delivery system also prevented diabetic ulcer formation. DFO-treated wounds demonstrated increased collagen density, improved neovascularization, and reduction of free radical formation, leading to decreased cell death. These findings suggest that transdermal delivery of DFO provides a targeted means to both prevent ulcer formation and accelerate diabetic wound healing with the potential for rapid clinical translation.

  16. Seronegative Herpes simplex Associated Esophagogastric Ulcer after Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Edouard Matevossian

    2008-03-01

    Full Text Available Herpes simplex infection is characterized by acute or subacute infection, often followed by a chronic carrier state. Consecutive recurrences may flare up if immunocompromise occurs. Herpes simplex associated esophagitis or duodenal ulcer have been reported in immunocompromised patients due to neoplasm, HIV/AIDS or therapeutically induced immune deficiency. Here we report the case of an HSV-DNA seronegative patient who developed grade III dysphagia 13 days after allogeneic liver transplantation. Endoscopy revealed an esophageal-gastric ulcer, and biopsy histopathology showed a distinct fibroplastic and capillary ulcer pattern highly suspicious for viral infection. Immunohistochemistry staining revealed a distinct nuclear positive anti-HSV reaction. Antiviral therapy with acyclovir and high-dose PPI led to a complete revision of clinical symptoms within 48 h. Repeat control endoscopy after 7 days showed complete healing of the former ulcer site at the gastroesophageal junction. Although the incidence of post-transplantation Herpes simplex induced gastroesophageal disease is low, the viral HSV ulcer may be included into a differential diagnosis if dysphagia occurs after transplantation even if HSV-DNA PCR is negative.

  17. Characterization of Helicobacter Pylori Infection in Patients with Gastric Ulcer

    Directory of Open Access Journals (Sweden)

    Marcos Félix Osorio Pagola

    2009-12-01

    Full Text Available Background: Nowadays, infection due to Helicobacter Pylori is recognized as a medical problem worldwide. It causes chronic gastritis, peptic ulcer disease, lymphatic proliferative disorders and it is a risk factor for gastric cancer. Objective: To characterize Helicobacter Pylori infection in patients with gastric ulcer and to relate this infection to gastric histological diagnoses. Methods: An observational, descriptive, correlational retrospective study in patients with gastric ulcers at the Dr.Gustavo Aldereguía Lima Hospital was carried out from January 2005 to December 2007. Endoscopy and mucous gastric biopsy were performed for the histological and diagnostic study of the infection due to Helicobacter Pylori by means of the hematoxiline-eosine and giemsa stain respectively. The sample was composed by 137 patients. Results: the frequency of infection due to Helicobacter pylori was 59,1 % prevailing in the age groups 51-60 years old (34,6 % and 61-70 yearsold. (30,8 %. The highest frequency of malignant ulcers were located at the antral region (85,7 % with predominance of Helicobacter Pylori (80 %. There was a 95 % reliability between the relationship of Helicobacter Pylori and the histological diagnoses. The patients under the diagnosis of Helicobacter Pylori showed a greater probability to present cancer (OR 4,32 IC: 0,58-39,44 and worsened chronic gastritis (OR 2,59 IC: 0,61-11,30. Chronic gastritis did not constitute a risk factor for acute gastritis(OR 0,86 IC: 0,09-7,08. Conclusions: The probability of suffering from gastric cancer, chronic gastritis and worsened chronic gastritis was greater in all those patients who presented with Helicobacter pylori infection but in this study Helicobacter pylori did not constitute a risk factor for acute gastritis

  18. Integrated Traditional Chinese Medicine-West Medicine for the Therapy of Chronic Ulcerative Coli-tis Report%中西医结合药物治疗慢性溃疡性结肠炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    张金涛; 王晓锋; 陈浩漩

    2015-01-01

    Objective To evaluate the effect of integrated traditional Chinese medicine-west medicine (TCM-WM) therapy for mild-moderate adult distal chronic ulcerative colitis(M-M ACUC).Methods This clinical randomized controlled trial was performed in Tongzhou Hospital of Traditional Chinese Medicine from Feb.2008 to Feb.2010.The observation group—TCM/WM group:45 cases of M-M ACUC were included, which were treated with oral mesalazine slow release tablets and topical metronidazole(glycoprival) 100 mL+hydrocortisone 100 mg during acute stage,and during paracmasia self-made TCM medicine ( longleaf garden burnet root 30 g,hairyvein agrimonia herb 30 g,lalang grass rhizome 30 g,common bletilla tuber 15 g,light-yellow sophora root 15 g,baikal skullcap root 10 g,dried alum 10 g and synthetic borneol 3 g) was offered as enema.The control group—WM group:40 cases during the same period were included,and were treated with oral mesalazine slow release tablets and topical metronidazole(glycoprival) 100 mL+hydrocortisone 100 mg during acute stage,and oral mesalazine slow release tablets combined with topical mesalazine were utilized during the paracmasia stage.All the cases were followed up for two years.The medication duration,effective-ness rate,side effect rate and the medical expense were recorded and analyzed.Results There was no signifi-cant difference between the TCM/WM group and the WM group:regarding the medication duration [ (27.5 ± 2.7) d vs (28.4 ±3.2) d] and effectiveness rate (93.3% vs 90.0%) (P>0.05),while the individual medical expense was (543 ±11) RMB for TCM/WM group,(1120 ±8) RMB for WM group,there was sta-tistically significant difference ( P <0.05 ) .And the side effect rate was 6.7% for TCM/WM group and 25.0% for WM group,with significant difference(P <0.05).Conclusion The TCM-WM therapyis eco-nomic,safe and effective in the treatment of M-M ACUC.%目的:探讨中西医结合药物治疗轻-中度远端成人型慢性溃疡性结

  19. Ehlers-Danlos Syndrome Type VIII: A Rare Cause of Leg Ulcers in Young Patients

    Science.gov (United States)

    Lucas, Antoine; Piérard, Gérald E.; Hermanns-Lê, Trinh; De Paepe, Anne; Dupuy, Alain

    2013-01-01

    Ehlers-Danlos syndrome type VIII (EDS-VIII) is a very rare autosomal dominant disease characterized by early-onset periodontitis associated with features of Ehlers-Danlos syndrome. We report a 32-year-old man whose chronic leg ulcer led to the diagnosis of EDS-VIII. He had severe periodontitis with complete loss of permanent teeth and skin fragility with thin skin, atrophic scars, and brownish atrophic pretibial plaques. Leg ulcer is not a prominent feature of EDS-VIII. We suggest adding EDS-VIII to the list of rare diseases accounting for chronic leg ulcers, if this case report prompts others to report leg ulcers associated with EDS-VIII. PMID:24198978

  20. Healing effect of aloe vera gel,in non-healed ulcers

    Institute of Scientific and Technical Information of China (English)

    Majid Avijgan; Victoria Beigi Broujeni; Ali Akbar Beigi; Hojatollah Rohi Borojeni; Seyyed Ka-myar Mostafavizadeh; Iraj Karimi; Abbas Ali Javadi

    2009-01-01

    Objective:Aloe Vera gel (AVG)has a prominent role as a contemporary folk remedy.The Non-healed chron-ic ulcers of 16 non-responders to conventional treatment were treated with AVG for which the clinical efficacy was studied.Methods:This study included 16 patients having chronic ulcer (9 males and 7 females)with mean age of 41.8 ±14.6 who following failure treatment to conventional therapy,were dispensed AVG to ap-ply.AVG is consisted from gel part of Aloe Vera plant plus one preservative material,in this study ECG jelly. The patients were assessed as responder whenever intensity of inflammation,the number and /or the size of ul-cers have been reduced.Results:The period of time till healing (complete or reduction in size of ulcer), were from 5 to 160 days with mean of 31.2 ±36.4 days.The mean time of decreasing for secreting,swelling and redness was from 5-11 days.Spearman coefficient of correlation,showed no significant correlation between first size and depth of ulcer and timing till 50% reduction in size of ulcer.Conclusion:All patients had been treated with conventional treatment all to no avail.There were some full thickness ulcer which at the end of treatment we observed an improvement and normal skin for those ulcers.There was a minor complication like itching in one patient but no leading to stop treatment.These findings suggest that AVG is an excellent and sa-fer choice than current conventional therapeutic management of chronic ulcers.

  1. Comparison of brucella and non-specific epididymorchitis: gray scale and color Doppler ultrasonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Ozturk, Adil [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey)]. E-mail: ozturka26@hotmail.com; Ozturk, Ebru [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey); Zeyrek, Fadile [Department of Microbiology, Harran University School of Medicine, Sanliurfa (Turkey); Onur, Kahraman [Department of Urology, SSK Sanliurfa Hastanesi, Sanliurfa (Turkey); Sirmatel, Ocal [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey); Kat, Nurcan [Department of Radiology, Harran University School of Medicine, Arastirma ve Uygulama Hastanesi, TR-63100 Sanliurfa (Turkey)

    2005-11-01

    Objective: The aim of this study is to find out if it is possible to differentiate between brucellar and non-specific epididymorchitis by comparing ultrasonography (US) and color Doppler ultrasonography (CDUS) findings. Material and methods: Fifty-six patients diagnosed to have epididymorchitis both clinically and ultrasonographically were included to study. All of the patients were investigated serologically for brucella. Twenty-eight of those patients were admitted brucella epididymorchitis because of high agglutinations titers for brucella. The other 28 patients were admitted non-specific epididymorchitis because of normal agglutinations titers for brucella. Testicular size, echogenicity, hydrocele, internal echoes and/or septations within hydrocele, and scrotal skin thickness of normal and involved testis were compared by ultrasonography. Besides, pick systolic velocity, end diastolic velocity, resistive index and pick systolic velocity ratio values were measured by bilateral testicular color Doppler ultrasonography in both groups. When the p-value is <0.05, the difference between groups is accepted as statistically significant. Results: Thickening of scrotal skin was seen in 17 of 28 patients with brucella epididymorchitis (BEPO) (67%) and in 25 of 28 patients with non-specific epididymorchitis (NEPO) (89.2%) (p < 0.01). There was no difference between groups regarding presence of hydrocele. However hydrocele seen in all patients was anechoic except for two patients (8.6%). Hydrocele seen in 18 of 22 patients with BEPO and hydrocele had internal echogenicity or septation (p < 0.001). Sizes of testes and epididymis were found to be increased in involved testis compared to normal testis. Testes of all patients with NEPO were homogenous with decreased echogenicity except for five patients (17.8%). However, 23 patients with BEPO (82%) found to have heterogenous testis (p < 0.001). Spectral measurements showed increased PSV and EDV values and decreased RI values in

  2. Non-specific histological variant of dysembryoplastic neuroepithelial tumor:a diagnostic challenge

    Institute of Scientific and Technical Information of China (English)

    Yanyang Chen; Bin Li; Boning Luo; Xiaoying Tian; Zhi Li

    2016-01-01

    Objective The accurate diagnosis of the non-specific variant of dysembryoplastic neuroepithelial tumor (DNT) is very dif icult because it is characterized by absence of the histological hal mark of the “specific glioneuronal element” in lesions. We herein present two cases of the non-specific form of DNT to analyze the clinical, radiological, and histological features of this unusual subtype of DNT. Methods A 16-year-old and a 23-year-old patient had been treated for pharmacoresistant epilepsy for several years before undergoing referral to the hospital for further examination and treatment. Magnetic resonance imaging (MRI) revealed that both patients had a smal , wel-demarcated cystic lesion within the cortex of the brain without obvious contrast enhancement or peritumoral edema. The lesions were total y resected and routinely examined using histological and immunohistochemical analysis. Results Both lesions exhibited similar histological appearances with cyst formation and mural nodule architecture. The glial nodules were mainly composed of oligodendrocyte-like components, and partly of piloid cel s resembling pilocytic astrocytoma. The cortex adjacent to the lesion in both cases was found to have the histological features of focal cortical dysplasia (FCD) Type I. Immunohistochemical y, the oligoden-drocyte-like components were dif usely positive for Syn and Olig-2, but staining for CD34, p53, and IDH1 R132H was negative. The Ki-67 (MIB-1) labeling index was low, approximately 1%. There was no 1p/19q co-deletion in either lesion by fluorescence in situ hybridization (FISH) assay. Neither patient received postoperative adjuvant treatment, and both underwent regular fol ow-up for at least 24 months. No signs of recurrence or epileptic attacks were observed during the fol ow-up period. Conclusion The non-specific variant of DNT is a diagnostic chal enge for pathologists in clinical practice, and dif erentiation from some low-grade gliomas needs to be considered

  3. The clinical course and prognostic factors of non-specific neck pain: a systematic review.

    Science.gov (United States)

    Borghouts, J A; Koes, B W; Bouter, L M

    1998-07-01

    Neck pain occurs frequently in western societies. In the majority of cases, no specific cause can be identified. In order to gain insight into the clinical course and prognostic factors of non-specific neck pain, a systematic review was conducted. A computerized literature search was carried out to identify observational studies on non-specific neck pain and randomized clinical trials (RCTs) on conservative treatment of non-specific neck pain. Two reviewers scored independently, the methodological quality of all identified publications, using a standardized set of 13 criteria which were divided into five categories according to: study population, study design, follow-up, outcome measures and analysis/data presentation. To determine prognosis per study, an overall percentage of recovery for the most important outcome measures (pain, general improvement, functional status, health care utilization and lost days of work) was calculated. In total 23 eligible publications were identified (six observational studies and 17 RCTs). Only seven of 23 studies scored 50% or more of the 13 items, indicating a generally poor quality of methods. The most prevalent methodological shortcomings appeared to be selection of the study population, the sample size and analysis techniques. Most information regarding the clinical course is available for the group of patients with complaints for more than 6 months, who are treated in a secondary care or an occupational setting. In this group of patients, 46% (median) had less pain, with a range of 22-79% and a general improvement that ranged between 37 and 95% (47% median). The reduction in the use of analgesics ranged between 32 and 80% (37% median). Six studies reported on prognostic factors. Bearing in mind the limited number of studies and the low methodological quality, there are some indications that the localization (radiation to the arms/neurologic signs) and radiologic findings (degenerative changes in the discs and joints) are not

  4. Exercise-induced bronchoconstriction and non-specific airway hyperreactivity in patients suffering from bronchial asthma

    Directory of Open Access Journals (Sweden)

    Novković Dobrivoje

    2014-01-01

    Full Text Available Background/Aim. Physical activity is a common stimulus of asthmatic symptoms manifestation. Airway hyperreactivity is a predisposing cause of exercise induced bronchial obstruction, diagnosed by histamine inhalation. The aim of this study was to determine the relation between the amounts of histamine needed to induce non-specific airway hyperreactivity and exercise-induced bronchial obstruction. Methods. This randomized cross-over study included 160 male patients (age 19-27 years suffering from bronchial asthma who showed positive results as the reaction after the histamine bronchial provocation test. Histamine concentrations were in a range of 0.03 to 4 mg/mL. Each patient participated in the exercise stress test conducted on a conveyor belt. The results of the exercise stress test were considered positive if the FEV1 level dropped by at least 15% from its initial value, 5-10 minutes after the test. Results. All the patients showed positive results as the reaction after the histamine bronchial provocation test, while 50 of them showed positive results after the exercise-induced stress test. There was a statistically highly significant difference in administrated histamine concentrations between the group of patients that had positive results on exercise stress test and those who did not (1mg/mL vs 0.5mg/mL; U = 1678; p < 0.01. Also, there was a statistically significant difference concerning the frequency of the positive results regarding histamine concentration after induced stress test (χ2 = 10.885; p = 0.001. Among the patients with positive results, there was a statistically highly significant number of patients with bronchial obstruction induced by less than 2 mg/mL of histamine (p < 0.01. A statistically significant relation between the amount of histamine needed to induce bronchial obstruction and the results of the exercise stress test (p < 0.01 was also observed after the testing. Conclusion. In the group of patients with positive

  5. Non-Specific Gastric Inflammation in Children is Associated with Proton Pump Inhibitor Treatment for More than 6 Weeks

    Science.gov (United States)

    Rosas-Blum, Eduardo; Tatevian, Nina; Hashmi, Syed Shahrukh; Rhoads, Jon Marc; Navarro, Fernando

    2014-01-01

    Background and Aims: Non-specific gastric inflammation (NSGI) is a commonly reported pathological finding. We investigated if it is associated with the use of proton pump inhibitors (PPIs) in children at a single tertiary center. Methods: We performed an IRB-approved chart review of all endoscopy and biopsy reports of patients who underwent esophagogastroduodenoscopy between July 2009 and July 2010 (n = 310). Demographic data, dose, duration of exposure to PPI, and biopsy results were collected and analyzed. All esophageal, gastric, and duodenal biopsies were independently reviewed by a pathologist. Patients with acute gastritis, moderate/severe chronic gastric inflammation, or Helicobacter pylori infection were excluded. The presence of NSGI was compared between patients exposed and not exposed to PPI as well as between patients with different doses and durations of PPI exposure to assess for potential associations. Results: A total of 193 patients were included: 88 (46%) had a history of PPI use and 48 (25%) were found to have NSGI. Compared to patients not exposed to PPI, the odds ratio of NSGI in patients exposed to PPIs was 2.81 (95% CI: 1.36–5.93). The odds ratio of NSGI in patients exposed to PPI for >3 months was 4.53 (95% CI: 1.69–11.97). Gender, ethnicity, and age were not associated with NSGI. No histological differences were found in the esophagus and duodenum between patients exposed and not exposed to PPI. Conclusion: This study found that PPI exposure is associated with NSGI with a higher risk for those exposed for >3 months. As the clinical implications of NSGI are not known, judicious use of PPIs is needed. Prospective studies are required to confirm and to determine the etiologic factors (i.e., alteration of the gastric pH, serum gastrin) that may be related with the presence of NGSI. PMID:24479108

  6. Non-specific gastric inflammation in children is associated with proton pump inhibitor treatment for more than 6 weeks

    Directory of Open Access Journals (Sweden)

    Eduardo Daniel Rosas-Blum

    2014-01-01

    Full Text Available Background & Aims: Non-specific gastric inflammation (NSGI is a commonly reported pathological finding. We investigated if it is associated with the use of proton pump inhibitors (PPI in children at a single tertiary center. Methods: We performed an IRB-approved chart review of all endoscopy and biopsy reports of patients who underwent esophagogastroduodenoscopy between July 2009 to July 2010 (n=310. Demographic data, dose, and duration of exposure to PPI, and biopsy results were collected and analyzed. All esophageal, gastric and duodenal biopsies were independently reviewed by a pathologist. Patients with acute gastritis, moderate/severe chronic gastric inflammation or Helicobacter pylori infection were excluded. The presence of NSGI was compared between patients exposed and not exposed to PPI as well as between patients with different doses and durations of PPI exposure to assess for potential associations. Results: A total of 193 patients were included: 88 (46% had a history of PPI use, and 48 (25% were found to have NSGI. Compared to patients not exposed to PPI, the odds ratio of NSGI in patients exposed to PPIs was 2.81(95% CI: 1.36-5.93. The odds ratio of NSGI in patients exposed to PPI for >3 months was 4.53(95% CI: 1.69-11.97. Gender, ethnicity, and age were not associated with NSGI. No histological differences were found in the esophagus and duodenum between patients exposed and not exposed to PPI. Conclusion: This study found that PPI exposure is associated with NSGI with a higher risk for those exposed for >3 months. As the clinical implications of NSGI are not known, judicious use of PPIs is needed. Prospective studies are required to confirm and to determine the etiologic factors (i.e. alteration of the gastric pH, serum gastrin that may be related with the presence of NGSI.

  7. Treatment of a Refractory Skin Ulcer Using Punch Graft and Autologous Platelet-Rich Plasma

    Directory of Open Access Journals (Sweden)

    Mauro Carducci

    2016-01-01

    Full Text Available Background. Chronic ulceration of the lower legs is a relatively common condition amongst adults: one that causes pain and social distress and results in considerable healthcare and personal costs. The technique of punch grafting offers an alternative approach to the treatment of ulcers of the lower limbs. Objective. Combining platelet-rich plasma and skin graft enhances the efficacy of treating chronic diabetic wounds by enhancing healing rate and decreasing recurrence rate. Platelet-rich plasma could, by stimulating dermal regeneration, increase the take rate after skin grafting or speed up reepithelialization. Methods and Materials. The ulcer was prepared by removing fibrin with a curette and the edges of the ulcer were freshened. The platelet-rich plasma has been infiltrated on the bottom and edges of the ulcer. The punch grafts were placed in 5 mm holes arranged. The ulcer was medicated with hydrogel and a pressure dressing was removed after 8 days. Results. After a few days the patient did not report more pain. Granulation tissue appeared quickly between implants. Most of the grafts were viable in 2-3 weeks. The grafts gradually came together to close the ulcer and were completed in four months.

  8. Diverticular colitis of the ascending colon preceding the onset of ulcerative colitis

    OpenAIRE

    Maeshiro, Tatsuji; Hokama, Akira; Kinjo, Tetsu; Fujita, Jiro

    2014-01-01

    We present a case of diverticular colitis of the ascending colon preceding the onset of ulcerative colitis. A 58-year-old man presented with positive faecal occult blood test. Colonoscopy disclosed diverticular colitis of the ascending colon. After a year's follow-up, typical ulcerative colitis developed and diverticular colitis improved. Diverticular colitis is a newly established disorder of chronic segmental mucosal inflammation affected by diverticular disease. There is increasing recogni...

  9. The expression of matrix metalloproteinase-9 in the chronic venous ulcer tissues and significance%基质金属蛋白酶-9在静脉性溃疡组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    杨帆; 李金朋; 王勇

    2016-01-01

    Objective To observe the expression of matrix metalloproteinase-9 (MMP-9) in the tissues of venous ulcer,and to explore the pathological mechanism of angiogenesis dysfunction.Methods Sixty-four ulcer samples were obtained from the patients [(56.27 ± 5.12) years old] including 52 males and 12 females with lower extremity venous ulcer treated in our hospital.The ulcer samples were divided into 2-,3-,4-,and 5-week groups based on the course of the disease,and 50 cases of traumatic ulcer [(54.42 ±6.87) years old] served as the contol group.The expression of MMP-9,and vascular endothelial growth factor receptor 2 (VEGFR2) was analyzed by Western blotting and grey ratio detection.The immunofluorescence double staining was used to observe the correlation of MMP-9/CD31 expression.Results There was significant difference in the grey ratio detection of MMP-9 between 4-,and 5-week groups with 2-,3-week groups (0.181 ± 0.031,0.007 ± 0.014 vs.0.512 ± 0.113,0.685 ± 0.174);VEGFR2 between 4-,and 5-week groups and 3-week group (0.614 ± 0.143,0.497 ± 0.262 vs.1.465 ± 0.074,P < 0.05).Immunofluorescence double staining revealed that the levels of MMP-9/CD31 was also markedly decreased in the venous ulcer group as compared with those in traumatic ulcer group,and the correlation was observed.Conclusion The low expression of VEGFR2 that is regulated by MMP-9 possibly is associated with angiogenesis dysfunction in the tissues of venous ulcer.%目的 观察静脉性溃疡组织中的基质金属蛋白酶-9(MMP-9)表达,探讨静脉性溃疡血管再生障碍机制.方法 采集我院64例静脉性溃疡患者溃疡创面标本,其中男52例,女12例,平均年龄(56.27±5.12)岁,按病程分为2周组、3周组、4周组、5周组,以创伤性溃疡50例作为对照组,平均年龄(54.42±6.87)岁,Western blot检测各组溃疡创面MMP-9、血管内皮生长因子受体2(VEGFR2)表达趋势;用免疫荧光双染色检测MMP-9/CD31在溃疡组

  10. Protective effects of pentadecapeptide BPC 157 on gastric ulcer in rats

    Institute of Scientific and Technical Information of China (English)

    Xiao-Chang Xue; Yong-Jie Wu; Ming-Tang Gao; Wen-Guang Li; Ning Zhao; Zeng-Lu Wang; Chun-Jie Bao; Zhen Yan; Ying-Qi Zhang

    2004-01-01

    AIM: To investigate the protective effects of gastric pentadecapeptide BPC 157 on acute and chronic gastric ulcers in rats and to compare the results in therapy of human gastric ulcers by different administration methods.METHODS: Gastric pentadecapeptide BPC 157 was administered (initial single or continuous administration) into rats either intragastrically or intramuscularly before (induced acute gastric ulcer) or after (induced chronic gastric ulcer) the applications of inducing agents, and each animal was sacrificed to observe the protective effects of BPC 157 on gastric ulcers.RESULTS: Both intramuscular (im) and intragastric (ig) administration of BPC 157 could apparently reduce the ulcer area and accelerate the healing of induced ulcer in different models and the effect of im administered BPC 157 was better than that of ig. The rats treated with higher dosages (400 ng/kg, 800 ng/kg) of BPC 157 (im and ig) showed significantly less lesion (P<0.01 vs excipient or saline control), the inhibition ratio of ulcer formation varied between 45.7% and 65.6%, from all measurements except 400 ng/kg BPC 157 in pylorus ligation induced model (P<0.05),in which the inhibition rate was 54.2%. When im administered (800 ng/kg BPC 157) in three models, the inhibition ratio of ulcer formation was 65.5%, 65.6% and 59.9%, respectively, which was better than that of famotidine (its inhibition rate was 60.8%, 57.2% and 34.3%,respectively). Continuous application of BPC 157 (in chronic acetate induced gastric ulcer) could accelerate rebuilding of glandular epithelium and formation of granulation tissue (P<0.05 at 200 ng/kg and P<0.01 at 400 ng/kg and 800 ng/kg vs excipient or saline control).CONCLUSION: Both im and ig administered gastric pentadecapeptide BPC 157 can apparently ameliorate acute gastric ulcer in rats and antagonize the protracted effect of acetate challenge on chronic ulcer. The effect of im administration of BPC 157 is better than that of ig, and the effective

  11. Effectiveness of infliximab in the treatment of perianal fistulas in ulcerative colitis: report of two cases.

    Science.gov (United States)

    de la Piscina, Patricia Ramírez; Duca, Ileana; Estrada, Silvia; Spicakova, Katerina; Calderón, Rosario; Urtasun, Leire; Marra-López, Carlos; Salvador, Marta; Delgado, Elvira; Campos, Francisco García

    2013-01-01

    Ulcerative colitis is a chronic inflammatory bowel disease of unknown etiopathogenesis and increasing incidence in recent years. Perianal complications of ulcerative colitis are rare and seem to be associated with higher extent of inflammation and a more severe course of the disease. The cases of two male patients with severe corticoid-dependent ulcerative colitis of protracted clinical course who developed perianal fistulas and abscesses successfully treated with infliximab are reported. Treatment with infliximab was followed by perianal fistula closure with marked improvement in the quality of life over 2-year follow-up period.

  12. Patent foramen ovale in trigeminal autonomic cephalalgias and hemicrania continua: a non-specific pathophysiological occurrence?

    Science.gov (United States)

    Amaral, Vanise; Freitas, Gabriel R de; Rodrigues, Bruno C B; Christoph, Daniel de H; Pinho, Carlos A de; Góes, Cristiana de Faria P; Vincent, Maurice B

    2010-08-01

    Patent foramen ovale (PFO), a relatively common abnormality in adults, has been associated with migraine. Few studies also linked PFO with cluster headache (CH). To verify whether right-to-left shunt (RLS) is related to headaches other than migraine and CH, we used transcranial Doppler following microbubbles injection to detect shunts in 24 CH, 7 paroxysmal hemicrania (PH), one SUNCT, two hemicrania continua (HC) patients; and 34 matched controls. RLS was significantly more frequent in CH than in controls (54% vs. 25%, p=0.03), particularly above the age of 50. In the HC+PH+SUNCT group, RLS was found in 6 patients and in 2 controls (p=0.08). Smoking as well as the Epworth Sleepiness Scale correlated significantly with CH, smoking being more frequent in patients with RLS. PFO may be non-specifically related to trigeminal autonomic cephalalgias and HC. The headache phenotype in PFO patients probably depends on individual susceptibility to circulating trigger factors.

  13. [Mechanisms underlying physiological functions of food factors via non-specific interactions with biological proteins].

    Science.gov (United States)

    Murakami, Akira

    2015-01-01

      We previously reported that zerumbone, a sesquiterpene found in Zingiber zerumbet SMITH, showed notable cancer preventive effects in various organs of experimental rodents. This agent up-regulated nuclear factor-E2-related factor (Nrf2)-dependent expressions of anti-oxidative and xenobiotics-metabolizing enzymes, leading to an increased self-defense capacity. On the other hand, zerumbone markedly suppressed the expression of cyclooxygenase-2, an inducible pro-inflammatory enzyme, by disrupting mRNA stabilizing processes. Binding experiments using a biotin derivative of zerumbone demonstrated that Keap1, an Nrf2 repressive protein, is one of its major binding proteins that promotes their dissociation for inducing Nrf2 transactivation. We then generated a specific antibody against zerumbone-modified proteins and found that zerumbone modified numerous cellular proteins in a non-specific manner, with global distribution of the modified proteins seen not only in cytoplasm but also the nucleus. Based on those observations, zerumbone was speculated to cause proteo-stress, a notion supported by previous findings that it increased the C-terminus of Hsc70 interacting protein-dependent protein ubiquitination and also promoted aggresome formation. Interestingly, zerumbone counteracted proteo-stress and heat stress via up-regulation of the protein quality control systems (PQCs), e.g., heat shock proteins (HSPs), ubiquitin-proteasome, and autophagy. Meanwhile, several phytochemicals, including ursolic acid and curcumin, were identified as marked HSP70 inducers, whereas most nutrients tested were scarcely active. Recent studies have revealed that PQCs play important roles in the prevention of many lifestyle related diseases, such as cancer, thus non-specific binding of phytochemicals to cellular proteins may be a novel and unique mechanism underlying their physiological activities.

  14. COMPARISON OF EFFECTIVENESS OF ISOMETRIC EXERCISES WITH AND WITHOUT STRETCHING EXERCISES IN NON SPECIFIC CERVICAL PAIN

    Directory of Open Access Journals (Sweden)

    Warda Hassan

    2016-06-01

    Full Text Available Background: Cervical pain is a common condition and almost two thirds of population suffers with this condition. Cervical region is the commonest region for non-traumatic neck pain. Neck pain generates many muscular disturbances in the neck region and may result in tightness of muscles of cervical region. Stretching is considered as an effective mean of treating cervical pain. Isometric exercise is used to enhance the performance of muscles because it provides strength required to perform dynamic exercise. Both of the regimens either separately or combined are used in clinical settings to treat nonspecific cervical pain. This study aims to compare the results of cervical isometrics with and without stretching exercises in reducing non-specific cervical pain Methods: A randomized controlled trial research was performed at physiotherapy department of Mayo Hospital Lahore, Pakistan. A convenience sample of 40 participants was divided into two groups. The cervical isometric exercise was applied to group A and stretching plus isometric exercise to group B for 3 weeks. Nonspecific neck pain was analyzed by using visual analogue scale and goniometry for pre and post treatment assessment. Results: Isometric exercises play an effective role in relieving pain (p value is 0.03 and minimizing inability of the body to perform functional activities (p value is 0.004 in contrast to the patients of group A. Isometric exercises were applied to the patients of group A (Level of pain: pain value is 0.172 and (physical inability to perform functional activities has P value 0.201. Conclusion: The result showed that the patients with the complain of non-specific neck discomfort who were treated by cervical isometric alone, showed less improvement in pain relief in contrast to the patients who were treated by the cervical isometric long with stretching.

  15. [Neurosis and genetic theory of etiology and pathogenesis of ulcer disease].

    Science.gov (United States)

    Kolotilova, M L; Ivanov, L N

    2014-01-01

    Based on the analysis of literature data and our own research, we have developed the original concept of etiology and pathogenesis of peptic ulcer disease. An analysis of the literature shows that none of the theories of pathogenesis of peptic ulcer disease does not cover the full diversity of the involved functions and their shifts, which lead to the development of ulcers in the stomach and the duodenum. Our neurogenic-genetic theory of etiology and pathogenesis of gastric ulcer and duodenal ulcer very best explains the cause-and-effect relationships in the patient peptic ulcer, allowing options for predominance in one or the other case factors of neurosis or genetic factors. However, it is clear that the only other: combination of neurogenic factor with genetically modified reactivity of gastroduodenal system (the presence of the target organ) cause the chronicity of the sores. The theory of peptic ulcer disease related to psychosomatic pathologies allows us to develop effective schema therapy, including drugs with psychocorrective action. On the basis of our theory of the role of Helicobacter pylori infection is treated as a pathogenetic factor in the development of peptic ulcer disease.

  16. The wound/burn guidelines - 5: Guidelines for the management of lower leg ulcers/varicose veins.

    Science.gov (United States)

    Ito, Takaaki; Kukino, Ryuichi; Takahara, Masakazu; Tanioka, Miki; Nakamura, Yasuhiro; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Isei, Taiki; Inoue, Yuji; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ohtsuka, Mikio; Ogawa, Fumihide; Kadono, Takafumi; Kawakami, Tamihiro; Kawaguchi, Masakazu; Kono, Takeshi; Kodera, Masanari; Sakai, Keisuke; Nakanishi, Takeshi; Hashimoto, Akira; Hasegawa, Minoru; Hayashi, Masahiro; Fujimoto, Manabu; Fujiwara, Hiroshi; Maekawa, Takeo; Matsuo, Koma; Madokoro, Naoki; Yamasaki, Osamu; Yoshino, Yuichiro; Le Pavoux, Andres; Tachibana, Takao; Ihn, Hironobu

    2016-08-01

    Varicose veins are treated at multiple clinical departments, but as patients often visit the dermatology clinic first due to leg ulcers, the present Guidelines for the Management of Lower Leg Ulcers/Varicose Veins were prepared in consideration of the importance of the dermatologist's role. Also, the disease concept of chronic venous insufficiency or chronic venous disorders and the CEAP classification of these disorders are presented. The objective of the present guidelines is to properly guide the diagnosis and treatment of lower leg ulcers/varicose veins by systematically presenting evidence-based recommendations that support clinical decisions.

  17. Effect of centrally administered oxytocin on gastric and duodenal ulcers in rats%脑室注射催产素对大鼠胃和十二指肠溃疡的作用

    Institute of Scientific and Technical Information of China (English)

    Mohammed ASAD; Deepak Gopal; Kallasam KOUMARAVELOU; Benny K ABRAHAM; Sadashivam VASU; Subramanian RAMASWAMY

    2001-01-01

    AIM: To investigate the effect of centrally administered oxytocin and its receptor antagonist, atosiban, on gasuic acid secretion and on experimentally induced gastric and duodenal ulcers. METHODS: The acute gastric ulcer models, such as pylorus ligation, indomethacin-induced and ethanol-induced gastric ulcers were used. Chronic gastric ulcers were induced by acetic acid and duodenal ulcers by cysteamine HC1. RESULTS: In pylorus ligated rats, oxytocin ( 10 μg/kg, icv) showed signifi cant antisecretory and antiulcer activity (P<0.01 ). However, it aggravated the ethanol-induced gastric ulcers and did not show any effect on indomethacin-induced gas tric ulcers. Oxytocin increased gastric ulcer healing in acetic acid-induced chronic gastric ulcers. The effect of oxytocin was reversed by atosiban (10 μg/kg, icy), a selective oxytocin receptor antagonist. Atosiban when given alone increased gastric acid secretion and ulcer index in pylorus-ligated rats and also aggravated acetic acid-induced chronic gastric ulcers. It seems the antiul cer activity of oxytocin was due to its anti-secretory ef fect. CONCLUSION: Centrally administered oxytocin possesses gastric anti-secretory and anti-ulcer activity and oxytocin antagonist, atosiban, is pro-ulcerogenic in rats.

  18. An unusual case of spontaneous Mycobacterium chelonae corneal ulcer in a healthy middle-aged adult

    Directory of Open Access Journals (Sweden)

    Bhandari V

    2016-05-01

    Full Text Available Vipul Bhandari, R Sriganesh, Kirti RelekarDepartment of Cornea, Nethradhama Eye Hospital, Bengaluru, IndiaBackground: To report a rare presentation of culture-positive Mycobacterium chelonae corneal ulcer and its management.Findings: We report a rare case of a patient with a history of chronic pain and blurriness of vision. Examination revealed a chronic nonhealing paracentral corneal ulcer inferiorly at the 5–7 o'clock meridian with anterior chamber reaction unresponsive to routine antibiotic and antifungal medications with Mantoux test positivity in a middle-aged nondiabetic patient with no prior history of trauma, ocular surgery, and contact lens usage. Ziehl–Neelsen staining of the nonhealing ulcer revealed acid-fast bacilli typical of M. chelonae, with subsequent culture positivity in Löwenstein–Jensen medium. Subsequent treatment with topical fortified amikacin and tobramycin resulted in rapid healing of the corneal ulcer.Conclusion: M. chelonae presenting as a chronic nonhealing corneal ulcer spontaneously occurring in a healthy adult with no predisposing factor draws attention towards the need to have a good index of suspicion by performing a Ziehl–Neelsen stain and culture, and subsequent successful management with topical fortified amikacin and tobramycin.Keywords: spontaneous, M. chelonae, nonhealing corneal ulcer, healthy

  19. Solitary rectal ulcer syndrome in children: A literature review

    OpenAIRE

    Dehghani, Seyed Mohsen; Malekpour, Abdorrasoul; HAGHIGHAT, MAHMOOD

    2012-01-01

    Solitary rectal ulcer syndrome (SRUS) is a benign and chronic disorder well known in young adults and less in children. It is often related to prolonged excessive straining or abnormal defecation and clinically presents as rectal bleeding, copious mucus discharge, feeling of incomplete defecation, and rarely rectal prolapse. SRUS is diagnosed based on clinical symptoms and endoscopic and histological findings. The current treatments are suboptimal, and despite correct diagnosis, outcomes can ...

  20. Crohn's-like complications in patients with ulcerative colitis after total proctocolectomy and ileal pouch-anal anastomosis.

    Science.gov (United States)

    Goldstein, N S; Sanford, W W; Bodzin, J H

    1997-11-01

    Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become an established surgical procedure for ulcerative colitis. Occasional patients who have undergone IPAA develop persistent or recurrent episodes of pouchitis (chronic pouchitis), from which a subset also develop gastrointestinal and systemic complications that are identical to those seen in Crohn's disease. These complications include enteric stenoses or fistulas in the pouch or pouch inlet segment, perianal fistulas or abscesses, pouch fistulas, arthritis, iridocyclitis, and pyoderma gangrenosum. The development of Crohn's-like gastrointestinal complications in a patient with chronic pouchitis frequently engenders concern that the pathologist misinterpreted the proctocolectomy specimen as ulcerative colitis instead of Crohn's disease. We describe eight patients who developed chronic pouchitis and Crohn's-like complications after IPAA and total proctocolectomy. In each case, concern was voiced about misinterpretation of the proctocolectomy specimen as ulcerative colitis instead of Crohn's disease after the development of the Crohn's-like complications. Preoperatively, all eight patients had characteristic clinical, radiographic, and pathologic features of ulcerative colitis. Review of the pathology specimens indicated that all eight had ulcerative colitis. Crohn's-like complications are most likely related to chronic pouchitis, which probably is a form of recrudescent ulcerative colitis within the novel environment of the pouch. A diagnosis of Crohn's disease after IPAA surgery should only be made when reexamination of the original proctocolectomy specimen shows typical pathologic features of Crohn's disease, Crohn's disease arises in parts of the gastrointestinal tract distant from the pouch, pouch biopsies contain active enteritis with granulomas, or excised pouches show the characteristic features of Crohn's disease, including granulomas. There were no histologic differences in the total

  1. Nutritional prediction of pressure ulcers.

    Science.gov (United States)

    Breslow, R A; Bergstrom, N

    1994-11-01

    This article focuses on nutritional risk factors that predict the development of pressure ulcers in hospital and nursing home patients. Cross-sectional studies associate inadequate energy and protein intake; underweight; low triceps skinfold measurement; and low serum albumin, low serum cholesterol, and low hemoglobin levels with pressure ulcers. Prospective studies identify inadequate energy and protein intake, a poor score on the Braden scale (a risk assessment instrument that includes a nutrition component), and possibly low serum albumin level as risk factors for developing a pressure ulcer. Nutritionists should provide a high-energy, high-protein diet for patients at risk of development of pressure ulcers to improve their dietary intake and nutritional status.

  2. Venous ulcers - self-care

    Science.gov (United States)

    Risk factors for venous ulcers include: Varicose veins History of blood clots in the legs ( deep vein thrombosis ) Blockage of the lymph vessels , which causes fluid to build up in the legs Older age, ...

  3. Challenges in pressure ulcer prevention.

    Science.gov (United States)

    Dealey, Carol; Brindle, C Tod; Black, Joyce; Alves, Paulo; Santamaria, Nick; Call, Evan; Clark, Michael

    2015-06-01

    Although this article is a stand-alone article, it sets the scene for later articles in this issue. Pressure ulcers are considered to be a largely preventable problem, and yet despite extensive training and the expenditure of a large amount of resources, they persist. This article reviews the current understanding of pressure ulcer aetiology: pressure, shear and microclimate. Individual risk factors for pressure ulceration also need to be understood in order to determine the level of risk of an individual. Such an assessment is essential to determine appropriate prevention strategies. The main prevention strategies in terms of reducing pressure and shear and managing microclimate are studied in this article. The problem of pressure ulceration related to medical devices is also considered as most of the standard prevention strategies are not effective in preventing this type of damage. Finally, the possibility of using dressings as an additional preventive strategy is raised along with the question: is there enough evidence to support their use?

  4. Diagnosis and classification of ulcerative colitis.

    Science.gov (United States)

    Conrad, Karsten; Roggenbuck, Dirk; Laass, Martin W

    2014-01-01

    Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease (IBD) characterised by superficial mucosal ulceration, rectal bleeding, diarrhoea, and abdominal pain. In contrast to Crohn's disease (CrD), UC is restricted to the colon and the inflammation is limited to the mucosal layer. Classic UC affects the colon in a retrograde and continuous fashion starting from the rectum and extending proximally. Dependent on the anatomic extent of involvement, UC can be classified as proctitis, left-sided colitis, or pancolitis. Inflammatory arthropathies and primary sclerosing cholangitis (PSC) are the most common and clinically most important extraintestinal manifestations of UC. The aetiopathogenesis of UC is incompletely understood, but immune-mediated mechanisms are responsible for dysregulated immune responses against intraluminal antigens in genetically predisposed individuals. The diagnosis is based on the history, as well as clinical, radiological, endoscopic and histological features. Autoantibodies, mainly antineutrophil cytoplasmic antibodies (ANCA) and anti-goblet cell antibodies (GAB) may be helpful in the early diagnosis of UC and in differentiating it from CrD.

  5. Management and treatment of distal ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Andrea Calafiore

    2013-12-01

    Full Text Available Ulcerative colitis (UC is a chronic inflammatory condition that is confined to the colonic mucosa. Its main symptoms include diarrhea, rectal bleeding and abdominal pain. Approximately two-thirds of UC patients have disease confined distal to the splenic flexure, which can be treated effectively with topical therapy. This means the active drug can be delivered directly to the site of inflammation, limiting the systemic absorption and potential side effects. Topical treatment with aminosalicylates is the most effective approach in the treatment of these forms, provided that the formulation reaches the upper margin of the disease. Given this, the suppository formulation is the treatment of choice for proctitis and distal sigmoiditis. Thanks to their proximal spread, enemas, foams and gels represent the treatment of choice for proctosigmoiditis and for distal ulcerative colitis. Oral aminosalicylates are less effective than topical therapies in patients with active disease, while the combination of topical and oral treatment is more effective in patients refractory to topical or oral mono-therapy. Topically administered aminosalicylates play an important role in the maintenance of remission, but the long-term adhesion to therapy is poor. For this reason, the oral formulation is the first-line therapy in the maintenance of remission. Refractory patients can be treated with topical steroids or systemic steroids and TNF-alpha inhibitors in severe forms.

  6. Psychological nursing influence on anxiety,depression and life quality of patients with chronic ulcerative colitis%心理护理对慢性溃疡性结肠炎患者焦虑、抑郁状况及生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    吴志娟; 吉雅玲; 孙春霞

    2016-01-01

    目的:探讨心理护理对慢性溃疡性结肠炎患者焦虑、抑郁状况与生活质量的影响。方法选取2013年6月—2015年6月收治的100例慢性溃疡性结肠炎患者,按随机数字法随机分为对照组(50例)和研究组(50例),对照组采用常规慢性溃疡性结肠炎治疗和护理,研究组在对照组的基础上进行针对性的心理疏导、音乐放松等心理护理。比较两组治疗效果、护理前后的汉密尔顿抑郁评分(HAMD)、汉密尔顿焦虑评分(HAMA)及生活质量。结果对照组治疗有效率84.00%,研究组治疗有效率96.00%,差异有统计学意义(P <0.05);干预后对照组 HAMD 得分、HAMA 得分分别为(16.76±3.69)分、(14.46±1.68)分,研究组 HAMD 得分、HAMA 得分分别为(10.28±2.41)分、(9.44±1.53)分,差异有统计学意义(P <0.05)。研究组护理后生理机能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能和精神健康8个维度的生存质量得分均高于对照组,差异有统计学意义(P <0.05)。结论在常规慢性溃疡性结肠炎治疗和护理的基础上进行心理疏导、音乐放松等心理护理有利于慢性溃疡性结肠炎疗效的提高、抑郁和焦虑等不良心理状态的缓解以及生存质量的提高。%Objective To investigate the influence of psychological nursing on anxiety,depression and quality of life of the patients with chronic ulcerative colitis.Methods One hundred patients with chronic ulcerative colitis in our hospital from June 201 3 to June 2015 were selected and randomly divided into control group (n =50)and study group (n =50)according to number random table.The patients in control group accepted the conventional chronic ulcerative colitis treatment and care,while the patients in study group accepted the psychological nursing including targeted psychological counseling and music

  7. Evaluation of clinical and laboratory correlates of sickle leg ulcers.

    Science.gov (United States)

    Madu, Anazoeze Jude; Ubesie, Agozie; Madu, Kenechi Anthony; Okwor, Bismarck; Anigbo, Chukwudi

    2013-01-01

    The exact mechanism for the occurrence of sickle leg ulcers (SLUs) has not been fully explained, although, popular opinion supports a multifactorial etio-pathogenetic process. Leg ulceration in sickle cell is a chronic and debilitating condition which is difficult to treat and may worsen the psychosocial impact of this illness. This study aims to evaluate the laboratory and clinical correlates of SLUs. One hundred sixty-seven patients who had been diagnosed with sickle cell anemia (homozygous S) had their steady-state hemoglobin concentration (Hb), hematocrit, white cell count, platelet count, serum bilirubin, and aspartate transaminase (AST) as well as frequency of crisis per annum evaluated with respect to their relationship to the occurrence of leg ulcers. They were aged 6-53 years (mean age 24.3 years), and prevalence of leg ulcer was found to be 2.75 per 1000 (2.54 per 1000 in females and 2.83 per 1000 in males). The independent sample t-test showed a significant difference in the serum AST levels in those with SLU (p = 0.029), though a positive correlation did not exist. Other predictors of disease severity found to have positive relationship with each other were the AST and total serum bilirubin 0.207 (p = 0.012); Hb and age 0.130 (p = 0.035); Hb and white cell count -0.159 (p = 0.010), white cell count and age -0.113 (p = 0.018). SLUs do not occur in patients with severe disease in sickle cell. The clinical and laboratory indicators of severe sickle cell disease do not correlate positively with the occurrence of SLU. Serum AST may have a relationship with leg ulceration in these patients. Environmental factors most likely play a major part in the etiopathogenesis of leg ulcer and this may require further studies in different sociocultural settings.

  8. Pharmacotherapy of Peptic Ulcer Disease

    Directory of Open Access Journals (Sweden)

    F Molina

    1991-01-01

    Full Text Available The etiology of peptic ulcer is multifactorial; except for omeprazole, all drugs used for the treatment of peptic ulcer result in healing with no statistical difference at four weeks. The healing rare increases with time for active medication and placebo, and is lower among smokers than nonsmokers for all drugs but misoprostol. Mucosal protectives (or ‘cytoprotectives’ as a group seem to have a lower relapse rate than the H2 receptor antagonists at one year. Combination therapy has not yet proved to be better than single drug therapy; however, the number of studies is still small, and more clinical trials are necessary. Resistant ulcers have demonstrated that acid is one of several etiological factors and that more research is needed to elucidate the reason(s for refractoriness. The choice of therapeutic agent is generally made according to patient compliance, medication cost, side effects, effectiveness, relapse rate and physician experience with the drug. Long term maintenance therapy is effective in the prevention of ulcer relapse and is especially recommended for selected patient groups, including patients with recurrent or bleeding ulcer, patients with concomitant nonsteroidal anti-inflammatory drug use, and elderly women. Omeprazole is the treatment of choice for moderate to severe esophagitis and should be reserved for large and resistant ulcers.

  9. Bioinformatics analysis of a non-specific nuclease from Yersinia enterocolitica subsp. palearctica.

    Science.gov (United States)

    Li, Zhen-Hua; Tang, Zhen-Xing; Fang, Xiu-Juan; Zhang, Zhi-Liang; Shi, Lu-E

    2013-12-01

    In this paper, the physical and chemical characteristics, biological structure and function of a non-specific nuclease from Yersinia enterocolitica subsp. palearctica (Y. NSN) found in our group were studied using multiple bioinformatics approaches. The results showed that Y. NSN had 283 amino acids, a weight of 30,692.5 ku and a certain hydrophilic property. Y. NSN had a signal peptide, no transmembrane domains and disulphide bonds. Cleavage site in Y. NSN was between pos. 23 and 24. The prediction result of the secondary structure showed Y. NSN was a coil structure-based protein. The ratio of α-helix, β-folded and random coil were 18.73%, 16.96% and 64.31%, respectively. Active sites were pos. 124, 125, 127, 157, 165 and 169. Mg(2+) binding site was pos. 157. Substrate binding sites were pos. 124, 125 and 169. The analysis of multisequencing alignment and phylogenetic tree indicated that Y. NSN shared high similarity with the nuclease from Y. enterocolitica subsp. enterocolitica 8081. The enzyme activity results showed that Y. NSN was a nuclease with good thermostability.

  10. Real-time Monitoring of Non-specific Toxicity Using a Saccharomyces cerevisiae Reporter System

    Directory of Open Access Journals (Sweden)

    Matti Karp

    2008-10-01

    Full Text Available Baker’s yeast, Saccharomyces cerevisiae, is the simplest and most well-known representative of eukaryotic cells and thus a convenient model organism for evaluating toxic effects in human cells and tissues. Yeast cell sensors are easy to maintain with short generation times, which makes the analytical method of assessing antifungal toxicity cheap and less-time consuming. In this work, the toxicity of test compounds was assessed in bioassays based on bioluminescence inhibition and on traditional growth inhibition on agar plates. The model organism in both tests was a modified S. cerevisiae sensor strain that produces light when provided with D-luciferin in an insect luciferase reporter gene activity assay. The bioluminescence assay showed toxic effects for yeast cell sensor of 5,6-benzo-flavone, rapamycin, nystatin and cycloheximide at concentrations of nM to µM. In addition, arsenic compounds, cadmium chloride, copper sulfate and lead acetate were shown to be potent non-specific inhibitors of the reporter organism described here. The results from a yeast agar diffusion assay correlated with the bioluminescence assay results.

  11. Influence of specific and non-specific solvent effects on frontal MO of DMABI system

    Science.gov (United States)

    Kampars, V.; Pastors, P.; Ornicane, G.

    2012-08-01

    Derivatives of 2-(4'-dimethylaminobenzylidene)-1,3-indandione (DMABI) are classical push-pull chromophores containing carbonyl groups like numerous other non-linear chromophores for electro-optical devices. The energy of the intramolecular charge transfer exciton of DMABI is determined by the difference of HOMO-LUMO energies and can be varied in width range by chemical modifications of the DMABI structure or by the nonspecific and specific solvent effects if the chromophore is incorporated into condensed environment. The condensed medium in a thin film (polymer or molecular glass) exhibits a solid state solvation effect similar to the effect of the organic solvents in a solution. The value of the medium effect depends on specific and non-specific interactions between the chromophore and medium. The main purpose of this work is to evaluate the specific effects. The chromophores often contain few centres for specific interaction, and thus we have synthesised and investigated UV-Vis spectra of three derivatives of DMABI and also three derivatives of 4-aza-DMABI in solutions with strong H-bond donor properties. The experimentally obtained results show that the strong H-bond with carbonyl group lowers the intramolecular charge-transfer energy by 900 cm-1, the strong H-bond with carbonyl group and heterocyclic nitrogen in 4-aza-DMABI by 1500 cm-1 and the protonation of heterocyclic nitrogen in 4-aza-DMABI by 3250 cm-1 respectivelly.

  12. Sequence-non-specific effects generated by various types of RNA interference triggers.

    Science.gov (United States)

    Olejniczak, Marta; Urbanek, Martyna O; Jaworska, Edyta; Witucki, Lukasz; Szczesniak, Michal W; Makalowska, Izabela; Krzyzosiak, Wlodzimierz J

    2016-02-01

    RNA interference triggers such as short interfering RNA (siRNA) or genetically encoded short hairpin RNA (shRNA) and artificial miRNA (sh-miR) are widely used to silence the expression of specific genes. In addition to silencing selected targets, RNAi reagents may induce various side effects, including immune responses. To determine the molecular markers of immune response activation when using RNAi reagents, we analyzed the results of experiments gathered in the RNAimmuno (v 2.0) and GEO Profiles databases. To better characterize and compare cellular responses to various RNAi reagents in one experimental system, we designed a reagent series in corresponding siRNA, D-siRNA, shRNA and sh-miR forms. To exclude sequence-specific effects the reagents targeted 3 different transcripts (Luc, ATXN3 and HTT). We demonstrate that RNAi reagents induce a broad variety of sequence-non-specific effects, including the deregulation of cellular miRNA levels. Typical siRNAs are weak stimulators of interferon response but may saturate the miRNA biogenesis pathway, leading to the downregulation of highly expressed miRNAs, whereas plasmid-based reagents induce known markers of immune response and may alter miRNA levels and their isomiR composition.

  13. Isolation and characterization of a non-specific endoglucanase from a metagenomic library of goat rumen.

    Science.gov (United States)

    Cheng, Jianbo; Huang, Shuai; Jiang, Haiqin; Zhang, Yunhai; Li, Lvmu; Wang, Juhua; Fan, Caiyun

    2016-01-01

    A cellulase gene (cel28a) was isolated from a rumen microbial metagenome library of goat rumen microorganisms, cloned into E. coli, and expressed in active form. The gene has a length of 1596 bp obtained using a genome walking Kit and encodes a protein of 509 amino acids with a calculated MW of 55 kDa. The deduced amino acid sequence was homologous with cellulases belonging to the glycosyl hydrolase family 5 (GH5). The expressed protein showed activity toward carboxymethylcellulose (CMC) and xylan, suggesting non-specific endoglucanase activity. The optimal conditions for endoglucanase and xylanase activities were 50 °C and pH 5.0. The metal ions (Ca(2+), Fe(2+), Mn(2+) and Co(2+)) stimulated the cellulase activity of cel28a, while the other metal ions and chemicals (Ni(2+), Mg(2+), Zn(2+), Cu(2+), SDS and EDTA) inhibited the cellulase activity. Further examination of substrate preference showed a higher activity with CMC, oat spelt xylan and birchwood xylan than with filter paper and microcrystalline cellulose, again suggesting that the protein was an endoglucanase with xylanase activity.

  14. Balance Control Comparison between Subjects with and without Non-specific Low Back Pain

    Institute of Scientific and Technical Information of China (English)

    XIE Bin; LUO Chun; WANG Rongli; WANG Ninghua

    2009-01-01

    Objective: To compare the balance ability between normal people and non-specific low back pain (nsLBP) patients and explore the relationship between balance ability and muscle function in nsLBP patients. Method: Ten nsLBP patients as nsLBP group and 10 age and gender-matched healthy control subjects as control group were investigated. Posturography on balance platform and surface electromyography (sEMG) were performed to assess all the subjects' function of equilibrium and muscle activities of erector spinea(ES), muhifidus(MF), abdominal external oblique (EO), hamstring (HS) and maximal gluteus (MG) bilaterally. Result: The nsLBP subjects had greater sway on anterior-posterior direction (Y-speed and Y-extension, P=0.05) on feet-together posture and bigger main axis (P=0.023) on nature standing with eyes closed when compared with controls. The iEMG ratios of right MG in nature standing (eyes closed)/ nature standing (eyes open) and feet-together (eyes open)/nature standing (eyes open) in control group were significant higher than that in nsLBP group (P=0.03 and P=0.013). Conclusion: Balance evaluation combined with sEMG measurement on trank and lower limb muscles provided some quantitative information about functional deficits such as pestural control and muscle activities in nsLBP patients. This relationship should be emphasized in prevention and rehabilitation of nsLBP.

  15. [Clinical evaluation of calcium-polycarbophil in the treatment of non-specific diarrhea].

    Science.gov (United States)

    Gizzi, G; Villani, V; Rubinetto, M P; Cianci, M; La Froscia, A; Barbara, L

    1993-09-01

    We performed a study on 10 patients aged between 26 and 54 males and females, affected by non-specific diarrhea. A single-blind clinical trial has been developed where Calcium-Polycarbophil was administered (2 cps t.i.d.) for a period of 8 weeks, half with placebo and half with drug in cross-over. No drop-out occurred. Number of evaluations, cramps and consistency of stools, have been evaluated before and after treatment. A definite decrease of evacuations per day and of cramps, when present, together with a higher consistency of stools, are reported when Calcium-Polycarbophil is administered, according to the favourable medical judgement. Haematochemical parameters, evaluated before, during and after the treatment didn't show any relevant variation, apart from slight increase (not statistically significant) of calcium both in blood and in urine). No other unwanted event has been detected. Hence, the high therapeutic index of Calcium-Polycarbophil makes it highly desirable in the treatment of diarrhea.

  16. Clinical effect of deep water running on non-specific low back pain: A randomised trial

    Directory of Open Access Journals (Sweden)

    A.I. Cuesta-Vargas

    2009-02-01

    Full Text Available Objectives: To evaluate clinical effect of deep water running(DW R on non-specific low back pain. Outcome measures were pain, disability,general health and physical fitness.  Materials and methods: Experimental, randomized,  controlled trial involving 46 persons with CLBP over 15 weekswith two experimental processes, each three times a week. Evidence-basedProgram (EBP, personalized physical exercise program, manual therapy andhealth educa tion was the common process to which was added 20 minutes ofpersonalized intensity DW R at the aerobic threshold. Measurements were made at the beginning and end of the studyof pain, disability, general health and physical fitness.  R esults: The pain of CLBP were homogeneous at baseline.Significant changes between group were don’t found for pain in favour of the EBP+DW R group (p<0.3. The within-group differences were highly significant for all clinical and functional variables. The effect was clinically relevant forpain in the EBP+DW R group (0.70 and in the EBP group (0.58, and for disability degree it was also relevant in theEBP+DW R group (0.48 and relevant for the EBP group (0.36. Conclusion: Significant improvement was seen inCLBP when EBP was complemented with the high-intensity exercise of DW R.

  17. The use of Functionalized Nanoparticles as Non-specific Compatibilizers for Polymer Blends

    Energy Technology Data Exchange (ETDEWEB)

    W Zhang; M Lin; A Winesett; O Dhez; L Kilcoyne; H Ade; M rubinstein; K Shafi; A Ulman; et al.

    2011-12-31

    The ability to form blends of polymers offers the opportunity of creating a new class of materials with enhanced properties. In addition to the polymer components, recent advances in nanoengineering have resulted in the development of nanosized inorganic particles that can be used to improve the properties of the blend, such as the flammability and the mechanical properties. While traditional methods using copolymer compatibilizers have been used to strengthen polymer blends, here, we show that the inorganic nanosized filler additive can also serve as a compatibilizer as it can localize to the interface between the polymers. We use experimental and theoretical studies to show the fundamental mechanisms by which inorganic fillers with large aspect ratio and at least one-dimension in the nanometer range, can act as non-specific compatibilizers for polymer blends. We examine a series of nanosized fillers, ranging from nanotubes to nanoclays (with varying aspect ratios) in a model polystyrene (PS)/poly(methylmethacyralate) (PMMA) blend. Using a number of experimental techniques such as transmission electron microscopy (TEM), scanning tunneling X-ray microscopy (STXM), and atomic force microscopy (AFM) we postulate that the mechanism of compatibilization occurs as a result of the fillers forming in situ grafts with the immiscible polymers. We also use theoretical studies to show that the aspect ratio and the bending energy of the fillers play a key role in the compatibilization process. Our results indicate that the compatibilization is a general phenomenon, which should occur with all large aspect ratio nanofiller additives to polymer blends.

  18. Intramedullary non-specific inflammatory lesion of thoracic spine: A case report

    Directory of Open Access Journals (Sweden)

    Antonelli Manila

    2010-01-01

    Full Text Available Abstract Background There are several non-neoplastic lesions which mimick intramedullary spinal cord neoplasm in their radiographic and clinical presentation. These can be classified as either infectious (TB, fungal, bacterial, parasytic, syphilis, CMV, HSV and non-infectious (sarcoid, MS, myelitis, ADEM, SLE inflammatory lesions, idiopathic necrotizing myelopathy, unusual vascular lesions and radiation myelopathy. Although biopsy may be indicated in many cases, an erroneous diagnosis of intramedullary neoplasm can often be eliminated pre-operatively. Case description the authors report a very rare case of intramedullary non-specific inflammatory lesion of unknown origin, without signs of infection or demyelinization, in a woman who showed no other evidence of systemic disease. Conclusions Intramedullary lesions that mimick a tumor can be various and difficult to interpret. Preoperative MRI does not allow a certain diagnosis because these lesions have a very similar signal intensity pattern. Specific tests for infective pathologies are useful for diagnosis, but histological examination is essential for establishing a certain diagnosis. In our case the final histological examination and the specific tests that we performed have not cleared our doubts regarding the nature of the lesion that remains controversial.

  19. [Guidelines of diagnosis for peptic ulcer disease].

    Science.gov (United States)

    Kim, Sang Gyun; Kim, Jae Gyu; Shin, Sung Kwan; Kim, Hyun Soo; Seol, Sang Young

    2009-11-01

    Peptic ulcer is one of the most prevalent diseases in gastrointestinal field. Recently, evolution was made for pathophysiology of peptic ulcer from "no acid, no ulcer" to Helicobacter pylori and non-steroidal anti-inflammatory drugs. The prevalence of peptic ulcer disease is estimated about 10% in Korea, and has declined due to Helicobacter pylori eradication therapy. Peptic ulcer has the cycle of exacerbation and improvement in the clinical course, and has not occasionally any clinical symptom. Helicobacter pylori eradication has made the marked reduction of relapse of peptic ulcer disease. Although nationwide endoscopic screening has enabled accurate diagnosis of peptic ulcer disease, general guideline for diagnosis of peptic ulcer has not made in Korea. Herein, we propose a guideline for the diagnosis of peptic ulcer according to domestic, international clinical studies, and experts opinions with level of evidence and grade of recommendation.

  20. [Peptic ulcer disease etiology, diagnosis and treatment].

    Science.gov (United States)

    Bak-Romaniszyn, Leokadia; Wojtuń, Stanisław; Gil, Jerzy; Płaneta-Małecka, Izabela

    2004-01-01

    Authors in this article present etiology, clinical manifestations, diagnostic procedures and treatment of peptic ulcer disease in children and adults. Increased gastric acid output, Helicobacter pylori, NSAIDs and stress are the basic risk factors in peptic ulcer disease. H. pylori infection is a widely known risk factor in peptic ulcer disease and influences diagnostic and treatment procedures. Primary ulcer disease concerns mainly duodenum and is accompanied by H. pylori infection. Gastroscopy and Helicobacter tests are the only reliable procedures to diagnose peptic ulcer disease. Nowadays the most important aim in peptic ulcer treatment is the H. pylori eradication. Therapy with two antibiotics and a protein pomp inhibitor eradicates the bacteria, treats the ulceration and lowers the number of ulcer recurrence. In non-infected H. pylori ulcers or in a long-term treatment protein pomp inhibitors and H2-inhibitors are effective as well in gastroprotective therapy.

  1. Somatic development disorders of children with non specific inflammatory bowel diseases.

    Science.gov (United States)

    Pawłowska, Katarzyna; Iwańczak, Barbara

    2014-01-01

    Frequency of inflammatory bowel diseases (Crohn's disease and ulcerative colitis) tends to increase in developing countries. Nearly 25% of cases affects pediatric patients. Inflammatory bowel diseases are often associated with weight loss and stunting in children. Moreover, weight and height deficiencies are often early symptoms. Initially, nonspecific or latent course of disease delays the diagnostic process. Malnutrition in inflammatory bowel diseases can be caused by disorders of digestion and nutrients' absorption, intestinal loss, increased energy expenditure and appetite impairment. Nutritional deficiencies and inflammatory agents lead to disturbance of tissue metabolism - muscle and bone - and retardation of somatic development of affected children. Thus, deficiencies of muscle mass, bone mineral density and body height are observed. Insufficient normalization of somatic features may be the consequence of recurrent nature of disease and specificity of pharmacological treatment. Present work deals with the current state of knowledge concerning the somatic development disorders of children with inflammatory bowel diseases. Abnormal nutritional status, bone mineral density deficits and growth failure of patients have been discussed in the context of their relations and dependencies on inflammatory, nutritional and therapeutic factors.

  2. Effect observation of hydrotalcite combined with amoxicillin clavulanic acid and berberine in the treatment of chronic stubborn gastritis and gastric ulcer in 60 cases%铝碳酸镁联用阿莫西林克拉维酸钾及黄连素治疗慢性顽固性胃炎、胃溃疡60例效果观察

    Institute of Scientific and Technical Information of China (English)

    邱桂扣

    2015-01-01

    Objective:To explore the effect of hydrotalcite combined with amoxicillin clavulanic acid and berberine in the treatment of chronic stubborn gastritis,gastric ulcer.Methods:60 patients with chronic stubborn gastritis,gastric ulcer were selected. They were randomly divided into the study group and the control group with 30 cases in each.The control group were given hydrotalcite combined with amoxicillin clavulanic acid treatment.The study group were given hydrotalcite combined with amoxicillin clavulanic acid and berberine treatment.We compared the treatment efficiency,helicobacter pylori clearance rate, recurrence rate and the rate of adverse reactions of the two groups.Results:In the study group,the effective rate was 86.67% ;helicobacter pylori eradication rate was 73.33%;the recurrence rate was 10.00%.They were all significantly better than the control group(P0.05).Conclusion:Hydrotalcite combined with amoxicillin clavulanic acid and berberine in the treatment of chronic stubborn gastritis,gastric ulcer can significantly improve the clinical efficacy,and reduce the recurrence rate.%目的:探讨铝碳酸镁联用阿莫西林克拉维酸钾及黄连素治疗慢性顽固性胃炎、胃溃疡的疗效。方法:收治慢性顽固性胃炎、胃溃疡患者60例,随机平均分成研究组和对照组,对照组给予铝碳酸镁联合阿莫西林克拉维酸钾治疗,研究组应用铝碳酸镁联用阿莫西林克拉维酸钾及黄连素治疗,比较两组患者治疗有效率、幽门螺杆菌清除率、复发率及不良反应率。结果:研究组治疗有效率86.67%,幽门螺杆菌清除率73.33%,复发率10.00%,均显著优于对照组(P<0.05),不良反应率组间比较,差异无统计学意义(P>0.05)。结论:铝碳酸镁联用阿莫西林克拉维酸钾及黄连素治疗慢性顽固性胃炎、胃溃疡能显著提高临床疗效、降低复发率。

  3. Avaliação da eficácia da pomada de própolis em portadores de feridas crônicas Evaluación de la eficacia de la pomada de própolis en portadores de heridas crónicas The effect of propolis cream in healing chronic ulcers

    Directory of Open Access Journals (Sweden)

    Marinaldo José dos Santos

    2007-06-01

    ón de todas las lesiones fue de 13,1 semanas. Considerando un seguimiento de 20 semanas el 74,1% de las úlceras lograron la cicatrización antes de ese período. En cuanto a la etiología, las úlceras venosas cicatrizaron en 35% (7 de los pacientes, contraponiéndose a las úlceras de presión cuya cicatrización sucedió en apenas el 10,0% (2 de los pacientes. CONCLUSIÓN: Se concluye, que la utilización de pomada de própolis, de fácil acceso y bajo costo, fue sido eficiente en la cicatrización de heridas.OBJECTIVE: To evaluate the effect of propolis cream in healing chronic. METHODS: This descriptive study used a sample of 20 subjects from a Basic Unit of Health of Maringá City, Paraná, Brazil, who had chronic wounds. Wound healing was measured through progress notes of wound length, width, and depth. Data were analyzed with Pearson's correlation to determine the degree and strength of the relationship between propolis cream treatment and wound healing. RESULTS: The progress notes of 22 chronic ulcers showed that the probability of wound healing was 18.7 weeks. Regarding the study period of 13,1 weeks, the majority of ulcers (74.1% of ulcers healed completely. Regarding wound etiology, vascular ulcers (35% healed in 7 patients. And, pressure ulcers (10% healed in patients. CONCLUSION: The use of propolis cream, which is widely accessible and inexpensive, was effective in healing chronic wounds.

  4. Assessment of external methods of traditional Chinese medicine in patients with chronic ulcer of the lower extremities: study protocol of a multicenter, randomized, parallel-group, prospective trial%“祛腐化瘀补虚生肌外治法治疗慢性下肢溃疡的临床示范性研究”的研究方案

    Institute of Scientific and Technical Information of China (English)

    王云飞; 单玮; 刘安民; 仇莲胤; 邓大一; 高丹; 阙华发; 徐杰男; 唐汉钧; 向寰宇; 刘晓鸫; 张臻; 邢捷; 沈亮

    2012-01-01

    BACKGROUND: Chronic ulcer of the lower extremities amounts for a grave and serious problem for public health. Western medicine focuses on controlling infection, improving blood circulation, surgical debridement, skin grafting, etc, but there are bottlenecks in the treatment. Traditional Chinese medicine (TCM) has a long history and a legacy of sound clinical efficacy in this area. TCM has developed a unique, effective external theory, and a large number of topical prescriptions and external technology. Through this research, a safe and effective treatment protocol of TCM for chronic ulcer of the lower extremities can be formed. During China's "Eleventh Five-Year" Plan, special research committees and projects on TCM external treatments and external technologies were established. This study on ulcer of the lower extremities constitutes one of the major research topics.METHODS AND DESIGN: Clinical information of patients with chronic ulcer of the lower extremities will be first collected in a large, multicenter, epidemiological survey. Concurrently, a large multicenter, randomized, parallel-group, prospective study will be launched based on evidence-based medical principles to evaluate the efficacy and safety of external methods for removing carrion, dissolving stasis, reinforcing deficiency and promoting tissue regeneration. The evaluated indexes will include the wound healing percentage for primary outcome, wound healing time, wound healing rate, time and rate of removal of necrotic tissue, and TCM syndromes for secondary outcomes and routine blood test, routine urine test, liver and kidney function, blood mercury content and finally urine mercury content for adverse events.DISCUSSION: In this trial, the authors will evaluate the efficacy and safety of external methods for removing carrion, dissolving stasis, reinforcing deficiency and promoting tissue regeneration in cases of chronic ulcer of the lower extremities for standardizing external therapy of TCM for

  5. Efficacy and tolerability of naproxen/esomeprazole magnesium tablets compared with non-specific NSAIDs and COX-2 inhibitors: a systematic review and network analyses

    Directory of Open Access Journals (Sweden)

    Datto C

    2013-02-01

    Full Text Available Catherine Datto,1 Richard Hellmund,1 Mohd Kashif Siddiqui21AstraZeneca Pharmaceuticals LP, Wilmington, DE, USA; 2HERON PVT India, Chandigarh, UT, IndiaAbstract: Non-steroidal anti-inflammatory drugs (NSAIDs, such as non-selective NSAIDs (nsNSAIDs or selective cyclooxygenase-2 (COX-2 inhibitors, are commonly prescribed for arthritic pain relief in patients with osteoarthritis (OA, rheumatoid arthritis (RA, or ankylosing spondylitis (AS. Treatment guidelines for chronic NSAID therapy include the consideration for gastroprotection for those at risk of gastric ulcers (GUs associated with the chronic NSAID therapy. The United States Food and Drug Administration has approved naproxen/esomeprazole magnesium tablets for the relief of signs and symptoms of OA, RA, and AS, and to decrease the risk of developing GUs in patients at risk of developing NSAID-associated GUs. The European Medical Association has approved this therapy for the symptomatic treatment of OA, RA, and AS in patients who are at risk of developing NSAID-associated GUs and/or duodenal ulcers, for whom treatment with lower doses of naproxen or other NSAIDs is not considered sufficient. Naproxen/esomeprazole magnesium tablets have been compared with naproxen and celecoxib for these indications in head-to-head trials. This systematic literature review and network meta-analyses of data from randomized controlled trials was performed to compare naproxen/esomeprazole magnesium tablets with a number of additional relevant comparators. For this study, an original review examined MEDLINE®, Embase®, and the Cochrane Controlled Trials Register from database start to April 14, 2009. Using the same methodology, a review update was conducted to December 21, 2009. The systematic review and network analyses showed naproxen/esomeprazole magnesium tablets have an improved upper gastrointestinal tolerability profile (dyspepsia and gastric or gastroduodenal ulcers over several active comparators (naproxen

  6. Why chronic wounds will not heal: a novel hypothesis

    DEFF Research Database (Denmark)

    Bjarnsholt, Thomas; Kirketerp-Moller, K.; Jensen, P.O.

    2008-01-01

    The present paper presents a hypothesis aimed at explaining why venous leg ulcers, pressure ulcers, and diabetic foot ulcers develop into a chronic state. We propose that the lack of proper wound healing is at least in part caused by inefficient eradication of infecting, opportunistic pathogens......, a situation reminiscent of chronic Pseudomonas aeruginosa infections found in patients suffering from cystic fibrosis (CF). We have analyzed sections from chronic wounds by fluorescence in situ hybridization and found distinct microcolonies-the basal structures of bacterial biofilms. Several researchers have...

  7. Solitary rectal ulcer syndrome: A single-center case series

    Directory of Open Access Journals (Sweden)

    Abdulaziz I AlGhulayqah

    2016-01-01

    Full Text Available Background/Aim: Solitary rectal ulcer syndrome (SRUS is a benign, chronic defecation disorder with varied presentations. The aim of this study is to summarize the clinical features, endoscopic findings, histological appearance, and treatment strategies associated with SRUS. Patients and Methods: This is a retrospective study of all patients diagnosed with SRUS at the King Faisal Specialist Hospital and Research Centre in Riyadh from January 2003 to December 2013. Cases were identified using the Department of Pathology database. Data were obtained from medical records that included clinical manifestation, endoscopic findings, and histopathological features. Results: Twenty patients were identified. The mean age was 42.5 years (±18.5 and 55% were females. Most of the patients presented with bleeding per rectum (85%, constipation (75%, and straining (50%, with a mean symptom duration of 26.7 months. The most common associated factors identified were constipation (75%, history of rectal surgery (25%, digital rectal manipulation (20%, and rectal prolapse (20%. Endoscopic findings included a single ulcer (50% and multiple ulcers (30%; 55% had a polypoidal appearance. On histopathology, there was surface ulceration (95%, fibrosis of the lamina propria (60%, distorted architecture (55%, and muscle hypertrophy with increased mucin production (50%. Patients were treated conservatively and none required surgery. Conclusion: SRUS is a rare disorder with variable clinical presentations. Stool softeners, a high fiber diet in addition to topical mesalamine, and biofeedback proved to be effective in this patient population.

  8. T-Cell Lymphomas Presenting as Colon Ulcers and Eosinophilia

    Directory of Open Access Journals (Sweden)

    Ping-Hsiu Wu

    2015-07-01

    Full Text Available Primary gastrointestinal T-cell lymphoma is an uncommon entity and primary colon T-cell lymphoma is even rarer. The majority of enteropathy-associated T-cell lymphomas present predominantly as ulcers or strictures in the endoscopic examinations, while primary B-cell lymphomas commonly present as exophytic lesions. Ulcerative colon T-cell lymphoma may mimic Crohn's disease (CD, which is a chronic inflammatory disease of the intestines with ulcer and fistula formations difficult for clinicians to diagnose based on endoscopic observations alone. Like CD, T-cell lymphoma may be characterized by the presence of multiple skipped ulcers distributed from the terminal ileum to the descending colon. Furthermore, it is difficult to diagnose this unusual lymphoma by a single endoscopic biopsy. Typically, the histological composition of T-cell lymphoma is made of medium to large atypical cells located in the base of the ulcer with extension to the muscle layer and the adjacent mucosa. However, it is common that biopsy specimens show only mixed inflammatory changes where the lymphoma cells are hard to be identified. The differential diagnosis of malignant lymphoma must be considered when clinically diagnosed CD is refractory to the medical treatment or when its clinical behavior becomes aggressive. The current study presents a rare case of primary colon T-cell lymphoma in a 56-year-old male with marked recent weight loss, watery diarrhea and bilateral neck lymphadenopathy, who received a laboratory checkup and endoscopic workup for colon biopsy. The initial pathological report was consistent with mucosal inflammation and benign colon ulcers. Interestingly, the blood test showed a prominent eosinophilia. A biopsy of the enlarged neck lymph nodes done approximately 1 month after the colon biopsy unexpectedly showed T-cell lymphoma, which led to a review of the initial colonic biopsy specimens. Additional immunohistochemical stains were used accordingly, which

  9. Histopathological Analysis of High {sup 18}F-FDG Uptake in Meniscoid Ulcer of Colon Carcinoma: Report of A Case

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee [Sung Ae Hospital, Seoul (Korea, Republic of); Jang, Ja June [Seoul National University School of Medicine, Seoul (Korea, Republic of)

    2008-04-15

    Prominent 18F-fluorodeoxyglucose (18F-FDG) accumulation has been reported to occur in meniscoid ulcer of gastric carcinoma. A mouse-model study carried out by Kubota et al. revealed that inflammatory cells, particularly macrophages, in necrotic tumor accumulates 18F-FDG more avidly than viable tumor cells. A search of literature failed to disclose earlier publication reporting histological study on such high 18F-FDG metabolism in patient with ulcerating colon cancer. This communication presents prominent 18FDG uptake observed in relation with chronic inflammation in meniscoid ulcer of sigmoid colon carcinoma. Cross correlation of PET findings with those of CT scan and colonoscopy showed that the high 18F-FDG uptake was localized to ulcerated part of tumor and not in heaved-up border that was not ulcerated. Histopathology of removed tumor revealed that the denuded bottom of ulcer consisted of a thick layer of submucosal tissue diffusely infiltrated with inflammatory cells. The meniscoid malignant ulcer, originally described in 1921 by Carman and re-studied in detail by Kirklin, is created by barium filling of crescent defect of ulcerating gastric carcinoma. Since then the sign has long been appreciated as a clue of ulcerating gastric carcinoma. In the meantime, the sign has also been reported to occur in the carcinomas of the esophagus by Gloyna et al. and the colon by Siskind and Burrell.

  10. Histopathological evaluation of gastric mucosal environments in peptic ulcer using the endoscopic 5-point gastric biopsy method.

    Directory of Open Access Journals (Sweden)

    Kobayashi,Hisataka

    1995-08-01

    Full Text Available Although a strong association has been established between chronic Helicobacter pylori infection and peptic ulcers, the role of H. pylori is not necessarily causative because there are many patients infected with H. pylori who do not develop peptic ulcer. Therefore, we studied the relationship between the gastric mucosal environment and the development of peptic ulcers. We examined 165 endoscopic biopsy specimens from the gastric mucosa of 33 patients with peptic ulcers using the 5-point gastric biopsy method. The follow-up biopsies done within 3 weeks were well correlated with the first biopsy samples. We also reviewed the clinicohistopathological findings of 2250 endoscopic biopsy specimens from 450 patients with active gastric and/or duodenal ulcers. Over 90% of the patients with duodenal ulcer, with or without gastric ulcer, had no fundic gland atrophy, and a high incidence of intestinal metaplasia and pyloric mucosal atrophy was found in the patients with gastric ulcer. These findings suggest that patients with concomitant active gastric and duodenal ulcers exhibit severe atrophic changes in the antral mucosa but not in the fundic mucosa.

  11. S100A8/A9 is an important host defence mediator in neuropathic foot ulcers in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Trøstrup, Hannah; Holstein, Per; Christophersen, Lars

    2016-01-01

    Chronic wounds and in particular diabetic foot ulcers (DFUs) are a growing clinical challenge, but the underlying molecular pathophysiological mechanisms are unclear. Recently, we reported reduced levels of the immunomodulating and antimicrobial S100A8/A9 in non-healing venous leg ulcers (VLUs...

  12. SCREENING FOR ANTI ULCER ACTIVITY OF CONVOLVULUS PLURICAULIS USING PYLORIC LIGATION METHOD IN WISTER RATS.

    Directory of Open Access Journals (Sweden)

    Sharath S S

    2015-01-01

    Full Text Available Peptic ulcer disease is a chronic problem of the gastrointestinal tract characterized by mucosal damage secondary to pepsin and gastric acid secretion. Herbal medicines are generally used in cases when drugs are to be used for chronic periods. The study was conducted to evaluate antiulcerogenic activity of convolvulus pluricaulis in wistar rats. The antiulcer activity was carried out employing - Pyloric ligation method. The rats were randomly divided into 4 groups of 6 animals each. First group was given 1ml of 0.1% of vehicle (Tween 80; the second group was treated with ranitidine 50 mg/kg in 1 ml Tween 80. The remaining groups receive 200 mg/kg and 400 mg/kg of Convolvulus pluricaulis alcoholic extract (CPAE in 1 ml Tween 80 respectively. All the drugs were administered orally for five days duration daily in two divided doses. Evaluation of antiulcer activity was done by Ulcer score/ulcer index. Volume of gastric juice secreted, gastric free acidity, total acidity, total protein, pepsin mucin and pH were also estimated. CPAE at a dose of 200 mg/kg inhibited ulcer index by 40.87% and at a dose of 400 mg/kg inhibited ulcer index by 26.64 %. Alcoholic extracts of Convolvulus pluricaulis have shown a significant protection against gastric ulcers in pyloric ligation model.

  13. Motor unit potential morphology differences in individuals with non-specific arm pain and lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    McLean Linda

    2008-12-01

    Full Text Available Abstract Background The pathophysiology of non-specific arm pain (NSAP is unclear and the diagnosis is made by excluding other specific upper limb pathologies, such as lateral epicondylitis or cervical radiculopathy. The purpose of this study was to determine: (i if the quantitative parameters related to motor unit potential morphology and/or motor unit firing patterns derived from electromyographic (EMG signals detected from an affected muscle of patients with NSAP are different from those detected in the same muscle of individuals with lateral epicondylitis (LE and/or control subjects and (ii if the quantitative EMG parameters suggest that the underlying pathophysiology in NSAP is either myopathic or neuropathic in nature. Methods Sixteen subjects with NSAP, 11 subjects with LE, eight subjects deemed to be at-risk for developing a repetitive strain injury, and 37 control subjects participated. A quantitative electromyography evaluation was completed using decomposition-based quantitative electromyography (DQEMG. Needle- and surface-detected EMG signals were collected during low-level isometric contractions of the extensor carpi radialis brevis (ECRB muscle. DQEMG was used to extract needle-detected motor unit potential trains (MUPTs, and needle-detected motor unit potential (MUP and surface detected motor unit potential (SMUP morphology and motor unit (MU firing rates were compared among the four groups using one-way analysis of variance (ANOVA. Post hoc analyses were performed using Tukey's pairwise comparisons. Results Significant group differences were found for all MUP variables and for MU firing rate (p p p p p Conclusion The size-related parameters suggest that the NSAP group had significantly smaller MUPs and SMUPs than the control and LE subjects. Smaller MUPs and SMUPs may be indicative of muscle fiber atrophy and/or loss. A prospective study is needed to confirm any causal relationship between smaller MUPs and SMUPs and NSAP as found

  14. On the existence of a generalized non-specific task-dependent network

    Directory of Open Access Journals (Sweden)

    Kenneth eHugdahl

    2015-08-01

    Full Text Available In this paper we suggest the existence of a generalized task-related cortical network that is up-regulated whenever the task to be performed requires the allocation of generalized non-specific cognitive resources, independent of the specifics of the task to be performed. We have labelled this general purpose network, the extrinsic mode network (EMN as complementary to the default mode network (DMN, such that the EMN is down-regulated during periods of task-absence, when the DMN is up-regulated, and vice versa. We conceptualize the EMN as a cortical network for extrinsic neuronal activity, similar to the DMN as being a cortical network for intrinsic neuronal activity. The EMN has essentially a fronto-temporo-parietal spatial distribution, including the inferior and middle frontal gyri, inferior parietal lobule, supplementary motor area, inferior temporal gyrus, We further hypothesize that this network is always active regardless of the cognitive task being performed. We suggest that failure of network up- and down-regulation dynamics may provide neuronal underpinnings for cognitive impairments seen in many mental disorders, such as e.g. schizophrenia. We start by describing a common observation in functional imaging, the close overlap in fronto-parietal activations in healthy individuals to tasks that denote very different cognitive processes. We now suggest that this is because the brain utilizes the EMN network as a generalized response to tasks that exceeds a cognitive demand threshold and/or requires the processing of novel information. We further discuss how the EMN is related to the DMN, and how a network for extrinsic activity is related to a network for intrinsic activity. Finally we discuss whether the EMN and DMN networks interact in a common single brain system, rather than being two separate and independent brain systems.

  15. Wireless communication fields and non-specific symptoms of ill health: a literature review.

    Science.gov (United States)

    Röösli, Martin; Hug, Kerstin

    2011-05-01

    This is an update of a previous systematic review on the association between radiofrequency electromagnetic field (RF-EMF) exposure and health-related quality of life that included studies published before August 2007 [1]. Since then, nine randomized trials addressed short-term exposures from close-to-body RF-EMF sources such as mobile phones, and two observational studies investigated the effects of mobile phone use on health-related quality of life. Six randomized trials addressed short-term far-field exposure arising, for instance, from mobile phone base stations, and eight studies evaluated the effects of environmental far-field RF-EMF exposure. In most of the randomized trials, no exposure-response association was observed. The sporadically reported associations did not show a consistent pattern regarding the type of symptoms or the direction of the effects (increase/decrease). Similarly, most of the recent observational studies did not show associations between RF-EMF exposure and non-specific symptoms. However, the exposure gradients were small and possible exposure misclassification is a limitation of these studies. Longitudinal studies as well as studies in children and adolescents are scarce. In summary, recent research did not indicate health-related quality of life to be affected by RF-EMF exposure in our everyday environment. Furthermore, none of the studies showed that individuals with self-reported electromagnetic hypersensitivity (EHS) were more susceptible to RF-EMF than the rest of the population. Nevertheless, the rapid technological development and anticipated increase in exposure levels warrant the conduct of further longitudinal studies. Due to the widespread use of wireless communication technologies potential adverse health effects would have major public health consequences.

  16. Knowledge, Attitude, and Practice in the Management of Mixed Arteriovenous Leg Ulcers.

    Science.gov (United States)

    Woo, Kevin Y; Sears, Kim

    2016-03-01

    Leg ulceration is a chronic health condition that constitutes a significant disease burden. In this cross-sectional descriptive study, a sample of wound care clinicians were asked to respond to a web-based survey. Based on a review of literature and recommended best practices in the management of mixed arteriovenous (AV) ulcers, a questionnaire was developed to examine the knowledge, attitude, and practice pattern in the management of AV ulcers. A total of 436 clinicians participated in the survey. A number of assessment techniques were perceived to be relevant for the assessment of AV ulcers; medical history and the appearance of ulcers were the most commonly used methods in clinical practice. While over 80% of the participants conceded that compression should be used to promote wound healing, half of them would consider using compression for AV ulcers if ankle brachial index was less than 0.8. Half of the participants considered an ankle brachial index of 0.8 or higher as the optimal cutoff value for safe compression. The majority of respondents disagreed with the perception that caring for people with AV ulcers was unrewarding. However, challenges to promote treatment adherence, address psychosocial concerns, and optimize symptom management are common.

  17. Does cryotherapy improve skin circulation compared with compression and elevation in preventing venous leg ulcers?

    Science.gov (United States)

    Kelechi, Teresa J; Mueller, Martina; Madisetti, Mohan; Prentice, Margie A; Dooley, Mary J

    2016-08-10

    This trial compared skin blood flow, temperature and incidence of venous leg ulcers in patients with chronic venous disease using compression wraps and elevation pillows. Patients with CEAP C4 skin damage and C5 history of ulcers were randomly assigned to a cryotherapy intervention (n = 138) or placebo cuff control (n = 138) applied to the lower legs over 9 months. The time the ulcers healed prior to enrollment in the study for the cryotherapy group ranged from 1 to 2218 days (n = 8, median = 32 days); for the control group, the range was 24 to 489 days (n = 6, median = 390 days). There were no statistically significant blood flow changes measured in perfusion units with a laser Doppler flowmetre within or between the groups; mean difference between the groups was 0·62, P = 0·619. No differences were noted in skin temperature measured with an infrared thermometer within and between the groups; mean difference between the groups was -0·17°C, P = 0·540. Cryotherapy did not improve skin blood flow or temperature and did not show efficacy in preventing ulcers. However, at least 30% of intervention and 50% of control participants were anticipated to develop an ulcer during the study; only ∼7% occurred. These findings suggest that strict adherence to standard of care decreases the incidence of leg ulcers and remains a best practice for leg ulcer prevention.

  18. Potassium Channelopathies and Gastrointestinal Ulceration

    Science.gov (United States)

    Han, Jaeyong; Lee, Seung Hun; Giebisch, Gerhard; Wang, Tong

    2016-01-01

    Potassium channels and transporters maintain potassium homeostasis and play significant roles in several different biological actions via potassium ion regulation. In previous decades, the key revelations that potassium channels and transporters are involved in the production of gastric acid and the regulation of secretion in the stomach have been recognized. Drugs used to treat peptic ulceration are often potassium transporter inhibitors. It has also been reported that potassium channels are involved in ulcerative colitis. Direct toxicity to the intestines from nonsteroidal anti-inflammatory drugs has been associated with altered potassium channel activities. Several reports have indicated that the long-term use of the antianginal drug Nicorandil, an adenosine triphosphate-sensitive potassium channel opener, increases the chances of ulceration and perforation from the oral to anal regions throughout the gastrointestinal (GI) tract. Several of these drug features provide further insights into the role of potassium channels in the occurrence of ulceration in the GI tract. The purpose of this review is to investigate whether potassium channelopathies are involved in the mechanisms responsible for ulceration that occurs throughout the GI tract. PMID:27784845

  19. Hallux ulceration in diabetic patients.

    Science.gov (United States)

    ElMakki Ahmed, Mohamed; Tamimi, Abdulhakim O; Mahadi, Seif I; Widatalla, Abubakr H; Shawer, Mohamed A

    2010-01-01

    We undertook a prospective cohort study to assess risk factors associated with hallux ulceration, and to determine the incidence of healing or amputation, in consecutive patients with diabetes mellitus who were treated over the observation period extending from September 2004 to March 2005, at the Jabir Abu Eliz Diabetic Centre, Khartoum City, Sudan. There were 122 diabetic patients in the cohort (92 males and 30 females) with an overall mean age of 58 +/- 9 years. Fifty-three percent of patients had complete healing within 8 weeks and 43% healed within 20 weeks. The overall mean time to healing was 16 +/- 8 weeks. In 32 (26.2%) patients, osteomyelitic bone was removed, leaving a healed and boneless hallux. The hallux was amputated in 17 (13.9%) patients; in 2 (1.6%) patients it was followed by forefoot amputation and in 7 (5.7%) patients by below-the-knee amputation. In 90 (73.8%) patients the initial lesion was a blister. In conclusion, hallux ulceration is common in patients with diabetes mellitus and is usually preceded by a blister. Neuropathy, foot deformity, and wearing new shoes are common causative factors; and ischemia, osteomyelitis, any form of wound infection, and the size of the ulcer are main outcome determinants. Complete healing occurred in 103 (85%) of diabetic patients with a hallux ulcer. Vascular intervention is important relative to limb salvage when ischemia is the main cause of the ulcer.

  20. Is there a relationship between pain intensity and postural sway in patients with non-specific low back pain?

    DEFF Research Database (Denmark)

    Ruhe, A.; Fejer, R.; Walker, B.

    2011-01-01

    pain intensity and postural sway in adults (aged 50 or less) with non-specific low back pain. Methods: Seventy-seven patients with non-specific low back pain and a matching number of healthy controls were enrolled. Center of pressure parameters were measured by three static bipedal standing tasks of 90...... compared to healthy controls. In addition, regression analysis revealed a significant and linear increase in postural sway with higher pain ratings for all included COP parameters. Statistically significant changes in mean sway velocity in antero-posterior and medio-lateral direction and sway area were......Background: Increased center of pressure excursions are well documented in patients suffering from non-specific low back pain, whereby the altered postural sway includes both higher mean sway velocities and larger sway area. No investigation has been conducted to evaluate a relationship between...