Preventing Pressure Sores

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[Sacral pressure sores and their treatment].

Science.gov (United States)

Bielecki, Marek; Skowroński, Rafał; Skowroński, Jan

2006-01-01

Sacral bed sores still present a serious problem in most surgery departments. They occur mainly in elderly patients of limited mobility. The treatment of such sores extends over long periods of time and therefore involves considerable costs. The material consisted of 11 sacral pressure ulcers treated surgically. The sores occurred in 4 severely disabled patients suffering from proximal third femur fractures, 4 patients with traumatic brain injury (treated in the Intensive Care Unit), and 3 patients suffering from bed sores after spinal cord injury. In 6 patients a fasciocutaneous flap was applied to the sores and in 5 cases a pedicled musculocutaneous gluteus maximus flap. The end results were assessed using Seiler's criteria. Complications of the "seroma" type were observed in 3 patients, and in 2 marginal necrosis. In all our patients complete healing was achieved within 2-4 weeks. On analysing our experience to date in surgical treatment of bed sores we are of the opinion that even extensive sacral sores can be covered with unilateral pedicled flaps provided that they are appropriately planned. Deep sores of the 4th degree sometimes with concomitant osteomyelitis require pedicled muscle flaps or in some cases musculocutaneous flaps to improve local circulation. The preparation of the patient for reconstruction surgery is just as important as the operation itself and therefore such preparation should never be neglected.

Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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[Program for lowering the incidence of pressure sores in neurosurgical patients].

Science.gov (United States)

Chang, Chau-Hui; Chen, Hui-Ling; Chen, Hsiang-Chi

2007-12-01

Pressure sores are one of the well known problems that occur in hospitals. As the literature on the subject indicates, a lot of money is expended in managing this problem every year, and 12-66% of pressure sores are caused during surgery. Patients who undergo neurosurgical procedures are susceptible to pressure sores because of lengthy operations. We collected data on patients with pressure sores who underwent surgery between May 2004 and August 2004, and found that the incidence of pressure sore in neurosurgical patients was 9.5%, which was the highest among all surgical patients. This project was developed to solve the problem of pressure sores by setting up standard preventive procedures, a nursing follow up system and continuing education courses, and utilizing cotton rolls to pad sites of pressure sores. The incidence of pressure sore in neurosurgical patients was reduced from 9.5% to 7% after the improvement project was carried out. The more concerned nurses are about pressure sores, the better the quality of operative nursing care.

[Surgical coverage technics of pressure sores and their outcomes].

Science.gov (United States)

Bilkay, Ufuk; Helvaci, Evren; Tokat, Cenk; Ozek, Cüneyt; Akin, Yalçin

2006-04-01

We reviewed the outcome of 66 patients with 100 pressure sores between 1984 and 2002. In the current study, 100 pressure sores in 66 patients (45 male, 21 female; mean age 39.4; range 13 to 80 years) who underwent surgical repair of pressure sores reconstructed using myocutaneous or fasciocutaneous flaps, skin grafts, excision and closure. The risk factors for pressure sores included acute trauma-induced spinal cord injury in 40 (61%) patients with paraplegia and in 5 (7%) patients with quadriplegia; congenital spina bifida and multiple sclerosis in 7 (11%) patients and prolonged immobilization in 14 (21 patients) patients. We achieved an overall pressure sore recurrence rate of 22% and overall patient recurrence of 24% in a-3-year follow-up. The recurrence rates according to anatomic sites; 23% (10 of 43) for the ischial pressure sore, sacral 21% (8 of 37), and trochanteric 20% (4 of 20). Fasciocutaneous and myocutaneous flap reconstructions were the most durable, as they were associated with 17% (6 of 34) and 12% recurrence rates (5 of 39). To reduce the recurrence rates the authors advocate the use of myocutaneous and fasciocutaneous flaps instead of skin grafts or direct closure for the coverage of pressure sores.

Preventing Pressure Sores

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Occipital pressure sores in two neonates.

Science.gov (United States)

Liu, Yi; Xiao, Bin; Zhang, Cheng; Su, Zhihong

2015-01-01

The preference for a specific head shape can be influenced by people's culture, religious beliefs and race. Modern Chinese people prefer a "talented" head shape, which is rounded and has a long profile. To obtain their preferred head shape, some parents try to change their neonates' sleeping position. Due to these forced sleeping positions, positional skull deformities, such as plagiocephaly, may be present during the first few months of life. In this article, we report two neonatal cases, of Hui nationality and Dongxiang nationality, with occipital pressure sores that were caused by using hard objects as pillows with the intention of obtaining a flattened occiput. The pressure sores were deep to the occipital bone and needed surgical management. These pressure sores caused wounds that were repaired by local skin flaps, after debridement, and the use of external constraints from a dense sponge-made head frame for approximately two weeks. One case recovered with primary healing after surgical operation. The other case suffered from a disruption of the sutured wound, and a secondary operation was performed to cover the wound. These occipital pressure sores are avoidable by providing guidance to the parents in ethnic minorities' area regarding the prevention, diagnosis and management of positional skull deformity.

[Prevalence of pressure sores in a university hospital in 2003].

Science.gov (United States)

Daideri, G; Berthier, F; Brocker, P; Darmon, M-J; Mignolet, F; Quaranta, J-F; Staccini, P

2006-12-01

To determine the prevalence of pressure sores in a university hospital and to assess the risk of developing a pressure sore. A one-day survey was performed in all hospitalized patients, day hospital excepted. The Garches scale was used to assess the severity of pressure sores and the Braden scale was used to measure the patient's risk for the development of pressure ulcers. One thousand six hundred and eleven patients were included, mean age was 62+/-23 years and 53.3% were over 65 years old. In hospitalized patients, 64% were in acute care, 29% in intermediate medicine and long-term care and 7% in intensive care units. We have found 675 pressure sores in 268 patients, mean age of 76 years; 263 decubitus ulcers were acquired during hospitalization. The most frequent sites were heels (46%) and sacrum (26%). Stage 1 pressure ulcers showed 33% of the total. The total prevalence was 16.6%, 95% CI (14.9-18.6), the hospital acquired pressure sores prevalence was 7.5%, all stages included. A Braden score less than or equal to 15 was found in 29.1% of hospitalized patients. Standard mattresses were used in 37% of patients with pressure sores. Multivariate analysis showed that age and a Braden score less than or equal to 15 were significantly associated with pressure sores. Pressure sores are still an important problem in hospital; occurrence must be considered as an iatrogenic event and management requires a multidisciplinary approach.

Osteomyelitis beneath pressure sores

International Nuclear Information System (INIS)

Sugarman, B.; Hawes, S.; Musher, D.M.; Klima, M.; Young, E.J.; Pircher, F.

1983-01-01

Twenty-eight pressure sores were evaluated prospectively. Osteomyelitis was reported histologically in nine of 28 bones and pressure-related changes were reported in 14 bones. Roentgenograms suggested the presence of osteomyelitis in four instances of histologically proved osteomyelitis. Technetium Tc 99m medronate bone scans were highly sensitive, showing increased uptake in all cases of osteomyelitis; however, increased uptake also occurred commonly in uninfected bones due to pressure-related changes or other noninfectious causes. Cultures of bone biopsy samples usually disclosed anaerobic bacteria, gram-negative bacilli, or both. The diagnosis of osteomyelitis must be considered if a pressure sore does not respond to local therapy. If the technetium Tc 99m medronate uptake is increased in the involved area, or roentgenographic findings are abnormal, the diagnosis can only be made with certainty by histologic examination of bone. Antibacterial treatment should be selected based on the results of bone culture

Pressure sores and blood and serum dysmetabolism in spinal cord injury patients.

Science.gov (United States)

Scivoletto, G; Fuoco, U; Morganti, B; Cosentino, E; Molinari, M

2004-08-01

Spinal cord injury (SCI) patients with pressure sores were studied before and after surgical intervention for ulcer healing and compared with matched SCI patients without sores and with patients with pressure sores and other diseases. To analyse the relationship between pressure sores and anaemia and serum protein alteration in SCI patients. To study the pathogenesis of these alterations and suggest appropriate therapy. Spinal cord unit in Rome, Italy. A total of 13 SCI patients with pressure sores, 13 comparable patients without pressure sores and four patients with other diseases and pressure sores. Haematochemical parameters. Patients with pressure sore showed significant decreased red cells, decreased haemoglobin and haematocrit, increased white cells and ferritin and decreased transferrin and transferrin saturation; total hypoproteinemia and hypoalbuminemia with increased Alfa-1 and gamma globulins increased erythrocyte sedimentation rate and C-reactive protein were also present. The alterations returned to normal after surgical intervention for pressure sore healing. Patients with pressure sores suffer from anaemia and serum protein alteration that fells within the range of metabolic alteration of chronic disorders and neoplastic diseases. The alterations depend on a decreased utilisation of iron stores in the reticuloendothelial system and on inhibition of the hepatic synthesis of albumin. With regard to treatment, iron treatment should be avoided because of the risk of haemochromatosis.

Cost analysis of surgically treated pressure sores stage III and IV.

Science.gov (United States)

Filius, A; Damen, T H C; Schuijer-Maaskant, K P; Polinder, S; Hovius, S E R; Walbeehm, E T

2013-11-01

Health-care costs associated with pressure sores are significant and their financial burden is likely to increase even further. The aim of this study was to analyse the direct medical costs of hospital care for surgical treatment of pressure sores stage III and IV. We performed a retrospective chart study of patients who were surgically treated for stage III and IV pressure sores between 2007 and 2010. Volumes of health-care use were obtained for all patients and direct medical costs were subsequently calculated. In addition, we evaluated the effect of location and number of pressure sores on total costs. A total of 52 cases were identified. Average direct medical costs in hospital were €20,957 for the surgical treatment of pressure sores stage III or IV; average direct medical costs for patients with one pressure sore on an extremity (group 1, n = 5) were €30,286, €10,113 for patients with one pressure sore on the trunk (group 2, n = 32) and €40,882 for patients with multiple pressure sores (group 3, n = 15). The additional costs for patients in group 1 and group 3 compared to group 2 were primarily due to longer hospitalisation. The average direct medical costs for surgical treatment of pressure sores stage III and IV were high. Large differences in costs were related to the location and number of pressure sores. Insight into the distribution of these costs allows identification of high-risk patients and enables the development of specific cost-reducing measures. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

[Pressure sores in geriatric medicine: the role of nutrition].

Science.gov (United States)

Fontaine, Juliette; Raynaud-Simon, Agathe

2008-01-01

Malnutrition is frequent in geriatric patients: it affects 30 to 60% of elderly residents of institutions and 30 to 70% of patients admitted for short-term hospitalization. Malnutrition is a risk factor for developing pressure sores, and patients with them are more often and more severely malnourished than patients without them. In elderly subjects, multiple and interlinked factors may trigger or aggravate malnutrition; they may be physical, psychological or social and may be worsened by drugs and some diets. Malnutrition has been recognized as a risk factor for the onset and perpetuation of pressure sores. Of the dietary factors, protein intake seems most important. A low body mass index (BMI), low serum albumin, and weight loss are associated with an increased risk of pressure sores. A physician observing pressure sores must conduct a nutritional assessment, using clinical and laboratory screening tools. The criteria for malnutrition in elderly subjects are weight loss > or =5% in 3 months or > or =10% in 6 months, BMIpressure sores in geriatric medicine. It must be adapted for each patient. The recommended calorie intake in malnourished patients at risk of or with pressure sores is 30-40 kcal/kg/d, with 1.2-1.5 g of proteins/kg/d.

[Options for flap coverage in pressure sores].

Science.gov (United States)

Nae, S; Antohi, N; Stîngu, C; Stan, V; Parasca, S

2010-01-01

Despite improvements in reconstructive techniques for pressure sores, recurrences are still seen frequently, and success rate remains variable. During 2003 - 2007, at the Emergency Hospital for Plastic Surgery and Burns in Bucharest, 27 patients underwent surgical repair of 45 pressure sores located at sacral (22 ulcers), ischial (12 ulcers) and trochanteric (11 ulcers) regions. The mean patient age was 57, 1 years (range 26 to 82 years). Mean postoperative follow-up was 6 months (range 2 months - 2 years). There were 18 complications for the 45 sores (40%). At 6 months postoperatively, recurrence was noted in 12 ulcers (27%). Details regarding indications, contraindications, advantages and disadvantages for different coverage options are outlined. The authors advocate the importance of surgical coverage in reducing morbidity, mortality and treatment costs.

Pressure sores following elective total hip arthroplasty: pitfalls of misinterpretation.

Science.gov (United States)

Keong, Nicole; Ricketts, David; Alakeson, Nuki; Rust, Philippa

2004-01-01

OBJECTIVE: To assess the reliability of reporting protocols regarding pressure sores. METHODS: Retrospective data were collected regarding pressure sore rates following total hip arthroplasty operations carried out during 2001 at two orthopaedic units in an NHS hospital (Princess Royal Hospital) and in a local private hospital. RESULTS: Preliminary results presented in audit and interim reports indicated an alarmingly high pressure sore rate across the two sites (17/172 [9.9%] NHS, 23/71 [32.4%] private hospital). On analysis, the data collection system was revealed to be flawed. Grade 1 areas (erythema with no ulceration) were included, leading to a dramatic discrepancy between reported and confirmed pressure sores. Re-analysis showed the confirmed pressure sore rates to be much lower (2.3% NHS, 1.0% private hospital). CONCLUSIONS: This audit suggests that both poor data collection and education lead to inaccurate audit. This may lead to subsequent inappropriate management and inappropriate NHS star ratings. PMID:15140301

Prevention of pressure sores by identifying patients at risk

DEFF Research Database (Denmark)

Andersen, Klaus Ejner; Jensen, O; Kvorning, S A

1982-01-01

The risk of pressure sores developing in patients admitted with acute conditions was assessed by a simple risk score system based on age, reduced mobility, incontinence, pronounced emaciation, redness over bony prominences, unconsciousness, dehydration, and paralysis in a prospective clinical stu...... of pressure sores prevents their development.......The risk of pressure sores developing in patients admitted with acute conditions was assessed by a simple risk score system based on age, reduced mobility, incontinence, pronounced emaciation, redness over bony prominences, unconsciousness, dehydration, and paralysis in a prospective clinical study...

Sacral pressure sore reconstruction – the pedicled superior gluteal ...

African Journals Online (AJOL)

Pressure sore reconstruction has always been challenging. Immobile patients are prone to develop pressure sores from unre- lieved pressure on tissue over the sacral area, with shear, friction, moisture and malnutrition as contributing factors. Up to one-third of immobilised patients in long-term care facilities will develop.

The evaluation of daily living activities, pressure sores and risk factors.

Science.gov (United States)

Aydın, Gökçen; Mucuk, Salime

2015-01-01

This study was conducted to assess daily living activities, pressure sores and risk factors. This was a descriptive study. The study was conducted at a rehabilitation center with 188 individuals participating in the study. Data were collected with a questionnaire form, Activities of Daily Living Scale (ADLS), Instrumental Activities of Daily Living Scale (IADLS) and Braden Risk Assessment Scale (BRAS). Among the participants, 48.9% were dependent according to activities of daily living and 71.8% were dependent on instrumental activities of daily living. It was noted that 4.8% had pressure sores and 38.8% were at high risk. A strong and positive correlation was found among ADLS, IADLS, and BRAS scores (p pressure sores (p pressure sores. Individuals who are treated at rehabilitation centers should be periodically assessed in terms of risk. Pressure sore development can be prevented with appropriate nursing interventions. To reduce the risk of developing pressure sores, nurses should describe the individual's degree of dependency according to ADLS and IADLS and initiate preventive nursing care. © 2014 Association of Rehabilitation Nurses.

[An assessment scale for the prevention of pressure sores in children].

Science.gov (United States)

Chauvet, Corinne; Poirier, Marie-Renée; Sourisseau, Petronela Rachieru; Béduneau, Denis; Soulard, Anthony; Delacroix, Delphine

2015-04-01

Pressure sores in children are rare. However, when they do occur they can have significant consequences. Professionals in paediatric units realised the importance of assessing the risk of pressure sores and developed a pressure sore assessment scale specific to children. This project, carried out through a hospital-training school partnership, emphasises the importance of clinical reasoning in nursing practices.

[The prevention of pressure sores in paediatric intensive care].

Science.gov (United States)

Thueux, Emilie

2014-01-01

In paediatric intensive care, children develop pressure sores as a result of various mechanical and clinical factors. The prevention and assessment of the risk of pressure sores constitute a key concern for the nursing teams which establish prevention strategies adapted to the young patients.

[Treatment of pubic osteomyelitis secondary to pressure sores].

Science.gov (United States)

Brunel, Anne-Sophie; Téot, Luc; Lamy, Brigitte; Masson, Raphaël; Morquin, David; Reynes, Jacques; Le Moing, Vincent

2014-01-01

There is no consensus regarding the diagnostic and therapeutic strategy for pubic osteomyelitis secondary to pelvic pressure sores. Diagnosis is often difficult and bone biopsies with microbiological and anatomical-pathological examination remain the gold standard. The rate of cicatrisation of pressure sores is low. Cleansing and negative pressure treatment are key elements of the treatment. Optimising the care management with medical-surgical collaboration is being studied in the Ostear protocol.

Oxidative stress and acute-phase response in patients with pressure sores.

Science.gov (United States)

Cordeiro, Maria Bernarda Cavalcanti; Antonelli, Elida Juliana; da Cunha, Daniel Ferreira; Júnior, Alceu Afonso Jordão; Júnior, Virmondes Rodrigues; Vannucchi, Helio

2005-09-01

We investigated the relation between oxidative stress and the occurrence of the acute-phase response with serum ascorbic acid and alpha-tocopherol levels in patients with pressure sores. The following groups of patients were studied: 1) those who had patients with pressure sores, 2) those who had pneumonia, and 3) those who did not develop pressure sores or any type of infection (control). Concentrations of total proteins, albumin, creatinine, iron, ferritin, transferrin, C-reactive protein, alpha1-acid glycoprotein, total iron-binding capacity, ascorbic acid, alpha-tocopherol, and malondialdehyde were measured during the first days of hospitalization. Albumin concentrations were significantly lower (P pressure sores compared with controls. Concentrations of ascorbic acid and alpha-tocopherol were significantly decreased (P pressure sores or infection, whereas malondialdehyde concentrations were significantly increased (P pressure sores and 10 of 12 patients (83.33%) with pneumonia presented serum ascorbic acid concentrations below the reference value (34 to 91 micromol/L). Concentrations of ascorbic acid and alpha-tocopherol versus malondialdehyde were significantly correlated in the three patient groups (r = -0.44, P pressure sores and acute infection present a systemic inflammatory response accompanied by an increase in lipid peroxidation that is associated with decreased serum ascorbic acid and alpha-tocopherol levels, suggesting that these patients may be at risk for important nutritional deficiencies.

Treatment of ischial pressure sores using a modified gracilis myofasciocutaneous flap.

Science.gov (United States)

Lin, Haodong; Hou, Chunlin; Chen, Aimin; Xu, Zhen

2010-04-01

Despite the availability of a variety of flap reconstruction options, ischial pressure sores continue to be the most difficult pressure sores to treat. This article describes a successful surgical procedure for the coverage of ischial ulcers using a modified gracilis myofasciocutaneous flap. From August 2000 to April 2004, 12 patients with ischial sores were enrolled in the study. All patients underwent early aggressive surgical debridement followed by surgical reconstruction with a modified gracilis myofasciocutaneous flap. The follow-up period ranged from 13 to 86 months, with a mean of 44 months. Overall, 91.7% of the flaps (11 of 12) survived primarily. Partial flap necrosis occurred in one patient. Primary wound healing occurred without complications at both the donor and recipient sites in all cases. In one patient, grade II ischial pressure sores recurred 13 months after the operation. There was no recurrence in other 11 patients. A modified gracilis myofasciocutaneous flap provides a good cover for ischial pressure sores. Because it is easy to use and has favorable results, it can be used in the primary treatment for large and deep ischial pressure sores. Copyright Thieme Medical Publishers.

Prevention of pressure sores by identifying patients at risk.

Science.gov (United States)

Andersen, K E; Jensen, O; Kvorning, S A; Bach, E

1982-01-01

The risk of pressure sores developing in patients admitted with acute conditions was assessed by a simple risk score system based on age, reduced mobility, incontinence, pronounced emaciation, redness over bony prominences, unconsciousness, dehydration, and paralysis in a prospective clinical study. During seven months in 1977, 600 of 3571 patients were classified as at risk. Of these 35 (5.8%) developed sores compared with five (0.2%) of those not at risk. The results of this study compared with those over the same period in 1976 show that close observation of at-risk patients and early detection of pressure sores prevents their development. PMID:6803980

Reconstruction of pressure sores with perforator-based propeller flaps.

Science.gov (United States)

Jakubietz, Rafael G; Jakubietz, Danni F; Zahn, Robert; Schmidt, Karsten; Meffert, Rainer H; Jakubietz, Michael G

2011-03-01

Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores were over the sacrum, five over the ischial tuberosity, and one on the tip of the scapula. Three patients were paraplegic, six were bedridden, and five were ambulatory. In three patients, no perforators were found. In 10 patients, propeller flaps were transferred. In two patients, total flap necrosis occurred, which was reconstructed with local advancement flaps. In two cases, a wound dehiscence occurred and had to be revised. One hematoma required evacuation. No further complications were noted. No recurrence at the flap site occurred. Local perforator flaps allow closure of pressure sores without harvesting muscle. The propeller version has the added benefit of transferring tissue from a distant site, avoiding reapproximation of original wound edges. Twisting of the pedicle may cause torsion and venous obstruction. This can be avoided by dissecting a pedicle of at least 3 cm. Propeller flaps are a safe option for soft tissue reconstruction of pressure sores. © Thieme Medical Publishers.

Cutaneous flaps in the treatment of 338 pressure sores: a better choice.

Science.gov (United States)

Greco, Manfredi; Marchetti, Francesco; Tempesta, Massimo; Ruggiero, Marco; Marcasciano, Marco; Carlesimo, Bruno

2013-01-01

Muscular flaps are considered by many surgeons as a treatment of choice for pressure sores. Nevertheless fasciocutaneous and adipofascial flaps are less sensitive to ischemia, more resistant to pressure and have higher mechanical resistance. The aim of this study is to evaluate the results of our integrated rehabilitative and surgical protocol in pressure sore management based on the use of cutaneous flaps. Since 1998, we treated 338 pressure sores (PS) in 195 patients (120 males; 75 females), 189 patients were affected by paraplegia and tetraplegia and 6 of them by neurological disorders. Ninety sacral, 156 ischiatic, 75 trochanteric, 9 calcanean and 8 sores of the iliac-crest were succesfully treated. All showed an involvement of the bone element, with osteitis and/or periosteitis. 14 cases of trocanteric sores showed a deeper bone involvement, with evidences of osteomyelitis. Follow up ranges from 7 years to 2 months. Median time for wound healing was 18 days. The use of fasciocutaneous flaps, as an alternative to the traditional muscolocutaneous flaps in the treatment of pressure sores leads to good and statistically comparable, healing rate, time and incidence of complications. Reconstructive plastic surgery as is a decisive factor to reach a good rehabilitative outcome, minimizing the time of rehabilitation with a following decrease of hospitalization costs. In spinal cord injured patients, surgical treatment of pressure sores is not proposed as the main procedure, but it is an important stage during the natural history of pressure sores. Cutaneous, adipofascial and fasciocutaneous flaps are less invasive, of a relatively easy execution, provided by a reliable vascular pedicle and they could be "re-used" in case of recurrences.

How elderly patients with femoral fracture develop pressure sores in hospital.

Science.gov (United States)

Versluysen, M

1986-01-01

The routine hospital management of 100 consecutive elderly patients was studied to determine the reason for the high incidence of pressure sores among patients admitted to hospital for femoral fractures. Of these patients, 66 developed sores, 83% occurring by the fifth day in hospital. This was due to the long periods that patients were immobilised on high pressure surfaces in the casualty department, wards, and theatres before repair of the fracture and restoration of their weight bearing function. Sores are not simply a ward or nursing problem, but an unintended consequence of hospital treatment. To reduce the incidence of sores elderly patients should be treated on low pressure patient support systems from the point of entry to hospital until mobility is restored. PMID:3085827

Treatment of ischial pressure sores with double adipofascial turnover flaps.

Science.gov (United States)

Lin, Haodong; Hou, Chunlin; Xu, Zhen; Chen, Aiming

2010-01-01

Despite a variety of flap reconstruction options, the ischium remains the most difficult pressure sore site to treat. This article describes the authors' successful surgical procedure for coverage of ischial ulcers using double adipofascial turnover flaps.After debridement, the adipofascial flaps are harvested both cephalad and caudal to the defect. The flaps are then turned over to cover the exposed bone in a manner so as to overlap the 2 flaps. The skin is then closed with sutures in 2 layers. A total of 15 patients with ischial sores were treated using this surgical procedure.The follow-up period ranged from 11 to 159 months, with a mean of 93.6 months. Overall, 86.7% of the flaps (13 of 15) healed primarily. One patient had a recurrent grade II ischial pressure sore again 11 months after the operation. The other 14 patients did not have a recurrence.Treatment of ischial pressure sores with adipofascial turnover flaps provides an easy, minimally invasive procedure, with preservation of future flap options, and a soft-tissue supply sufficient for covering the bony prominence and filling dead space. This technique is a reliable and safe reconstructive modality for the management of minor ischial pressure sores.

Pressure sores--a multifaceted approach to prevention and treatment.

Science.gov (United States)

Staas, W. E.; Cioschi, H. M.

1991-01-01

The incidence and effect of pressure sores on the disabled and elderly population have created a challenge to physicians and health care professionals, from emergency departments to rehabilitation units, and in the community. If not prevented, the morbidity and mortality of patients and the direct and indirect costs to both patients and the health care system are radically increased. In this article we define the impact on our health care system of pressure sores, provide an overview of a multifaceted approach to their prevention and management, and introduce successful behavioral and educational approaches for patients with chronic, recurrent sores. A coordinated approach with patients as informed participants and their care givers enhances the chances for success. PMID:1830985

What role can nurse leaders play in reducing the incidence of pressure sores?

Science.gov (United States)

Wurster, Joan

2007-01-01

Pressure sores have plagued the nursing profession for many years as a major health care problem in terms of a patient's suffering and financial cost. Pressure sores are increasingly common in hospitalized patients in the United States with a 63% increase from 1993 to 2003. The nurse leader is accountable for the occurrence of pressure sores, a nurse-sensitive indicator, by a scorecard which is benchmarked against other facilities. The nurse leader must take a systematic approach in the prevention of pressure sores, with the strategy being consistent and motivating to the staff in order to improve patient outcome. The chief nursing officer, the unit manager, and the bedside nurse must all collaborate to prevent tissue injury in patients at risk for developing pressure sores and to promote wound healing in patients with existing breakdown.

Risk factors for pressure sores in adult patients with myelomeningocele--a questionnaire-based study.

Science.gov (United States)

Plaum, Pål-Erik; Riemer, Gunnar; Frøslie, Kathrine Frey

2006-12-29

Myelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Little is known about the risk factors for pressure sores in adults with MMC. The aim of this study was to investigate an association between the presence of pressure sores and other patient characteristics, in order to develop an improved strategy for the management of sores. A structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway. Out of 193 total, 87 patients participated and 71 patients (82%) reported sores; 26 (30%) at the time of the interview and 45 (52%) during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02), Arnold Chiari malformation (p = 0.02) and a record of previous sores (p = 0.004). Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21%) reported skin inspection by others and the remainder relied on self-inspection. Patients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment.

[High-grade pressure sores in frail older high-risk persons. A retrospective postmortem case-control-study].

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Von Renteln-Kruse, W; Krause, T; Anders, J; Kühl, M; Heinemann, A; Püschel, K

2004-04-01

Some old persons at risk do develop, but others, at comparable risk, do not develop high-grade pressure sores. To evaluate potentially different risk factors, we performed a post mortem case-control study in old persons who developed high-grade pressure sores within six months until 14 days before death. Consecutive cases with pressure sores grade >/=3 and potential controls at comparably high risk for pressure sores were examined before cremation. After written informed consent had been obtained by the next relatives, all available nursing and medical records of the deceased were thoroughly evaluated. Cases and controls were matched according to age, gender, immobility, and cachexia.A total of 100 cases with 71 pressure sores grade 3 and 29 pressure sores grade 4 were compared to 100 controls with 27 pressure sores grade pressure sores in frail older high-risk persons. Sedative drug effects and impaired patient compliance with preventive and therapeutic measures may also be associated with the development of high-grade pressure sores in old persons at high risk.

Reduction of the incidence of pressure sores by an education program on nursing care.

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Srisupan, Vijitr; Senaratana, Wilawan; Picheansatian, Wilawan; Chittreecheur, Jittaporn; Watanakool, Malinee; Chaisri, Pratin; Singhakumfu, Laddawan; Tribuddharat, Chanwit; Danchaivijitr, Somwang

2005-12-01

To determine whether an education and campaign program would reduce the incidence of pressure sores. The study was performed in a 1,400-bed teaching hospital in Thailand with a total number of 697patients from 47 wards for a point prevalence study; 1,201 and 1,268 patients from 12 wards to determine whether reduction of pressure sore occurrence would be obtained by an education program. The point prevalence of pressure sores was 10.8%. The significant risk factors were age older than 60 years, fecal incontinence, and history of diarrhea. The occurrence of pressure sores was significantly reduced after the educational program from 9.91% to 5. 76%. The education on patient care aiming at reduction of the occurrence of pressure sores could be adopted nation-wide in order to reduce the morbidity, mortality and expenses. The education program was effective in reducing the incidence of pressure sores.

Practical Management of Pressure Sores

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Jordan, John M.

1992-01-01

Pressure sores are common in the debilitated elderly. Causal factors are unrelieved pressure, shearing forces, friction, and moisture. Preventive measures should be used for all high-risk patients, defined by general condition, mental status, degree of incontinence, amount of activity, and mobility. Principles of treating ulcers include pressure relief, reducing bacterial counts, debriding necrotic tissue, and providing a moist, clean environment. Imagesp2385-ap2389-ap2392-a PMID:21221298

Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

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Kamal Kataria

2012-05-01

Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.

Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

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Kataria, Kamal; Sagar, Sushma; Singhal, Manish; Yadav, Rajni

2012-01-01

Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature. PMID:29181131

Evaluation of blood and serum markers in spinal cord injured patients with pressure sores.

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Gurcay, Eda; Bal, Ajda; Gurcay, Ahmet G; Cakci, Aytul

2009-03-01

To evaluate blood and serum markers in traumatic spinal cord injured (SCI) patients, with and without pressure sores. This cross-sectional study was performed at the Ministry of Health Diskapi Yildirim Beyazit, and Numune Education and Research Hospitals, Ankara, Turkey, from 2006-2008. A total of 23 SCI patients with pressure sores (group I) and a control group of 25 SCI patients without pressure sores (group II) were evaluated. Characteristics of sores were examined with respect to duration, location, grade, tissue types, surface area, and exudate amount. Recorded laboratory parameters included erythrocyte sedimentation rates (ESR), C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Htc), lymphocytes, white blood cells (WBC), red blood cells (RBC), serum iron, transferrin, total iron-binding capacity (TIBC), ferritin, total protein, albumin, vitamin B12, and zinc. The most common pressure sore location was the sacrum (38%). Compared to the control group, the patients with pressure sores showed anemia with reduced serum iron, transferrin, TIBC, and increased ferritin. They also had increased ESR, CRP, and WBC and reduced lymphocytes, total protein, albumin and zinc. Statistically significant correlations were found between CRP, Hb, Htc, lymphocytes, RBC, WBC, and serum protein levels, and grade of pressure sores. Clinicians should regularly screen patients with respect to blood and serum markers, in order to determine any risks for pressure sores, and they should perform immediate preventive measures based on the patient's condition.

Aetiology of pressure sores in patients with spinal cord injury.

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Thiyagarajan, C; Silver, J R

1984-01-01

One hundred consecutive patients admitted to the National Spinal Injuries Centre, Stoke Mandeville Hospital, with pressure sores were studied to assess the relative importance of factors known to predispose to the development of scores. Loss of feeling was critical, because patients were unable to appreciate pain when the sore was developing. Risk of developing a sore increased with age, but duration of the paralysis was of equal importance. After discharge from hospital the presence of a caring relative or friend was essential for survival. Many patients developed sores because of poor facilities at home or inappropriate advice from those who looked after them. An even more distressing factor was the number of patients who developed sores in hospital owing to inadequate nursing care. There are relatively few paralysed patients in the community, but the lessons learnt in this study may be applied to all patients with orthopaedic injuries and to geriatric patients with limited mobility. Nursing and medical staff must turn patients regularly and ensure that there is proper equipment to relieve pressure on the skin. Patients should not be allowed to sit in a chair if they develop a sacral or trochanteric sore. More effort should be directed towards the appropriate education of patients, their relatives, and all those who are concerned with their welfare. Images FIG 1 FIG 2 FIG 3 PMID:6439284

A comparative analysis of pressure sore treatment modalities in community settings

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N. Small

2002-09-01

Full Text Available The management of pressure sores in community settings, poses a clinical problem which challenges the patient’s tolerance and the clinician’s diligence and ingenuity. Pressure sores can be painful, lead to infection and are associated with considerable morbidity and increased mortality (Patterson & Bennett, 1995:919; Bale, Banks, Hagelstein & Harding, 1998:65. Treatment costs of these wounds are high in terms of resources (Colin 1995:65; Wood, Griffiths & Stoner, 1997:256. However, since there are untold cost in terms of pain and suffering to the patient, it is impossible to calculate the true cost of pressure sores (Dealey, 1994:87.

Detection and Isolation of Digital Dermatitis Treponemes from Bovine Pressure Sores.

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Clegg, S R; Crosby-Durrani, H E; Bell, J; Blundell, R; Blowey, R W; Carter, S D; Evans, N J

2016-05-01

Pressure sores cause severe pain and discomfort in hospitalized people and in farmed cattle and are often infected with unknown bacteria. Pressure sores occur on the upper legs of 6-10% of recumbent cattle and are generally considered to be caused by constant pressure, commonly on bony areas of the limbs. This study analyzed pressure sores taken from the upper limbs of 14 cattle using isolation in culture and nested polymerase chain reaction (PCR) to detect treponemes associated with digital dermatitis (DD). A 100% association of DD treponemes with the pressure sores was demonstrated, but treponemes were shown not to be part of the normal skin microbiota. Immunohistochemistry showed an association of DD treponemes with lesions and particularly with the hair follicles in lesions, identifying the bacteria deep within wounds, thereby suggesting that they could contribute to lesion pathogenesis. The bacteria isolated from the pressure sore lesions were similar or identical on analysis of the 16S rRNA gene to those found in DD foot lesions in cattle, suggesting the same bacteria can infect multiple lesions. Indeed, the results of this study suggest that these spirochaetal bacteria may be expanding in host range and in their ability to colonize different tissues and contribute to a range of disease manifestations in farm animals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost analysis of surgically treated pressure sores stage III and IV.

NARCIS (Netherlands)

Filius, A.; Damen, T.H.; Schuijer-Maaskant, K.P.; Polinder, S.; Hovius, S.E.R.; Walbeehm, E.T.

2013-01-01

Health-care costs associated with pressure sores are significant and their financial burden is likely to increase even further. The aim of this study was to analyse the direct medical costs of hospital care for surgical treatment of pressure sores stage III and IV. We performed a retrospective chart

[Surgical issues and outcomes in ischial pressure sores treatment].

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Voulliaume, D; Grecea, M; Viard, R; Brun, A; Comparin, J-P; Foyatier, J-L

2011-12-01

Ischiatic pressure sores are frequent in spinal cord injury patients, associated with bad prognosis and high recurrence rate. Many surgical techniques were described, including surgical debridement followed by pedicled flap coverage. We aim to propose a practical decision tree for primary or secondary ischial pressure sore treatment. Our series of 48 operated ischial sores with an average follow up of 4 years (range 2 to 8years) is analyzed and compared to previously published reports. Surgical techniques are discussed according to their specific indications. The optimal recurrence rate in published reports about pressure sore treatment is 20%; a rate inferior to 19% is found in our series, showing the equal importance of flap selection and postoperative care and education. Depending on each situation, various available flaps are described and compared: gluteus maximus flap, biceps femoris flap, gracilis flap, tensor fascia lata flap, fasciocutaneous thigh flaps, rectus femoris and vastus lateralis flap, rectus abdominis flap. Specific surgical indications for more extensive wounds are studied: resection arthroplasty of the hip, hip disarticulation, fillet flaps from the leg, microsurgery. Based upon our experience, a decision tree summarizes our proposition of flap selection, depending on the wound size and the patient background. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Risk factors for pressure sores in adult patients with myelomeningocele – a questionnaire-based study

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Frøslie Kathrine

2006-12-01

Full Text Available Abstract Background Myelomeningocele (MMC is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Little is known about the risk factors for pressure sores in adults with MMC. The aim of this study was to investigate an association between the presence of pressure sores and other patient characteristics, in order to develop an improved strategy for the management of sores. Methods A structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway. Results Out of 193 total, 87 patients participated and 71 patients (82% reported sores; 26 (30% at the time of the interview and 45 (52% during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02, Arnold Chiari malformation (p = 0.02 and a record of previous sores (p = 0.004. Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21% reported skin inspection by others and the remainder relied on self-inspection. Conclusion Patients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment.

Risk factors for pressure sores in adult patients with myelomeningocele – a questionnaire-based study

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Plaum, Pål-Erik; Riemer, Gunnar; Frøslie, Kathrine Frey

2006-01-01

Background Myelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Little is known about the risk factors for pressure sores in adults with MMC. The aim of this study was to investigate an association between the presence of pressure sores and other patient characteristics, in order to develop an improved strategy for the management of sores. Methods A structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway. Results Out of 193 total, 87 patients participated and 71 patients (82%) reported sores; 26 (30%) at the time of the interview and 45 (52%) during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02), Arnold Chiari malformation (p = 0.02) and a record of previous sores (p = 0.004). Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21%) reported skin inspection by others and the remainder relied on self-inspection. Conclusion Patients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment. PMID:17196099

Pressure Sores and Systemic Inflammatory Response Syndrome: UC Davis Quality Improvement Initiative.

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Jairam, Abhishek; Song, Ping; Patel, Nirav B; Wong, Michael S

2018-05-01

The National Pressure Ulcer Advisory Panel estimates pressure sore care to approach $11 billion annually. It is not uncommon for these patients to present to the emergency department (ED) with a chief concern of a pressure sore, while concurrently carrying an undiagnosed infectious process that is the culprit for the acute presentation, rather than the chronic pressure injury. We aim to identify patients who met systemic inflammatory response syndrome (SIRS) criteria at ED presentation who were referred to plastic and reconstructive surgery for pressure sore debridement prior to a complete medical workup. We hypothesize that a restructuring of the ED triaging system would help conserve hospital resources, reduce costs of pressure sore management, and improve patient care and outcomes by first treating primary, underlying pathologies. This is a retrospective chart review of 36 patients who presented to the University of California, Davis Medical Center Emergency Department with a pressure sore and met SIRS criteria, but obtained a plastic surgery consult prior to a full medical workup. We defined SIRS based on standardized criteria: temperature greater than 100.4°F or less than 96.8°F, pulse rate greater than 90 beats/min, respiratory rate greater than 20 breaths/min or PaCO2 less than 32 mm Hg, white blood cell count greater than 12,000, less than 4000, or greater than 10% bands. Fifty percent of patients (18/36) met SIRS criteria at ED presentation for their pressure sores. Of these SIRS patients, 9 (50%) had a diagnosis of urinary tract infection or urosepsis, 6 (33.3%) had sepsis of undefined origin, and 3 (16.7%) had other diagnoses such as osteomyelitis or acute respiratory distress syndrome. Half of patients consulted while in the University of California, Davis Medical Center Emergency Department with pressure sores met SIRS criteria and received a plastic and reconstructive surgery consult prior to a full medical workup. We propose a new algorithm for

Vitamin C depletion and pressure sores in elderly patients with femoral neck fracture.

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Goode, H. F.; Burns, E.; Walker, B. E.

1992-01-01

OBJECTIVE--To evaluate the contribution of specific nutritional deficiencies (as indicated by zinc; vitamin A, C, and E; albumin; and haemoglobin concentrations) to the risk of pressure sores. DESIGN--Observational cohort study. SETTING--St James's University Hospital, Leeds. SUBJECTS--21 elderly patients presenting consecutively to the orthopaedic unit with femoral neck fracture. MAIN OUTCOME MEASURE--Full thickness epidermal break over a pressure bearing surface. RESULTS--10 patients (48%) developed a pressure sore during their hospital stay. Indices of zinc status and concentrations of albumin, haemoglobin, and vitamins A and E were similar in patients who developed a pressure sore and those who did not. Mean leucocyte vitamin C concentration, however, was 6.3 (SD 2.2) micrograms/10(8) cells in patients who developed a pressure sore as compared with 12.8 (4.6) micrograms/10(8) cells in patients who did not. CONCLUSIONS--Low concentrations of leucocyte vitamin C appear to be associated with subsequent development of pressure sores in elderly patients with femoral neck fractures. PMID:1458073

Preventing Pressure Sores

Medline Plus

Full Text Available ... Sores Mary Zeigler, MS Transition from Hospital to Home Kim Eberhardt Muir, MS ... medical advice, recommend or endorse health care products or services, or control the information found on external websites. ...

[Indication of sclerotherapy in the treatment of ischiatic pressure sore: about 13 cases].

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Bahé, L; Prud'homme, A; Penaud, A; Formé, N; Zakine, G

2012-12-01

Ischiatic pressure sore is a common pathology of the paraplegic patient. Usually treated after medical therapy, with fasciocutaneous or musculocutaneous local flaps, despite this treatment the recurrence rate is high. Sclerotherapy, injection of pure ethanol in the cavity of the pressure sore could be an interesting solution in the armentarium of the plastic surgeon in some indications. Sclerotherapy was used for 13 patients in the plastic surgery department to treat ischiatic pressure sores with a cavity, beneath the defect. The mean length of stay was 24 days. The ischiatic pressure sore was completely healed with no skin defect or cavity for nine patients (65%). For two patients, there was a delay of healing of the skin defect but no cavity beneath. There were two early recurrences of the pressure sore. They were treated by sclerotherapy with a complete recovery in 2 months with simple hydrocolloid dressings. The mean post op follow-up was 14,6 months (4 to 24). Only one recurrence was observed after 12 months. The injection of pure ethanol in the cavity of specifics ischiatics pressure sores is a simple, fast and effective technique with a good and stable long term wound healing. The mean length of stay is shorter and the recurrence rate is equivalent to other techniques. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

Does a foamy-block mattress system prevent pressure sores ? A prospective randomised clinical trial in 1729 patients.

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Berthe, J V; Bustillo, A; Mélot, C; de Fontaine, S

2007-01-01

Pressure ulcers are a frequent complication of bed rest. The development of an efficient and low cost pressure relieving system for the prevention of bed-sores would be of considerable hospital health and economic interest. Our study was designed to determine the effectiveness in pressure-sore prevention of an interface pressure-decreasing mattress, the Kliniplot mattress, used in our institution since 1978. In a prospective randomised controlled 7-month clinical trial we compared the Kliniplot mattress with our standard hospital mattress in 1729 patients admitted to medical and surgical departments (neurology, cardiology, oncology-haematology, neurosurgery, thoracic surgery and orthopaedic surgery). Two groups (Klinipot mattress and standard hospital mattress) were monitored for the prevention of pressure sores. The patients were evaluated on a daily basis from their admission until the eventual occurrence of a bed-sore. Patients' characteristics and pressure-sore risk factors were similar at the baseline in both groups. Patients presenting with a pressure sore at the time of admission were excluded. Forty-two of the 1729 patients (2.4%) who entered the study developed at least one pressure sore. Twenty-one of the 657 patients (3.2%) nursed on the Kliniplot mattress, and 21 of the 1072 patients (1.9%) on the standard mattress developed bed-sores (p = 0.154). The median time for the occurrence of pressure sores was 31 days (range 6-87) with the Kliniplot mattress and 18 days (range 2 to 38) with the standard mattress (p sores using the modified Ek's scale were no different at the baseline between both groups (p = 0.764). The severity of the pressure sores was no different between both groups (p = 0.918). Our results show that the occurrence of pressure sores is not reduced but is delayed when patients are nursed on a Kliniplot pressure-decreasing mattress.

Preventing Pressure Sores

Medline Plus

Full Text Available ... Sores Mary Zeigler, MS Transition from Hospital to Home Kim Eberhardt Muir, MS Coping with a New ... not provide medical advice, recommend or endorse health care products or services, or control the information found ...

Mouth sores

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... To help cold sores or fever blisters, you can also apply ice to the sore. You may reduce your chance of getting common mouth sores by: Avoiding very hot foods or beverages Reducing stress and practicing relaxation techniques like yoga or meditation ...

[Clinical application of modified upper gluteal rhomboid fasciocutaneous flap in repairing sacrococcygeal pressure sores].

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Jiang, Maohua; Yang, Xiaoliang; Wei, Bangmin; Li, Yinghao

2012-03-01

To investigate the method and effectiveness of repairing sacrococcygeal pressure sores with modified upper gluteal rhomboid fasciocutaneous flap. Between January 2004 and March 2011, 43 patients with sacrococcygeal pressure sores were treated. There were 25 males and 18 females with an average age of 63 years (range, 38-95 years). The disease duration was 3 months to 2 years and 6 months (mean, 8.5 months). The size of pressure sores ranged from 6 cm x 5 cm to 18 cm x 13 cm. According to the extent and lesion degree of pressure scores, 23 pressure sores were rated as degree III and 20 pressure sores as degree IV. The modified upper gluteal rhomboid flap was designed, one-side upper gluteal fasciocutaneous flaps were transplanted to repair sacrococcygeal pressure sores in 19 cases and two-side flaps in 24 cases. The size of one side flap ranged from 6.5 cm x 4.5 cm to 18.0 cm x 11.5 cm. Fluid under flap occurred in 1 case and edge necrosis of the flaps in 3 cases at 7 days after operation, which were cured after drainage and dressing change; the other flaps survived, and incisions healed by first intention. All patients were followed up 6 months to 3 years with an average of 11 months. Two patients relapsed at 5 months and 8 months, respectively; the other patients had no recurrence. The color of the flaps was normal, and the appearance and elasticity of the flaps were good. The modified upper gluteal rhomboid fasciocutaneous flap has the advantages of simple design and operation, less injury, and reliable effect in repairing sacrococcygeal pressure sores.

An audit of the physiotherapy management of paraplegic patients with sacral pressure sores

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D. Pather

2013-01-01

Full Text Available Introduction: Pressure sores are the most common complication post spinal cord injury that requires patients to be on bed rest. Patient bed rest delay rehabilitation and may lead to other complications associated with immobility. This study sought to establish the treatment interventions physiotherapists provide to patients with sacral pressure sores and the factors that they consider when deciding whether the patient should receive physiotherapy in the ward or gym. Methods: This was a questionnaire based survey of physiotherapists working in spinal cord injury rehabilitation units in South Africa. The self-designed questionnaire was sent to all the main spinal rehabilitation units in the country (14 located in Gauteng, Kwa-Zulu Natal, Western Cape, Eastern Cape and Free State provinces. Results: Thirty-nine physiotherapists from a total of 51 completed the questionnaires (76% response rate. The most common treatment practice for patients with sacral pressure sores was bed rest (98%. The most common physio-therapy practices (70% included were upper limb muscle strengthening, upper and lower limb passive movements, positioning into prone and side lying and passive stretching. The choice of treatment environment was influenced by doctors’ orders and the size, grade and duration of the pressure sores. Conclusion: Direct involvement in pressure sore management in South Africa seem to be less than in other parts of the world. If we are to minimise the pressure sore impact, it appears like we need more focus on gait re-education and standardised ADL programmes and patient treatment in the gym to possibly maximise healing and rehabilitation.

Medial circumflex femoral artery flap for ischial pressure sore

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Palanivelu S

2009-01-01

Full Text Available A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap.

[Urinary incontinence as a risk factor for pressure sores does not withstand a critical examination].

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Krause, Tom; Anders, Jennifer; von Renteln-Kruse, Wolfgang

2005-10-01

The association between urinary incontinence and pressure sores is put down to various causes. Most frequently urinary wet and following maceration of the skin are mentioned. However, it is possible that urinary incontinence is only an indicator for other risk factors or a measure of the need for care without any causal relation to pressure sores. There are hardly any controlled or randomised studies; this lack of scientific evidence is problematic. Based on a case-control-study including data of 200 patients as well as on the existing models of explanation, the following study tries to examine critically the connections between pressure sores and urinary incontinence. Out of the patients in our study population 97.5 percent were incontinent. Different categories of the risk factor urinary incontinence and different dichotomisations have led to different statistical results. Statements concerning the connection between urinary incontinence and pressure sores have to be interpreted critically. The dependence of urinary incontinence on other risk factors such as patients' need for care or compliance suggests that the causal connection to pressure sores be not reduced to the influence of wetness. We advise to research connections between urinary incontinence and pressure sores in a methodologically appropriate setting.

Approach to the pressure sores in geriatric patients

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Emre İnözü

2012-09-01

Full Text Available Objectives: The aim of this study was to evaluate the follow-up results of nutritionally supported geriatric patientswho were admitted for their pressure sores then plannedtheir treatment.Materials and methods: In this study, we analyzed thehospitalized geriatric pressure sore patients in our clinicwho were admitted between 2006 and 2011. We calculatedBody Mass Index and the blood albumin levels of allhospitalized geriatric patients. In this patient group proteinenergy malnutrition and deficiency were analyzed andproper nutrition support was provided accordingly. Afterrecovering from malnutrition further treatment surpassed.Results: The mean albumin levels of the hospitalized patientswas 2,53 ± 0,25 g/dL after nutritional support thoselevels increased to mean 3,95 ± 0,42 g/dL . Of all thosepatients 75% were operated when their general conditionallowed us for a surgery. Due to their high risk wedid not perform any surgical operation to the remaining25%.. Post operative mean hospitalization period was 12(8-21 days. Majority of the patients (78.6% were treatedsuccessfully either with surgical or conservative treatmentmodalities.Conclusions: The success of the geriatric pressure soretreatment is highly related with the proper nutritional supportfor the ongoing malnutrition-like pathologies. Beforeoperation nutritional support not only makes a healthygranulation tissue but also yields fast and reliable woundhealing. Despite their chronic health problems many ofour geriatric patients were treated surgically for their pressuresores.Key words: Pressure sore, geriatric medicine, malnutrition,nutritional support

Improving outcomes following reconstruction of pressure sores in spinal injury patients: A multidisciplinary approach.

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Tadiparthi, S; Hartley, A; Alzweri, L; Mecci, M; Siddiqui, H

2016-07-01

Pressure sore treatment in spinal injury patients is challenging. A multidisciplinary approach with joint management by the plastic surgery and spinal injury teams was initiated at our institution in 2005 to improve patient care and surgical outcomes following reconstruction. This study assessed the surgical outcomes following reconstruction using the team approach and to compare inpatient stay and readmissions for complications before and after the multidisciplinary protocol was introduced. A retrospective review of consecutive patients in the multidisciplinary pressure sore clinic was performed. Data were collected on patient demographics, reconstructive techniques, surgical outcomes and readmission for any complications. In total, 45 patients with 60 pressure sores (grade 3 or 4) were reviewed in the joint clinic between 2005 and 2011. The majority of patients were paraplegic (78%), while the remaining 22% were tetraplegic. Ischial sores were the most common (45%) followed by trochanteric (23%) and sacral (20%) sores. Multiple sores were noted in 44% of patients. Flap reconstruction was required in 32 patients (71%); after a mean follow-up time of 33 months (range 25-72 months), there were three (9%) major complications (two recurrences of pressure sores and one sinus) and seven (22%) minor complications. After introduction of patient care pathways through the multidisciplinary approach, the rate of readmission for complications decreased from 14% to 5.5% and inpatient stay upon readmission reduced from 65 to 45 days. Implementation of a multidisciplinary approach was key to optimising surgical outcomes, achieving a low recurrence rate (6%) and reducing readmissions. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Canker sore

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... under one third inch or 1 centimeter across) Gray color as healing starts Less common symptoms include: ... Aphthous ulcer; Ulcer - aphthous Images Canker sore Mouth anatomy Canker sore (aphthous ulcer) Fever blister References Bope ...

Treatment of pressure sores in spina bifida patients with calcium alginate and foam dressings.

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Ausili, E; Paolucci, V; Triarico, S; Maestrini, C; Murolo, D; Focarelli, B; Rendeli, C

2013-06-01

Prospective study on local treatment of pressure sores using calcium alginate and foam dressings in spina bifida patients. Investigate if this sequential approach is valid and safe for selected patients with neurological impairments. Using European Pressure Ulcer Grading System, after clinical evaluation of local sore, selected patients of Spina Bifida Center of Rome were treated with sequential calcium alginate and foam dressings for 12 weeks. Pressure ulcere surfaces were measured monthly by ulcer tracing. The endpoints were the mean absolute areas surface reduction during every month and number of patients achieving a 50% or more during study. 14 patients (7 males aged 12-24 years) with spina bifida and pressure sores were treated. Mean and standard deviation of mean surface area reduction were 12.5 ± 7.5 cm 2 at start of the study versus 3.7 ± 5.2 cm 2 after 12 weeks, p pressure sores in selected patients with spina bifida. In fact, they protect the wound and create an environment favorable to healing.

Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps.

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Wang, Chih-Hsin; Chen, Shih-Yi; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shao-Liang; Chen, Tim-Mo; Chen, Shyi-Gen

2011-05-01

To provide an alternative choice for covering trochanteric pressure sores, we report on a modified pedicle anterolateral thigh (ALT) myocutaneous flap based on the descending branch of the lateral circumflex femoral artery. From August 2007 to January 2010, 20 consecutive patients (10 men and 10 women) underwent 21 pedicled ALT myocutaneous flaps for reconstruction of trochanteric pressure sores. The flap was designed and elevated, resembling the ALT perforator flap including part of the vastus lateralis muscle but without skeletonisation of the perforators. The mean age of patients was 79.4 years (range: 46-103). The mean follow-up period was 13.9 months (range: 3-32). The flaps were 8-21 cm long and 5-11 cm wide. All flaps healed without major complications. All donor sites were closed primarily without skin grafting and showed good aesthetic results. No recurrence was observed. This modified design of pedicled ALT myocutaneous flap without skeletonisation of perforators is a reliable and easily harvested flap for reconstruction of trochanteric pressure sores with limited morbidity. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

[Randomized controlled trial on the effectiveness of Corpitolinol 60 in the prevention of pressure sores in patients undergoing surgery].

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Chiari, Paolo; Giorgi, Sabina; Ugolini, Daniela; Montanari, Morena; Giudanella, Pietro; Gramantieri, Antonella; Collesi, Franca; Pau, Michelina; Smaldone, Maddalena; Matarasso, Maddalena; Mazzini, Cinzia; Russo, Francesca; Gazineo, Domenica; Fontana, Mirella; Taddia, Patrizia

2012-01-01

Randomized controlled trial on the effectiveness of Corpitolinol 60 in the prevention of pressure sores in surgical patients. The risk of pressure sores in surgical patients is widely recognised. The Corpitolinol 60 (Sanyréne®) applied on compressed areas seems to reduce the risk of pressure sores. To assess the efficacy of Corpitolinol 60 in preventing pressure sores in the operatory theatre. The open label randomized clinical trial was conducted in 5 operating theatres of Northen Italy. Patients were randomized to receive Corpitolinol 60 in areas undergoing compression. Experimental group and controls were treated with usual measures for preventing pressure sores. The lesions were staged according to NPUAP up to 24 hours after surgery. Three-hundred-one patients were randomized (155 in the Sanyréne® group and 143 controls). The main variables predictive of pressure sores risk (ASA class, sex, age, duration of the surgery, and BMI) were comparable across groups. At the end of the surgery 71 patients (23.8%) in the experimental group and 47 controls (30.8%) had a pressure sore (p 0.006; RR 1.81 IC95% 1.17-2.79). Twelve and 24 hours after surgery the differences between groups were not significant. The aim of reducing pressure sores was not reached for patients treated with Corpitolinol 60.

Long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores.

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Lin, Haodong; Hou, Chunlin; Chen, Aimin; Xu, Zhen

2010-08-01

Among the many difficult problems presented by patients with spinal cord injuries, management of ischial pressure ulcers remains challenging for reconstructive surgeons. This study describes the long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores. Between January 1999 and June 2003, 12 patients with ischial sores were enrolled in this study. All the patients underwent early aggressive surgical debridement followed by surgical reconstruction with a laterally based posterior-thigh fasciocutaneous flap. The follow-up period ranged from 24 months to 97 months (mean, 62 months). All the flaps survived, and there were no partial flap losses. Primary-wound healing occurred in all the cases. In two patients, Grade II ischial pressure sores recurred 24 months and 27 months after the operation. There was no recurrence in the other 10 patients. The posterior-thigh fasciocutaneous pedicled flap was a good method for treating ischial bed sores. This flap could be used to treat recurrences observed after primary bed-sore treatment with other methods. The flap was easy to raise, and it did not cause any donor-site morbidity. The long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores was generally good. (c) Thieme Medical Publishers.

Efficiency of Magnetic Field Treatment on Pressure Sores in Bedridden Patients

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Ferda Özdemir

2011-09-01

Full Text Available Objective: Pressure sores are an important source of complications in patients who are immobilized and bedridden. We aimed to investigate the efficiency of magnetic field treatment in pressure sores. Material and Methods: This was a randomized, double blind controlled design study. 20 patients in the study group received magneto-therapy, once a day for 30 minutes and with 150G, keeping to the BTL09 magnetotherapy device’s program. In the control group, 20 patients received the dressing only once a day. The surface areas of the pressure sores were evaluated at the onset of the treatment (1st day, and on the 7th and 15th days.Results: When within group comparisons were conducted, a significant difference was observed between the 1st and 7th day, 7th and 15th day, and 1st and 15th day measures in both the groups in terms of the scar area. The average healing time for the treatment group was 10.80±4.06 (6-20 days, and the average healing time for the control group was 18.85±9.75 (5-32 days. There was a statistically significant difference between the two groups (z=-2.114, p=0.034. Also, there was a significant difference in the scar area between the two groups in the 15th day measure (z=-3.818, p=0.000.Conclusion: The healing process of the tissue can be accelerated.with the use of magnetotherapy in the treatment of pressure sores of stage II and III,

[A variant of island flaps for the covering of pressure sores: the hatchet flap. Apropos of 31 cases].

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Quillot, M; Lodde, J P; Pegorier, O; Reynaud, J P; Cormerais, A

1994-08-01

The authors propose a modification of the classical design of island flaps for cover of pressure sores, applied to gluteus maximus and tensor fascia lata muscles: the hatchet flap. 31 flaps have been used including 13 gluteus maximus superior flaps for sacral pressure sores, 9 gluteal inferior flaps for ischial pressure sores and 9 tensor fascia lata flaps for trochanteric pressure sores. A small partial necrosis and two cases of sepsis were observed in this series, but did not require surgical revision. The authors emphasize the value of this modification of the classical flap design, which preserves an even better musculocutaneous capital in these patients, who are often already multi-operated. The very rapid recovery of patients supports the authors' application of hatchet flaps to the surgery of pressure sores, and suggests the extension to other musculocutaneous flaps in the future.

Treatment of ischial pressure sores with both profunda femoris artery perforator flaps and muscle flaps.

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Kim, Chae Min; Yun, In Sik; Lee, Dong Won; Lew, Dae Hyun; Rah, Dong Kyun; Lee, Won Jai

2014-07-01

Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

Directory of Open Access Journals (Sweden)

Chae Min Kim

2014-07-01

Full Text Available Background Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. Methods We retrospectively analyzed data from 14 patients (16 ischial sores whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. Results All flaps survived the entire follow-up period. Seven patients (50% had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years. The mean follow-up period was 27.9 months (range, 3-57 months. In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%, wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%, but resolved with conservative treatment. Among 16 cases, there was only one (6% recurrence at 34 months. Conclusions The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

[A scale for the assessment of the risk of pressure sores in paediatric intensive care].

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Weigel, Virginie

2014-01-01

Pressure sores are a frequent complication in paediatric intensive care. A multi-disciplinary nursing team has drawn up an assessment scale for the risk of pressure sores and has put in place guidelines for caring for children in intensive care. Prevention actions are thereby adapted to each young patient.

Pressure sores--a constant problem for plegic patients and a permanent challenge for plastic surgery.

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Giuglea, Carmen; Marinescu, Sllviu; Florescu, Ioan Petre; Jecan, Crenguta

2010-01-01

Pressure sores can be defined as lesions caused by unrelieved pressure resulting in damage of the underlying tissue. They represent a common problem in the pathology of plegic patients and, plastic surgery has a significant role in their treatment. Pressure sores occur over bony prominences and so, they are most commonly seen at the sacrum and trochanters in paralyzed patients and at ischium for the patients who sit in a wheelchair for a long time. For these patients, surgical treatment is very important because on one hand, it stops the loss of nutrients and proteins at the site of the pressure sore, and on the other hand, it permits the initiation of neuromuscular recuperation treatment much faster.

Inferior gluteal artery perforator flap: a viable alternative for ischial pressure sores.

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Kim, Young Seok; Lew, Dae Hyun; Roh, Tai Suk; Yoo, Won Min; Lee, Won Jai; Tark, Kwan Chul

2009-10-01

The ischial area is by far the most common site for pressure sores in wheelchair-bound paraplegic patients, because most of the pressure of the body is exerted on this area in the seated position. Even after a series of successful pressure sore treatments, the site is very prone to relapse from the simplest everyday tasks. Therefore, it is crucial to preserve the main pedicle during primary surgery. Several surgical procedures, such as myocutaneous flap and perforator flap, have been introduced for the treatment of pressure sores. During a 4-year time period at our institute, we found favourable clinical results using the inferior gluteal artery perforator (IGAP) procedure for ischial sore treatment. A total of 23 patients (20 males and three females) received IGAP flap surgery in our hospital from January 2003 to January 2007. Surgery was performed on the same site again in 10 (43%) patients who had originally relapsed after undergoing the conventional method of pressure sore surgery. The average age of patients was 47.4 years (range 26-71 years). Most of the patients were paraplegic (16 cases, 70%) and others were either quadriplegic (four cases, 17%) or ambulatory (three cases, 13%). Based on hospital records and clinical photographs, we attempted to assess the feasibility and practicability of the IGAP flap procedure through comparative analysis of several parameters including the size of the defective area, treatment modalities, relapses, complications, and postoperative treatments. The average follow-up duration for 23 subjects was 25.4 months (range 5-42 months). All flaps survived without major complications. Partial flap necrosis developed in one case but secondary healing was achieved and the final outcome was not impaired. Most of the cases healed well during the follow-up period. Postoperative complications such as wound dehiscence and fistula developed in some subjects, but all healed well with a secondary treatment. A total of five cases relapsed

[Assessment of patients with pressure sores admitted in a tertiary care center].

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Moro, Adriana; Maurici, Alice; do Valle, Juliana Barros; Zaclikevis, Viviane Renata; Kleinubing, Harry

2007-01-01

To determine the prevalence and analyze the profile of patients with pressure sores, focusing on risk factors, the patients' clinical characteristics at a tertiary care center, as well as stage and location of the lesions on the body. This was a cross sectional not controlled observational study, all patients admitted from April to June of 2005 were observed daily to identify all cases of pressure sores. The affected patients were evaluated by a standard questionnaire and the Scale of Braden was applied to define the risk of developing ulcers. Of the 690 patients admitted during the referred period, a prevalence of 5.9% of patients with lesions was observed, equivalent to 41 patients 63.9% of which were elderly and the average length of stay was 18 days. In the sample studied 41.5% of patients were found in the internal medicine section and the intensive care unit, ICU. The most common location for sores was the sacral area, corresponding to 73.1% of the patients, and stage II was the most frequent, observed in 58.5% of those patients. According to the Braden scale, most patients, 80.4%, had a high risk of developing pressure ulcers, compared to 9.7% of patients with moderate risk and 7.4% with low risk. The affected patients were at high risk of developing pressure sores. Prevalence of these lesions and the clinical and demographic profile of the affected patients are in accordance with the data in literature.

Decubitus grade IV (deep pressure sore) with intact skin in a patient with spinal cord injury

NARCIS (Netherlands)

Theunissen, C.C.W.; Zeilstra, J.T.; van Voorst Vader, P.C.; Kardaun, S.H.; Leeman, F.W.J.

2006-01-01

Even with intact skin the possibility of pressure sores should not be dismissed. Early recognition of a pressure sore is important for adequate treatment and prevention of progression. Multidisciplinary intervention is essential. A wheelchair patient with spinal cord injury is described, who

A composite gluteofemoral flap for reconstruction of large pressure sores over the sacrococcygeal region.

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Xie, Yun; Zhuang, Yue-Hong; Xue, Lan; Zheng, He-Ping; Lin, Jian-Hua

2015-12-01

Gigantic pressure sores pose a daunting challenge for plastic surgeons. This paper presents a composite gluteofemoral flap for reconstruction of large pressure sores over the sacrococcygeal region. In this anatomical study, 30 embalmed cadaveric lower limbs were used for dissection to observe the musculocutaneous perforators of the inferior gluteal artery and the longitudinal nutritional vascular chain of the posterior femoral cutaneous nerve. In this clinical study, eight patients underwent surgical harvest of the composite gluteofemoral flap for coverage of grade IV sacrococcygeal pressure sores. The size of the pressure sores ranged between 16 × 9 cm and 22 × 10 cm. The inferior gluteal artery was present in 26 cases and absent in four cases. It gave off two to four musculocutaneous branches with a diameter larger than 0.5 mm to the gluteus maximus. A direct cutaneous branch was given off at the inferior margin of the gluteus maximus, serving as a nutritional artery for the posterior femoral cutaneous nerve. The size of the flap harvested ranged between 22 × 9 cm and 32 × 10 cm. Flaps in seven patients survived uneventfully and developed epidermal necrosis at the distal margin in one case. An average 2-year follow-up revealed no recurrence of pressure sores. The composite gluteofemoral flap, being robust in blood supply, simple in surgical procedure, and large in donor territory, is an important addition to the armamentarium. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Genital sores - male

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Sores - male genitals; Ulcers - male genitals ... A common cause of male genital sores are infections that are spread through sexual contact, such as: Genital herpes (small, painful blisters filled with clear ...

Pharyngitis - sore throat

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... A streptococcus. Less commonly, bacterial diseases such as gonorrhea and chlamydia can cause sore throat. Most cases ... physical exam alone. A culture for chlamydia or gonorrhea is positive. Sore throat caused by the flu ( ...

At-Home Application of Autologous Platelet Rich Plasma as Treatment for Pressure Sore and Related Anemia.

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Tendas, Andrea; Niscola, Pasquale; Giovannini, Marco; Costa, Adriana; Venditti, Daniela; Volta, Laura; Malandruccolo, Luigi; Sabbadini, Stefania; Lasorella, Rosa; Fabritiis, Paolo de; Cassetta, Rita; Perrotti, Alessio P

2017-01-01

Pressure sores are a major complication in the bed-ridden older patient. In this report, we present the case of platelet rich plasma (PRP) application for the treatment of a pressure sore in an 88-year-old female affected by transfusion-dependent chronic inflammatory disease anemia associated with the congenital and inherited condition of thalassemic trait carrier. A weekly application schedule was planned athome, given the patient's debilitation and her decreased performance status as well as personal and family difficulties to go as outpatients at our treatment center. After 9 PRP applications, a remarkable sore improvement was achieved so that PRP was discontinued; nevertheless, sore rapidly improved until the full resolution and the complete closing after 4 months from the start of PRP treatment. Noteworthy, transfusion support was interrupted and a significant recovery and a sustained stabilization of hemoglobin (Hb) level at 1 year after ulcer healing were observed. The present case suggests that PRP application, performed athome in our case, is a feasible and effective treatment for pressure sores and related complications. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

[A clinical audit on the use of medications for pressure sores, after the implementation of guidelines].

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Chiari, Paolo; Fontana, Mirella; Bianchi, Tommaso; Bonzagni, Cristina; Galetti, Caterina

2006-01-01

Although guidelines for the management of pressure sores are widely available, their implementation is not always easy and sometimes does not produce the desired changes. To describe the results of a clinical audit aiming at assessing the appropriate use of medications for pressure sores, after the implementation of guidelines. The audit group, with an expert in assessment, a nurse expert in pressure sores, a microbiologist, a dermatologist and a chemist analysed the clinical and nursing records of all the patients with a pressure sore, discharged during the first trimester of 2005 and 2006, after the implementation of the guidelines, from wards with higher prevalence of pressure sores: geriatric, medical, intensive care, rehabilitation and post acute wards. Each documented treatment was classified as appropriate, not appropriate or "grey area", treatments inappropriate according to guidelines but not according to expert or current knowledge (e.g. poliurethane medications for heel pressure sores). After each stage, the results were returned and discussed with the involved wards. One hundred 74 patients were surveyed in 2005 and 199 in 2006, with a total of respectively 287 and 326 sores. The percentage of inappropriate treatments was 20% in 2005 and 12.8% in 2006 (OR 1.79 I.C. 95% 1.10- 2.91), while an increase of treatments considered grey area (from 7% to 13.5%) was observed. The medium number of medications used was 17.3 per lesion, in 2005 and 16.4 in 2006 with a cost respectively of 83.6 and 67.35 per lesion, but the two populations were not strictly comparable. Clinical audit is a strategy that involving doctors and nurses, may promote positive changes. The rate of inappropriate treatments (higher in areas with high turnover of nurses) can be improved with educational interventions. The identification of treatments of the grey area highlights the need of periodically revising guidelines to update their contents according to new knowledge and technologies.

Pressure sores and underlying bone infection

International Nuclear Information System (INIS)

Sugarman, B.

1987-01-01

Pressure sores are a serious complication of hospitalized and chronically ill patients. Evaluation for underlying bone infection can be made difficult by radiographic, nuclear imaging, and soft-tissue culture studies that are abnormal and suggest the presence of bone infection, when no infection is present. Evaluation by bone biopsy with histologic and microbiological studies can accurately and promptly diagnose whether bone infection is present. This allows appropriate treatment when infection is present, and prevents unneeded and potentially toxic antibiotic therapy when preliminary studies incorrectly suggest that infection is present

Evaluating the effects of pentoxifylline administration on experimental pressure sores in rats by biomechanical examinations.

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Velaei, Kobra; Bayat, Mohammad; Torkman, Giti; Rezaie, Fatemealsadat; Amini, Abdollah; Noruzian, Mohsen; Tavassol, Azaedh; Bayat, Mehernoush

2012-09-01

This study used a biomechanical test to evaluate the effects of pentoxifylline administration on the wound healing process of an experimental pressure sore induced in rats. Under general anesthesia and sterile conditions, experimental pressure sores generated by no. 25 Halsted mosquito forceps were inflicted on 12 adult male rats. Pentoxifylline was injected intraperitoneally at a dose of 50 mg/kg daily from the day the pressure sore was generated, for a period of 20 days. At the end of 20 days, rats were sacrificed and skin samples extracted. Samples were biomechanically examined by a material testing instrument for maximum stress (N mm(2)), work up to maximum force (N), and elastic stiffness (N/mm). In the experimental group, maximum stress (2.05±0.15) and work up to maximum force (N/mm) (63.75±4.97) were significantly higher than the control group (1.3±0.27 and 43.3±14.96, P=0.002 and P=0.035, respectively). Pentoxifylline administration significantly accelerated the wound healing process in experimental rats with pressure sores, compared to that of the control group.

[Pedicled superior gluteal artery perforator bilateral quadrilobed flaps for repair of large sacrococcygeal pressure sores].

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Hai, Henglin; Li, Huatao; Chen, Yang; Li, Qiang; Wu, Shenggang; Lili, Wang; Yan, Lei; Xiaoying, Zhou

2013-03-01

To investigate the effectiveness of pedicled superior gluteal artery perforator bilateral quadrilobed flaps for repairing large sacrococcygeal pressure sores. Between June 2003 and August 2011, 6 paraplegia patients with large sacrococcygeal pressure sores were repaired with the pedicled superior gluteal artery perforator bilateral quadrilobed flaps. There were 2 males and 4 females with an average age of 45.6 years (range, 37-62 years). The mean disease duration was 8.4 months (range, 3-26 months). According to National Pressure Ulcer Advisory Panel (NPUAP) standard, 6 cases rated as degree IV. The size of pressure sores ranged from 15 cm x 13 cm to 18 cm x 16 cm. The size of flaps ranged from 18 cm x 14 cm to 21 cm x 15 cm. After operation, all flaps survived successfully. The wounds healed by first intention in 5 cases; partial dehiscence of incision occurred in 1 case, which was cured after dressing change for 26 days. Six patients were followed up 6-24 months (mean, 12.5 months). The appearance and texture of the flaps were smooth and soft with good elasticity and no ulceration. Pedicled superior gluteal artery perforator bilateral quadrilobed flaps can repair large sacrococcygeal pressure sores. The appearance of flaps is smooth and has good compression-resistance effect.

[Support devices for the prevention and treatment of pressure sores].

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Perrouin-Verbe, Brigite

2014-12-01

There is a strategy to be followed in the treatment of patients with specific pathologies placing them at high risk of pressure sores. In some cases, sophisticated support devices are used.These techniques must be combined with basic good practices.

Cirugía reconstructiva de las úlceras por presión Reconstructive surgery of pressure sores

Directory of Open Access Journals (Sweden)

2007-09-01

Full Text Available Pressure sores are frequent in certain group of patients with predisposing conditions. In their evolution, this type of sores may require surgery, but the incidence of postoperative complications is high in this type of patients, given the confluence of factors that go against the sucessful surgery of these lesions in these patients. A retrospective cross-sectional descriptive study was made to evaluate the results of surgical treatment of pressure sores in a 3 years-period. Taking into account the studied variables, the drawn conclusions will allow designing new strategies for care of these patients, in order to reduce postoperative morbidity and lenght of stay at hospital

Preventing pressure sores of the nasal ala after nasotracheal tube intubation: from animal model to clinical application.

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Huang, Tze-Ta; Tseng, Chih-En; Lee, Tsan-Mu; Yeh, Jen-Ying; Lai, Yu-Yung

2009-03-01

Nasal-ala pressure sores induced by nasotracheal intubation are common complications of oral and maxillofacial surgery, but are easily ignored. To determine whether such sores could be prevented, we studied the effects of a combination of cushioning material in an animal model, and then analyzed the efficacy of this combination clinically. Four pigs received nasotracheal intubation. Each pig received intubation for 4, 8, 12, or 16 hours. Outcomes from pigs undergoing 500-gram-weight compression on each nostril were compared: one nostril received an application of cushioning materials, and the contralateral nostril did not. After the required study period, clinical assessment and further evaluation were performed by measuring pressure-sore dimensions and performing incisional biopsies. Clinical applications of this protective technique were then undertaken. Eight patients who underwent intubation without Soft Liner (GC Co, Tokyo, Japan) and DuoDERM CGF (ConvaTec, Inc, Princeton, NJ) protection, and 10 patients with Soft Liner and DuoDERM protection, were evaluated. The protective efficacy of the cushioning materials was significant in the animal model as well as in clinical practice. Pressure sores were avoided on the protected side, with severe tissue necrosis documented on the control side. We found that the combined use of Soft Liner and DuoDERM reduced the size and severity of nasal-ala pressure sores attributable to nasotracheal intubation during oral and maxillofacial surgery.

The posterior thigh flap for defect coverage of ischial pressure sores - a critical single-centre analysis.

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Djedovic, Gabriel; Morandi, Evi M; Metzler, Julia; Wirthmann, Anna; Matiasek, Johannes; Bauer, Thomas; Rieger, Ulrich M

2017-12-01

The development of pressure sores is still not only an enormous economical but also a medical burden. Especially in the ischial region, the local defect coverage remains demanding as it is the main weight-bearing area in wheelchair-mobilised patients and is prone to high mobility. The purpose of our study was to report our long-time experience with the reconstruction of ischial pressure ulcers with the medially based posterior thigh flap. A retrospective analysis of all primary pressure sores grade III-IV in the ischial area, which were covered with a medially based posterior thigh flap between January 2008 and December 2014, at our department was conducted. A total of 28 patients underwent defect coverage of an ischial pressure sore with the aforementioned flap. The subgroup with complications showed a statistically significant longer hospital stay. A statistically significant correlation between age and the coincidence of comorbidities could be seen. Older patients showed significantly higher grades of pressure sores. The medially based posterior thigh flap is a safe and reliable flap design. Complication rates are comparable to other flaps. Nevertheless, in case of complications, a significantly longer duration of hospitalisation has to be taken into account. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Comparison of gluteal perforator flaps and gluteal fasciocutaneous rotation flaps for reconstruction of sacral pressure sores.

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Chen, Yen-Chou; Huang, Eng-Yen; Lin, Pao-Yuan

2014-03-01

The gluteus maximus myocutaneous flap was considered the workhorse that reconstructed sacral pressure sores, but was gradually replaced by fasciocutaneous flap because of several disadvantages. With the advent of the perforator flap technique, gluteal perforator (GP) flap has gained popularity nowadays. The aim of this study was to compare the complications and outcomes between GP flaps and gluteal fasciocutaneous rotation (FR) flaps in the treatment of sacral pressure sores. Between April 2007 and June 2012, 63 patients underwent sacral pressure sore reconstructions, with a GP flap used in 31 cases and an FR flap used in 32 cases. Data collected on the patients included patient age, gender, co-morbidity for being bedridden and follow-up time. Surgical details collected included the defect size, operative time and estimated blood loss. Complications recorded included re-operation, dehiscence, flap necrosis, wound infection, sinus formation, donor-site morbidity and recurrence. The complications and clinical outcomes were compared between these two groups. We found that there was no significant difference in patient demographics, surgical complications and recurrence between these two groups. In gluteal FR flap group, all recurrent cases (five) were treated by reuse of previous flaps. Both methods are comparable, good and safe in treating sacral pressure sores. Gluteal FR flap can be performed without microsurgical dissection, and re-rotation is feasible in recurrent cases. The authors suggest using gluteal FR flaps in patients with a high risk of sore recurrence. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

[Reduction of pressure sores during prone positioning of ventilated intensive care patients by the prone-head support system: a pilot study].

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Prebio, Michael; Katz-Papatheophilou, Elfriede; Heindl, Werner; Gelbmann, Herbert; Burghuber, Otto C

2005-02-01

Prone positioning in patients with adult respiratory distress syndrome is a well-known method to improve oxygenation. The aim of our study was to evaluate a new device for prone positioning, the prone-head support system (PHS system), with regard to reduction of cutaneous pressure sores. In a pilot study we randomized 8 patients with ARDS in two groups: 180 degrees standard prone positioning (group without mask) and prone positioning with the PHS system (group with mask). The PHS system consists of a facemask support, which is connected to an adapted air suspension bed. The patients of both groups were intermittently proned for several days. We evaluated the pressure sores on head and neck before turning the patients prone for the first time and after each period of prone positioning. We documented the quantity, the size, the type and the localization of the pressure sores. There was no significant difference in the mean duration of prone positioning (27.1+/-14.7 hours in the group with mask versus 24.5+/-18.7 h in the group without mask). In the group with mask there were 1.5+/-0.8 new pressure sores by each proning, whereas in the group without mask there were 2.37+/-1.6 new pressure sores, which was lower, but not significantly. The overall area of pressure sores (798 mm2 versus 3184 mm2, p=0.004), the area of pressure sores per patient (199.5+/-104.7 mm2 versus 796+/-478 mm2, p=0.03) and the increase of the area of pressure sores per proning (79.8+/-52.0 mm2 versus 398.0+/-214.3 mm2, p=0.004) were significantly lower in the group with mask in comparison to the group without mask. The lips were the most effected localization in both groups. The pressure sores in the group with mask were less severe and showed a homogenous distribution in comparison to the group without mask. Blisters dominated in the group with mask in comparison to erosions, necrosis and ulcers in the group without mask. The PHS system with its face mask is able to reduce the extent and the

Clinical effects of Angelica dahurica dressing on patients with I-II phase pressure sores.

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Gong, Fen; Niu, Junzhi; Pei, Xing

2016-11-02

Angelica dahurica is a well-known traditional Chinese Medicine (TCM), while little information is available about its effects on pressure sores. We aimed to investigate the clinical effect of Angelica dahurica on patients with I-II phase pressure sores, as well as the underlying mechanism. Patients (n = 98) with phase I and phase II pressure sores were enrolled and randomly assigned to control and treated groups. In addition to holistic nursing, patients in the control group received compound clotrimazole cream, while patients in the treated group received continuous 4 weeks of external application of Angelica dahurica dressing. Therapeutic effect was recorded, along with the levels of interleukin-8 (IL-8), epidermal growth factor (EGF), transforming growth factor (TGF)-β, and vascular endothelial growth factor (VEGF). Besides, HaCaT cells were cultured with different concentrations of Angelica dahurica, and then cell viability, clone formation numbers, cell cycle, and levels of cyclin D1 and cyclin-dependent kinase (CDK) 2 were determined. The total effective rate in the treated group was significantly higher than in the control group. Levels of IL-8, EGF, TGF-β, and VEGF were statistically increased by Angelica dahurica. In addition, the cell viability and clone formation numbers were significantly upregulated by Angelica dahurica in a dose-dependent manner. Also, the percentage of cells in G0/G1 phase, and levels of cyclin D1 and CDK2 were significantly elevated. Our results suggest that Angelica dahurica may provide an effective clinical treatment for I-II phase pressure sores.

Pattern of Pressure Sores in Spinal Injured Patients with in the First ...

African Journals Online (AJOL)

Background: Before 2006, all our spinal injured patients were nursed on conventional form mattress without pressure redistributing support surface. Pressure sore was a common complication and was a major contributing factor to prolonged hospitalization. Aim: The aim of this study is to determine the pattern of pressure ...

Flap surgery for pressure sores: should the underlying muscle be transferred or not?

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Thiessen, Filip E; Andrades, Patricio; Blondeel, Philip N; Hamdi, Moustapha; Roche, Nathalie; Stillaert, Filip; Van Landuyt, Koenraad; Monstrey, Stan

2011-01-01

Musculocutaneous flaps have become the first choice in the surgical repair of pressure sores, but the indication for including muscle in the transferred flaps still remains poorly defined. This study compares outcomes after muscle and non-muscle flap coverage of pressure sores to investigate whether it is still necessary to incorporate muscle tissue as part of the surgical treatment of these ulcers. A retrospective revision of 94 consecutive patients with ischial or sacral pressure sores operated between 1996 and 2002 was performed. Depending on the inclusion of muscle into the flap, the patients were divided in two groups: musculocutaneous flap group and fasciocutaneous flap group. Charts were reviewed for patient characteristics, ulcer features and reconstructive information. Data between groups were compared with emphasis on early (haematoma or seroma, dehiscence, infections, necrosis and secondary procedures) and late (recurrence) postoperative complications. A total of 37 wounds were covered with muscle and 57 wounds covered without muscle tissue. The groups were comparable in relation to age, gender, ulcer characteristics and timing for surgery. There were no significant differences in early complications between the study groups. The mean follow-up period was 3.10 ± 1.8 years (range: 0.5 to 6.7). There were no statistical differences in ulcer recurrence between the groups. The type of flap used was not associated with postoperative morbidity or recurrence in the univariate and multivariate analyses. The findings of this clinical study indicate that the musculocutaneous flaps are as good as fasciocutaneous flaps in the reconstruction of pressure sores, and they question the long-standing dogma that muscle is needed in the repair of these ulcers. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover

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Mehrotra Sandeep

2009-01-01

Full Text Available Pressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles.

Pressure sores in spinal cord injury: Active intervention saves costs

African Journals Online (AJOL)

2008-07-22

Jul 22, 2008 ... interrogated for all cervical spine injuries. Patients were identified retrospectively for the period April 2003 to May 2006 and divided into 4 groups according to the level of intervention they received to prevent pressure sores. Group A. These were the first 100 patients with cervical injuries managed in the unit ...

Therapeutic Effect of External Application of Ligustrazine Combined with Holistic Nursing on Pressure Sores.

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Niu, Junzhi; Han, Lin; Gong, Fen

2016-08-15

BACKGROUND This study aimed to explore the therapeutic effect of external application of ligustrazine combined with holistic nursing on pressure sores, as well as the underlying mechanism. MATERIAL AND METHODS From February 2014 to March 2015, a total of 32 patients with Phase II and Phase III pressure sores were enrolled and randomly assigned to an experimental group or a control group. The clinical data were comparable between the 2 groups. In addition to holistic nursing, the patients in the experimental group received 4 weeks of continuous external application of ligustrazine, whereas patients in the control group received compound clotrimazole cream. Therapeutic effect and healing time were recorded. HaCaT cells were used as an in vitro model for mechanism analysis of the effect of ligustrazine in treating pressure sores. After culturing with different concentrations of ligustrazine or the inhibitor of AKT (LY294002) for 72 h, cell viability, clone formation numbers, and levels of phosphatidyl inositol 3-kinase (PI3K), p-AKT, and p-mammalian target of rapamycin (mTOR) were determined. RESULTS Compared to the control group, the total effective rate in the experimental group was significantly higher, and the healing time was significantly reduced. Cell viability and clone formation numbers were significantly upregulated by ligustrazine in a dose-dependent manner. Both the cell viability and clone formation numbers were significantly inhibited by application of LY294002. CONCLUSIONS Our results suggest that ligustrazine combined with holistic nursing is an effective treatment of pressure sores. The protective effect may be associated with the promotion of cell growth by activation of the PI3K/AKT pathway.

Reducing risk of pressure sores: effects of watch prompts and alarm avoidance on wheelchair push-ups.

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White, G W; Mathews, R M; Fawcett, S B

1989-01-01

People who use wheelchairs are at risk for developing pressure sores. Regular pressure relief, in the form of a wheelchair push-up, is one way to reduce the likelihood of pressure sores. We examined the effects of antecedent (i.e., instructions, audible prompts) and consequent (i.e., alarm avoidance) events on wheelchair push-ups, using a multiple baseline analysis with 2 participants with spina bifida. Results suggest that the combined procedure was more effective than either antecedent or consequent events alone, and there is some evidence suggesting maintenance of effects over time. PMID:2793635

The operative treatment of pressure sores in the pelvic region: A 10-year period overview.

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Jósvay, János; Klauber, András; Both, Béla; Kelemen, Péter B; Varga, Zsombor Z; Pesthy, Pál Cs

2015-07-01

Pelvic region pressure sores often develop following spinal cord injury. Surgery is often necessary for long standing, large-sized pressure sores not responding to conservative treatment. Authors analyze their results of a 10-year period, and identify factors contributing to the reduction of the recurrence rate. A total of 119 pressure sores were operated on 98 patients in two institutions during a 10-year period (1 January 2003 to 31 December 2012). The encountered perioperative complications are summarized, and the recurrence rate is analyzed with a patient follow-up questionnaire. We experienced 15 perioperative complications (12.6%). All complications were fully resolved by conservative treatment. Fifty-eight returned patient replies were processed. The average follow-up time after surgery was 5.2 years. The recurrence rate was 5.47%. The strict adherence to surgical indications, full patient compliance, specialized pre- and post-operative patient care, our routinely used preferred surgical method, all contribute to a low post-operative complication rate, long-term flap survival, and an extended recurrence free period.

Profunda Femoris Artery Perforator Propeller Flap: A Valid Method to Cover Complicated Ischiatic Pressure Sores.

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Scalise, Alessandro; Tartaglione, Caterina; Bolletta, Elisa; Pierangeli, Marina; Di Benedetto, Giovanni

2015-08-01

We report the case of a 50-year-old paraplegic man with a complicated grade III/IV ischiatic pressure sore treated with a propeller flap based on the first perforator of the profunda femoris artery. Our aim was to surgically reconstruct an ischiatic pressure sore in a patient with ankylosis using a fasciocutaneous perforator propeller flap obtained from the posterior region of the thigh. Our decision to perform a profunda femoris artery perforator propeller flap reconstruction was mainly due to the anatomical contiguity of the flap with the site of the lesion and the good quality of the skin harvested from the posterior region of the thigh. The use of the perforator fasciocutaneous flap represents a muscle-sparing technique, providing a better long-term result in surgical reconstruction. The choice of the 180-degree propeller flap was due to its ability to provide a good repair of the pressure ulcer and to pass over the ischiatic prominence in the patient in the forced decubitus position. The operatory course did not present any kind of complication. Using this reconstructive treatment, we have obtained complete coverage of the ischiatic pressure sore.

The Effect of Early Complications on Flap Selection on Sacral Pressure Sores

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Musa Kemal Keleş

2017-06-01

Full Text Available Objective: Pressure sores occur in bedridden patients in intensive care units, clinics, and even at their own places. Care for sick relatives and working with doctors to address treatment options and ensure proper follow-up are some of the problems associated with these types of wounds. Surgical therapy in the treatment of pressure ulcers is associated with significant complications. In comparison to non-surgical treatment, surgical treatment has a low complication rate and is more cost-effective. The surgical treatment enables the patients to return to their social life sooner than non-surgical treatment. Patient's ability to early return to their social life is advantageous in terms of reducing morbidity and the need for additional operations. This study is aimed to review the flap choices used to treat sacral pressure sores and the resulting acute complications rates retrospectively. Material and Methods: Patients treated for stage 3 and stage 4 sacral pressure sores in our clinic in the past 5 years were included in the study. Patient records were analyzed retrospectively. Patients' demographic data and surgical treatment they received were documented. Surgical method and surgical outcomes were evaluated and early complication rates were determined. Result: Fifty patients were included in the study; 10 of them were female, 40 of were male cases. The most common causative agent was paraplegia after traffic accident. Conclusion: A significant difference was not observed between the type of flap used in the surgical treatment and the rate of complications. Consequently, the surgical treatment of pressure ulcers in the sacral region depends on the patient's individual situation, the cooperation of the family, and previously applied treatments

Herpes Simplex Virus (Cold Sores)

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... Print Share Cold Sores in Children: About the Herpes Simplex Virus Page Content ​A child's toddler and ... Cold sores (also called fever blisters or oral herpes) start as small blisters that form around the ...

Antibiotics for sore throat.

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Spinks, Anneliese; Glasziou, Paul P; Del Mar, Chris B

2013-11-05

Sore throat is a common reason for people to present for medical care. Although it remits spontaneously, primary care doctors commonly prescribe antibiotics for it. To assess the benefits of antibiotics for sore throat for patients in primary care settings. We searched CENTRAL 2013, Issue 6, MEDLINE (January 1966 to July week 1, 2013) and EMBASE (January 1990 to July 2013). Randomised controlled trials (RCTs) or quasi-RCTs of antibiotics versus control assessing typical sore throat symptoms or complications. Two review authors independently screened studies for inclusion and extracted data. We resolved differences in opinion by discussion. We contacted trial authors from three studies for additional information. We included 27 trials with 12,835 cases of sore throat. We did not identify any new trials in this 2013 update. 1. Symptoms Throat soreness and fever were reduced by about half by using antibiotics. The greatest difference was seen at day three. The number needed to treat to benefit (NNTB) to prevent one sore throat at day three was less than six; at week one it was 21. 2. Non-suppurative complications The trend was antibiotics protecting against acute glomerulonephritis but there were too few cases to be sure. Several studies found antibiotics reduced acute rheumatic fever by more than two-thirds within one month (risk ratio (RR) 0.27; 95% confidence interval (CI) 0.12 to 0.60). 3. Suppurative complications Antibiotics reduced the incidence of acute otitis media within 14 days (RR 0.30; 95% CI 0.15 to 0.58); acute sinusitis within 14 days (RR 0.48; 95% CI 0.08 to 2.76); and quinsy within two months (RR 0.15; 95% CI 0.05 to 0.47) compared to those taking placebo. 4. Subgroup analyses of symptom reduction Antibiotics were more effective against symptoms at day three (RR 0.58; 95% CI 0.48 to 0.71) if throat swabs were positive for Streptococcus, compared to RR 0.78; 95% CI 0.63 to 0.97 if negative. Similarly at week one the RR was 0.29 (95% CI 0.12 to 0

Dual-dermal-barrier fashion flaps for the treatment of sacral pressure sores.

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Hsiao, Yen-Chang; Chuang, Shiow-Shuh

2015-02-01

The sacral region is one of the most vulnerable sites for the development of pressure sores. Even when surgical reconstruction is performed, there is a high chance of recurrence. Therefore, the concept of dual-dermal-barrier fashion flaps for sacral pressure sore reconstruction was proposed. From September 2007 to June 2010, nine patients with grade IV sacral pressures were enrolled. Four patients received bilateral myocutaneous V-Y flaps, four patients received bilateral fasciocutaneous V-Y flaps, and one patient received bilateral rotation-advanced flaps for sacral pressure reconstruction. The flaps were designed based on the perforators of the superior gluteal artery in one patient's reconstructive procedure. All flaps' designs were based on dual-dermal-barrier fashion. The mean follow-up time was 16 months (range = 12-25). No recurrence was noted. Only one patient had a complication of mild dehiscence at the middle suture line, occurring 2 weeks after the reconstructive surgery. The dual-dermal fashion flaps are easily duplicated and versatile. The study has shown minimal morbidity and a reasonable outcome.

[Thigh and leg musculo-cutaneous island flap for giant bilateral trochanteric and perineal pressure sores coverage: Extreme treatment in spinal cord injury].

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André, A; Crouzet, C; De Boissezon, X; Grolleau, J-L

2015-06-01

Surgical treatment of perineal pressure sores could be done with various fascio-cutaneous or musculo-cutaneous flaps, which provide cover and filling of most of pressure sores after spinal cord injuries. In rare cases, classical solutions are overtaken, then it is necessary to use more complex techniques. We report a case of a made-to-measure lower limb flap for coverage of confluent perineal pressure sores. A 49-year-old paraplegic patient developed multiple pressure sores on left and right ischial tuberosity, inferior pubic bone and bilateral trochanters with hips dislocation. Surgical treatment involved a whole right thigh flap to cover and fill right side lesions, associated to a posterior right leg musculo-cutaneous island flap to cover and fill the left trochanteric pressure sore. The surgical procedure lasted 6.5 hours and required massive blood transfusion. Antibiotics were adapted to bacteriological samples. There were no postoperative complications; complete wound healing occurred after three weeks. A lower limb sacrifice for coverage of a giant perineal pressure sores is an extreme surgical solution, reserved to patients understanding the issues of this last chance procedure. A good knowledge of vascular anatomy is an essential prerequisite, and allows to shape made-to-measure flaps. The success of such a procedure is closely linked to the collaboration with the rehabilitation team (appropriate therapeutic education concerning transfers and positioning). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The Use of Magnetic Resonance Imaging in Planning a Pedicled Perforator Flap for Pressure Sores in the Gluteal Region.

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Park, Sun-June; Lee, Kyeong-Tae; Jeon, Byung-Joon; Woo, Kyong-Je

2018-04-01

Pedicled perforator flaps (PPFs) have been widely used to treat pressure sores in the gluteal region. Selection of a reliable perforator is crucial for successful surgical treatment of pressure sores using PPFs. In this study, we evaluate the role of magnetic resonance imaging (MRI) in planning PPF reconstruction of pressure sores in the gluteal region. A retrospective chart review was performed in patients who had undergone these PPF reconstructions and who had received preoperative MRI. Preoperatively, the extent of infection and necrotic tissue was evaluated using MRI, and a reliable perforator was identified, considering the perforator location in relation to the defect, perforator size, and perforator courses. Intraoperatively, the targeted perforator was marked on the skin at the locations measured on the MRI images, and the marked location was confirmed using intraoperative handheld Doppler. Superior gluteal artery, inferior gluteal artery, or parasacral perforators were used for the PPFs. Surgical outcomes were evaluated. A total of 12 PPFs were performed in 12 patients. Superior gluteal artery perforator flaps were performed in 7 patients, inferior gluteal artery perforator flaps were performed in 3 patients, and parasacral perforator flaps were performed in 2 patients. We could identify a reliable perforator on MRI, and it was found at the predicted locations in all cases. There was only one case of partial flap necrosis. There was no recurrence of the pressure sores during the mean follow-up period of 6.7 months (range = 3-15 months). In selected patients with gluteal pressure sores, MRI is a suitable means for not only providing information about disease extent and comorbidities but also for evaluating perforators for PPF reconstructions.

Sore Throat

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... as those that cause colds, the flu, and mononucleosis) can lead to a sore throat. Bacteria (such ... to the valves of the heart. What is mononucleosis? Mononucleosis (mono) is a viral infection caused by ...

Canker Sores

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... mouth that move, such as the tongue, soft palate, cheeks, and lips. This condition is recurrent because ... week. Most of the time, canker sores are self-limiting. This means that they will go away ...

The Pacman Perforator-Based V-Y Advancement Flap for Reconstruction of Pressure Sores at Different Locations.

Science.gov (United States)

Bonomi, Stefano; Salval, André; Brenta, Federica; Rapisarda, Vincenzo; Settembrini, Fernanda

2016-09-01

Many procedures have been proposed for the treatment of pressure sores, and V-Y advancement flaps are widely used to repair a defect. Unfortunately, the degree of mobility of a V-Y advancement flap is dependent on the laxity of the underlying subcutaneous tissue. This is an important disadvantage of traditional V-Y advancement flap and limits its use.We used V-Y advancement flaps as perforator-based to overcome mobility restriction problem, with a further modification (Pacman-like shape) to improve the covering surface area of the flap. Between January 2012 and December 2014, the authors used 37 V-Y Pacman perforator-based flaps in 33 consecutive patients for coverage of defects located at sacral (n = 21), ischial (n = 13), trochanter (n = 1) regions. There were 27 male and 6 female patients with a mean age of 49.9 years (range, 15-74 years). All flaps survived completely (92.3%) except 3 in which one of them had undergone total necrosis due to hematoma and the other 2 had partial necrosis. No venous congestion was observed. The mean follow-up period was 14.9 months (range, 2-38 months). No flap surgery-related mortality or recurrence of pressure sores was noted. The V-Y Pacman perforator-based advancement flaps are safe and very effective for reconstruction of pressure sores at various regions. The advantage of our modification procedure include shorter operative time, lesser pedicle dissection, low donor site morbidity, good preservation of muscle, and offers remarkable excursion to the V-Y flap, which make the V-Y Pacman perforator-based flaps an excellent choice for large pressure sore coverage.

Cold Sore

Science.gov (United States)

... may reduce how often they return. Symptoms A cold sore usually passes through several stages: Tingling and itching. Many people feel an itching, burning or tingling sensation around their lips for a day or so ...

[Topic efficacy of ialuronic acid associated with argentic sulphadiazine (Connettivina Plus) in the treatment of pressure sores: a prospective observational cohort study].

Science.gov (United States)

Paghetti, Angela; Bellingeri, Andrea; Pomponio, Giovanni; Sansoni, Julita; Paladino, Dario

2009-01-01

The aim of this observational study was to evaluate the efficacy, tolerability and methods of application of ialuronic acid associated with argentic sulphadiazine (Connettivina Plus) in routine clinical activity, on a target of "complex" patients with pressure sores, for the most realistic assessment possible. The study comprised 127 patients hospitalized between January 2006 and December 2007, who received ialuronic acid associated with argentic sulphadiazine in addition to the standard treatment. Inclusion criteria were th presence of at least one stage 2 or 3 pressure sore (NPUAP '89 classification), pressure sore that the researcher had already decided to treat using ialuronic acid associated with argentic sulphadiazine , according to hospital protocol, area of the lesion less than 25cm2, patient age 18 years or more, informed patient consensus. Patients with these characteristics were , however, excluded if they did not provide written consent or if they had one of the following: presence of pressure sores with escara, concomitant neoplastic disease, concomitant insulin-dependent diabetes or other pathologies that interfere with skin regeneration, allergic diasthesis (acclaimed or presumed) to ialuronic acid - argentic sulphadiazine, inability / refusal to undergo all the subsequent controls required by the study. Improvement or complete healing of the pressure sores was observed in 67% of patients at early follow-up (10 days), increasing to 76% and 87% at 20 and 35 day controls respectively. The Push tool further improved in patients who carried on treatment. Use of ialuronic acid associated with argentic sulphadiazine was effective for treating grade 2-3 pressure sores in patients with chronic lesions and its efficacy was confirmed in association with both advanced and traditional types of medication.

Development of a cushion to prevent ischial pressure sores.

Science.gov (United States)

Bowker, P; Davidson, L M

1979-01-01

A study was carried out jointly by nursing staff and technologists in an attempt to develop a cushion based on scientific principles and measurement that might prevent pressure sores. At each stage in the development clinical trials were carried out, and using the results of these together with the opinions of medical staff and patients who used the cushion the design was suitably modified. Over four years a seat was evolved that was simple to construct and fulfilled the clinical requirements for a wide range of patients while providing maximum relief of high-pressure points. The design was subsequently taken up commercially. Images Fig 3 PMID:509176

Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores.

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Lin, Chin-Ta; Chen, Shih-Yi; Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Chang, Shun-Cheng

2015-07-01

Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients' sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects.

Canker Sores

Science.gov (United States)

... lack of vitamins and minerals, hormonal changes or menstrual periods. In some cases the cause is unknown. In most cases, the sores go away by themselves. Some ointments, creams or rinses may help with the pain. Avoiding hot, spicy food while you have a ...

Comparison of fasciocutaneous V-Y and rotational flaps for defect coverage of sacral pressure sores: a critical single-centre appraisal.

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Djedovic, Gabriel; Metzler, Julia; Morandi, Evi M; Wachter, Tanja; Kühn, Shafreena; Pierer, Gerhard; Rieger, Ulrich M

2017-12-01

Pressure sore rates remain high in both nursing homes as well as in hospitals. Numerous surgical options are available for defect coverage in the sacral region. However, objective data is scarce as to whether a specific flap design is superior to another. Here, we aim to compare two fasciocutaneous flap designs for sacral defect coverage: the gluteal rotation flap and the gluteal V-Y flap. All primary sacral pressure sores of grades III-IV that were being covered with gluteal fasciocutaneous rotational or V-Y flaps between January 2008 and December 2014 at our institution were analysed. A total of 41 patients received a total of 52 flaps. Of these, 18 patients received 20 gluteal rotational flaps, and 23 patients received 32 V-Y flaps. Both groups were comparable with regards to demographics, comorbidities and complications. Significantly more V-Y flaps were needed to cover smaller defects. Mean length of hospital stay was significantly prolonged when surgical revision had to be carried out. Both flap designs have proven safe and reliable for defect coverage after sacral pressure sores. Gluteal rotational flaps appear to be more useful for larger defects. Both flap designs facilitate their reuse in case of pressure sore recurrence. Complication rates appear to be comparable in both designs and to the current literature. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Use of inferior gluteal artery and posterior thigh perforators in management of ischial pressure sores with limited donor sites for flap coverage.

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Unal, Cigdem; Ozdemir, Jale; Yirmibesoglu, Oktay; Yucel, Ergin; Agir, Hakan

2012-07-01

Reconstructive surgery for ischial pressure sore defects presents a challenge because of high rates of recurrence. The aim of this study was to describe the use of inferior gluteal artery (IGA) and posterior thigh perforators in management of ischial pressure sores with limited donor sites. Between September 2005 and 2009, 11 patients (9 male, 2 female) with ischial sores were operated by using IGA and posterior thigh perforator flaps. The data of patients included age, sex, cause of paraplegia, flap size, perforator of flap, previous surgeries, recurrences, complications, and postoperative follow-up. Nine IGA and 5 posterior thigh perforator flaps were used. Six patients presented with recurrent lesions, 5 patients were operated for sacral and contralateral ischial pressure sores previously. In 2 patients, IGA and posterior thigh perforator flaps were used in combination. Patients were followed for an average of 34.3 months. In 2 recurrent cases, readvancement of IGA perforator flap and gluteus maximus myocutaneous flap were treatment of choice. Treatment of patients with recurrent lesions or multiple pressure sores is challenging because of limited available flap donor sites. In this study, posterior thigh perforator flaps were preferred in patients in whom the previous donor site was the gluteal region. IGA perforator flaps were the treatment of choice in patients for whom posterior thigh region was previously used. Alternately, preserved perforators of previous conventional myocutaneous flaps enabled us to use these perforators in recurrences.

A novel technique for preventing skin pressure sores using a rubber tube during surgical treatment of mandibular condyle fractures.

Science.gov (United States)

Kawase-Koga, Yoko; Mori, Yoshiyuki; Hoshi, Kazuhito; Takato, Tsuyoshi

2013-11-01

Craniofacial surgery occasionally results in sores and necrosis of the facial skin because of pressure from surgical instruments. During surgical treatment of mandibular condylar process fractures, the main mandibular fragment is routinely retracted downward using a wire to achieve a satisfactory anatomic reduction. This procedure may injure the facial skin. This potential complication is easily overlooked by medical staff, but it is easily preventable. We herein describe a method of using a rubber tube to avoid causing pressure sores of the facial skin during surgical treatment of mandibular condylar process fractures.

Activation of lower back muscles via FES for pressure sores prevention in paraplegia: a case study.

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Vanoncini, M; Holderbaum, W; Andrews, B J

2010-04-01

The aim of this paper is to show the feasibility of the use of functional electrical stimulation (FES) applied to the lower back muscles for pressure sores prevention in paraplegia. The hypothesis under study is that FES induces a change in the pressure distribution on the contact area during sitting. Tests were conducted on a paraplegic subject (T5), sitting on a standard wheelchair and cushion. Trunk extensors (mainly the erector spinae) were stimulated using surface electrodes placed on the skin. A pressure mapping system was used to measure the pressure on the sitting surface in four situations: (a) no stimulation; (b) stimulation on one side of the spine only; (c) stimulation on both sides, at different levels; and (d) stimulation at the same level on both sides, during pressure-relief manoeuvres. A session of prolonged stimulation was also conducted. The experimental results show that the stimulation of the erector spinae on one side of the spine can induce a trunk rotation on the sagittal plane, which causes a change in the pressure distribution. A decrease of pressure on the side opposite to the stimulation was recorded. The phenomenon is intensified when different levels of stimulation are applied to the two sides, and such change can be sustained for a considerable time (around 5 minutes). The stimulation did not induce changes during pressure-relief manoeuvres. Finally, from this research we can conclude that the stimulation of the trunk extensors can be a useful tool for pressure sores prevention, and can potentially be used in a routine for pressure sores prevention based on periodical weight shifts.

[Cohort study of the incidence of heel pressure sores in patients with leg casts at the Rizzoli Orthopedic Hospital and of the associated risk factors].

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Forni, Cristiana; Zoli, Marina; Loro, Loretta; Tremosini, Morena; Mini, Sandra; Pirini, Valter; Turrini, Roberta; Durante, Stefano; Nicolini, Annamaria; Riccioni, Francesca; Girolami, Roberto

2009-01-01

Pressure sores, especially at the heel, are a side effect of the cast. To assess the incidence of late skin complications (heel pressure sores) of a cast and determine risk factors. All consecutive patients treated with a leg cast over a 16 months observation time were recruited. Risk factors were identified by the nurse that placed the cast and skin lesions classified with the NPUAP scale when the cast was removed. In the 216 enrolled patients 17.6% (38) developed a pressure sore: 16/124 in orthopedic wards; 22/92 in oncology wards. The multivariate analysis identified the following risk factors: administration of cytotoxic drugs (p = 0.033; OR = 2.61; having a cancer did not increase the risk); skin redness before cast application (p = 0.001; OR = 4.44) and having reported symptoms after the application (p = 0.000; OR = 7.86). Pressure sores were mainly stage 1 and only 6/216 (2.4%) > or = stage II. The type of plaster cast, the material, the number of days it was worn and having had a surgery are not significant risk factors. Pressure sores related to leg plaster casts are a frequent complication in at risk sub-groups. The acknowledgement and identification of specific risk factors may allow to identify and evaluate preventive interventions to improve the care of these patients.

An audit of pressure sores caused by intermittent compression devices used to prevent venous thromboembolism.

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Skillman, Joanna; Thomas, Sunil

2011-12-01

When intermittent compression devices (ICDs) are used to prevent venous thromboembolism (VTE) they can cause pressure sores in a selected group of women, undergoing long operations. A prospective audit pre and post intervention showed a reduced risk with an alternative device, without increasing the risk of VTE.

[Multicentre, prospective cohort study, to validate the Italian version of the Braden Q scale for the risk of the pressure sores in newborns and up to 8 years old children].

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Chiari, Paolo; Poli, Marco; Magli, Claudia; Bascelli, Emanuele; Rocchi, Roberto; Bolognini, Silvia; Tartari, Piero; Armuzzi, Roberta; Rossi, Gianna; Peghetti, Angela; Biavati, Catia; Fontana, Mirella; Gazineo, Domenica; Cordella, Simona; Tiozzo, Emanuela; Ciliento, Gaetano; Carta, Giovanna; Taddia, Patrizia

2012-01-01

Multicenter prospective cohort study, to validate the Italian version of the Braden Q scale for the risk of pressure sores in newborns and up to 8 years old children. Children admitted to Intensive care Units (ICU), oncology and neurology/neurosurgery wards are at risk of developing pressure sores. To validate the Italian version of the Braden Q scale for the assessment of the risk of developing pressure sores in children. Children from 21 days to 8 years, admitted to intensive and sub intensive units were recruited. Premature babies, children admitted with a pressure sore and with a story of congenital cardiomiopathy were excluded. In this cohort, multicentre and with repeated measurements study, the first assessment was performed after 24 hours from hospital admission, using the Braden Q Scale (Suddaby's version). The pressure sores were assessed with the Skin assessment Tool and staged according to the National Pressure Ulcer Advisory Panel. RESULTS. On the 157 children 524 observation were conducted. The incidence of pressure sores was 17.2%. Only the analysis on specific subgroups of patients showed a good diagnostic accuracy: 71.4% on children 3-8 years; 85.6% in sub intensive wards. The Braden Q scale may be reliably used and shows a good diagnostic accuracy in children 3-8 years of age admitted to sub-intensive, neurology, oncology and heamatology wards.

Specific and cross over effects of massage for muscle soreness: randomized controlled trial.

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Jay, Kenneth; Sundstrup, Emil; Søndergaard, Stine D; Behm, David; Brandt, Mikkel; Særvoll, Charlotte A; Jakobsen, Markus D; Andersen, Lars L

2014-02-01

Muscle soreness can negatively interfere with the activities of daily living as well as sports performance. In the working environment, a common problem is muscle tenderness, soreness and pain, especially for workers frequently exposed to unilateral high repetitive movements tasks. The aim of the study is therefore to investigate the acute effect of massage applied using a simple device Thera-band roller Massager on laboratory induced hamstring muscle soreness, and the potential cross over effect to the non-massaged limb. 22 healthy untrained men (Mean age 34 +/- 7 years; mean height 181.7 +/- 6.9 cm; mean weight 80.6 +/- 6.4 kg; BMI: 24.5 +/- 1.3) with no prior history of knee, low back or neck injury or other adverse health issues were recruited. Participants visited the researchers on two separate occasions, separated by 48 hours, each time providing a soreness rating (modified visual analog scale 0-10), and being tested for pressure pain threshold (PPT) and active range of motion (ROM) of the hamstring muscles. During the first visit, delayed onset muscular soreness of the hamstring muscles was induced by 10 x 10 repetitions of the stiff-legged dead-lift. On the second visit participants received either 1) 10 minutes of roller massage on one leg, while the contralateral leg served as a cross over control, or 2) Resting for 10 minutes with no massage at all. Measurement of soreness, PPT and ROM were taken immediately before and at 0, 10, 30 and 60 min. after treatment. There was a significant group by time interaction for soreness (p < 0.0001) and PPT (p = 0.0007), with the massage group experiencing reduced soreness and increasing PPT compared with the control group. There was no group by time interaction for ROM (p = 0.18). At 10 min. post massage there was a significant reduction in soreness of the non-massaged limb in the cross over control group compared to controls but this effect was lost 30 minutes post massage. Massage with a roller device reduces

[Reliability and validity of the Braden Scale for predicting pressure sore risk].

Science.gov (United States)

Boes, C

2000-12-01

For more accurate and objective pressure sore risk assessment various risk assessment tools were developed mainly in the USA and Great Britain. The Braden Scale for Predicting Pressure Sore Risk is one such example. By means of a literature analysis of German and English texts referring to the Braden Scale the scientific control criteria reliability and validity will be traced and consequences for application of the scale in Germany will be demonstrated. Analysis of 4 reliability studies shows an exclusive focus on interrater reliability. Further, even though examination of 19 validity studies occurs in many different settings, such examination is limited to the criteria sensitivity and specificity (accuracy). The range of sensitivity and specificity level is 35-100%. The recommended cut off points rank in the field of 10 to 19 points. The studies prove to be not comparable with each other. Furthermore, distortions in these studies can be found which affect accuracy of the scale. The results of the here presented analysis show an insufficient proof for reliability and validity in the American studies. In Germany, the Braden scale has not yet been tested under scientific criteria. Such testing is needed before using the scale in different German settings. During the course of such testing, construction and study procedures of the American studies can be used as a basis as can the problems be identified in the analysis presented below.

A simple concept for covering pressure sores: wound edge-based propeller perforator flap.

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Kelahmetoglu, Osman; Van Landuyt, Koenraad; Yagmur, Caglayan; Sommeling, Casper E; Keles, Musa K; Tayfur, Volkan; Simsek, Tekin; Demirtas, Yener; Guneren, Ethem

2017-12-01

We present a new surgical modification to allow propeller perforator flaps to cover pressure sores at various locations. We used a propeller perforator flap concept based on the detection of newly formed perforator vessels located 1 cm from the wound margin and stimulated by the chronic inflammation process. Between January 2009 and January 2017, 33 wound edge-based propeller perforator flaps were used to cover pressure sores at various locations in 28 patients. In four cases more than one flap was used on the same patient. The patients comprised 18 males and 10 females with a mean age of 41·25 (range, 16-70) years. All patients underwent follow-up for 0-12 months. The mean follow-up duration was 5·03 months. Venous congestion was observed in three flaps that were rotated by 180° (9·1%). However, there was a significant difference between flaps rotated by 90° and 180° according to the complication rate (P = 0·034). Out of 33 flaps, 29 flaps healed uneventfully. Patients were able to sit and lie on their flaps three weeks after surgery. In our study, we were able to obtain satisfying final results using these novel flaps. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Muscular soreness following prolonged intermittent high-intensity shuttle running.

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Thompson, D; Nicholas, C W; Williams, C

1999-05-01

The aim of this study was to examine the impact of prolonged intermittent high-intensity shuttle running on soreness and markers of muscle damage. Sixteen males took part in the study, half of whom were assigned to a running group and half to a resting control group. The exercise protocol involved 90 min of intermittent shuttle running and walking (Loughborough Intermittent Shuttle Test: LIST), reflecting the activity pattern found in multiple-sprint sports such as soccer. Immediately after exercise, there was a significant increase (P < 0.05) in serum activities of creatine kinase and aspartate aminotransferase, and values remained above baseline for 48 h (P < 0.05). Median peak activities of creatine kinase and aspartate aminotransferase occurred 24 h post-exercise and were 774 and 43 U x l(-1), respectively. The intensity of general muscle soreness, and in the specific muscles investigated, was greater than baseline for 72 h after the shuttle test (P < 0.05), peaking 24-48 h post-exercise (P < 0.05). Muscle soreness was not correlated with either creatine kinase or aspartate aminotransferase activity. Soreness was most frequently reported in the hamstrings. Neither soreness nor serum enzyme activity changed in the controls over the 4 day observation period. It appears that unaccustomed performance of prolonged intermittent shuttle running produces a significant increase in both soreness and markers of muscle damage.

PROGNOSTIC FACTORS IN PATIENTS WITH PRESSURE SORES IN A UNIVERSITY HOSPITAL IN SOUTHERN BRAZIL.

Science.gov (United States)

Walter, Gustavo Palmeiro; Seidel, William; Giustina, Renata Della; Bins-Ely, Jorge; Maurici, Rosemeri; Narciso-Schiavon, Janaína Luz

2017-01-01

Despite advances in medical care, patients who are hospitalized or have spinal cord injuries often develop pressure sores. The objective of this study was to describe the epidemiological characteristics of pressure sores and evaluate factors associated with recurrence and cure. In this historical cohort study, clinical and laboratory data were collected from medical records between 1997 and 2016. Sixty individuals with pressure ulcers were included; mean patient age was 38.1±16.5 (37.0) years, 83.3% were men, and 86.8% identified as white. Most patients (85.1%) had paraplegia, amputation, or trauma of the lower limbs with motor sequelae; the remainder (14.9%) were quadriplegic. Most (78.3%) underwent surgery, and the mean follow-up time was 1.8±2.5 years. The lesions were cured in 25 patients; they recurred in 25% of the patients, and recurrence was seen to be associated with the location of the lesions. Patients with recurrent lesions had more medical consultations and a longer treatment time. Individuals whose ulcers had healed had fewer lesions, higher body mass index (BMI), and a higher proportion of these patients underwent surgery. BMI and location and number of lesions are prognostic factors. Level of Evidence IV, Case Series.

Flurbiprofen microgranules for relief of sore throat: a randomised, double-blind trial

Science.gov (United States)

Russo, Marc; Bloch, Mark; de Looze, Fred; Morris, Christopher; Shephard, Adrian

2013-01-01

Background Many people with sore throat seek, and are often inappropriately prescribed, antibiotics. Aim The objective of this study was to determine the analgesic efficacy of flurbiprofen 8.75 mg microgranules versus placebo. These microgranules are a possible alternative treatment for patients with sore throat due to upper respiratory tract infection (URTI). Design and setting Randomised, double-blind, placebo-controlled, multiple-dose study conducted at eight primary care sites in Australia. Method Participants with sore throat of onset within the past 4 days received either flurbiprofen 8.75 mg microgranules or non-medicated placebo microgranules. Throat soreness, difficulty in swallowing, sore throat pain intensity, sore throat relief, oral temperature, and treatment benefits were all assessed at regular intervals. Result Of 373 patients from eight centres, 186 received flurbiprofen 8.75 mg microgranules and 187 received placebo microgranules (intent-to-treat population). Throat soreness was significantly reduced over the first 2 hours after the first dose. Reductions in difficulty in swallowing were observed at all time points from 5 to 360 minutes after the first dose, after taking flurbiprofen microgranules versus placebo. Sore throat relief was also evident at 1 minute and lasted for at least 6 hours. The multiple-dose efficacy results showed reduction of difficulty in swallowing at the end of days 1–3 and sore throat relief at the end of day 1. Conclusion Microgranules containing flurbiprofen 8.75 mg provided fast and effective relief from sore throat due to URTI and represent an alternative treatment option to antibiotic therapy. PMID:23561694

The accordion gracilis muscle flap: a new design for coverage of recurrent and complicated ischeal pressure sores.

Science.gov (United States)

El-Sabbagh, Ahmed H

2011-10-01

Management of patients with large or recurrent pressure ulcerations can be complicated by the lack of available local flap, whether already used or because adjacent lesions make such flap insufficient for complete coverage. In this article, the gracilis muscle was modified to cover large defects without help from its cutaneous territory. Twelve ischeal pressure sores were treated between August 2007 and 2009 with the modified gracilis muscle flap in a single-staged procedure. Five ulcers were recurrent and seven patients have associated pressure ulcers. All reconstructions were successful. Mean patient age was 35 years and nearly all patients had multiple significant comorbidities, including associated ulcers, diabetes and urethrocutaneous fistula. All flaps and donor sites healed uneventfully. There was one complication presented as cellulites at the donor site. Follow-up in some cases extend up to 1·5 years. No recurrence was observed. The accordion gracilis muscle flap is a handy, safe and fast flap for reconstruction of recurrent, difficult ischeal pressure sores. © 2011 The Author. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

[Repair of pressure sores over ischial tuberosity with long head of biceps femoris muscle flap combined with semi-V posterior thigh fasciocutaneous flap].

Science.gov (United States)

Hai, Heng-lin; Shen, Chuan-an; Chai, Jia-ke; Li, Hua-tao

2012-02-01

To explore the clinical effect of transplantation of the long head of biceps femoris muscle flap in combination with semi-V posterior thigh fasciocutaneous flap for repair of pressure sores over ischial tuberosity. Eight patients with 10 deep pressure sores over ischial tuberosity were admitted to the First Affiliated Hospital to the PLA General Hospital and the 98th Hospital of PLA from April 2004 to June 2010. The wounds measured from 2 cm × 2 cm to 6 cm × 4 cm were covered with the long head of biceps femoris muscle flap and semi-V posterior thigh fasciocutaneous flap (ranged from 10 cm × 6 cm to 13 cm × 8 cm). The condition of flaps was observed and followed up for a long time. All flaps survived. Nine wounds healed by first intention. Subcutaneous accumulation of fluids occurred in one wound with formation of a sinus at drainage site, and it healed after dressing change for 25 days. Patients were followed up for 7 to 34 months. Sore recurred in one patient 9 months after surgery, and it was successfully repaired with the same flap for the second time. Flaps in the other 7 patients appeared satisfactory with soft texture and without ulceration. This combined flap is easy in formation and transfer, and it causes little side injury with good resistance against pressure. It is a new method for repair of pressure sore over sacral region.

Effect of St.John's wort (Hypericum perforatum) oily extract for the care and treatment of pressure sores; a case report.

Science.gov (United States)

Yücel, Ali; Kan, Yüksel; Yesilada, Erdem; Akın, Onat

2017-01-20

Topical formulations such as oily extracts or ointments prepared with the flowering aerial parts of St. John's wort (Hypericum perforatum L., Hypericaceae) have been used in the management of a wide range dermatological problems including superficial wounds and burns, bruises, contusions and many others in the worldwide traditional medicines. This is the first case study reporting the beneficial effects of an oily extract of St. John's wort in the treatment of pressure sores in a intensive care unit (ICU) patient. The oily extract of St. John's wort was applied to a volunteer patient at ICU daily for forty successive days for wound care and treatment. Healing status was monitored macroscopically by measuring the wound size and stages at certain intervals as well as histopathological evaluation of the tissue sections taken at the initial and final dates of treatment. Evaluation of the results obtained from the macroscopical and histopathological experimentation have shown that oily extract of St. John's wort provided significant efficacy for the treatment of pressure sore wounds. St. John's wort oily extract may be suggested as a cost-effective option for the prevention or treatment of pressure sores in ICU patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Intraoperative indocyanine green fluorescent angiography-assisted modified superior gluteal artery perforator flap for reconstruction of sacral pressure sores.

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Chang, Chun-Kai; Wu, Chien-Ju; Chen, Chun-Yu; Wang, Chi-Yu; Chu, Tzi-Shiang; Hsu, Kuo-Feng; Chiu, Han-Ting; Liu, Hung-Hui; Chou, Chang-Yi; Wang, Chih-Hsin; Lin, Chin-Ta; Dai, Niann-Tzyy; Tzeng, Yuan-Sheng

2017-12-01

Pressure sores are often observed in patients who are bedridden. They can be a severe problem not only for patients and their caregivers but also for plastic surgeons. Here, we describe a new method of superior gluteal artery perforator flap harvesting and anchoring with the assistance of intraoperative indocyanine green fluorescent angiography. In this report, we describe the procedure and outcomes for 19 patients with grades III and IV sacral pressure sores who underwent the operation between September 2015 and November 2016. All flaps survived, and two experienced wound-edge partial dehiscence. With the assistance of this imaging device, we were able to acquire a reliable superior gluteal artery perforator flap and perform modified operations with it that are safe, easy to learn and associated with fewer complications than are traditional. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

[Skin care and prevention of bed sores in bedridden patients].

Science.gov (United States)

Martínez Cuervo, Fernando; Soldevilla Agreda, J Javier; Verdú Soriano, José; Segovia Gómez, Teresa; García Fernández, Francisco Pedro; Pancorbo Hidalgo, Pedro Luís

2007-12-01

The aging process and environmental aggressions will leave their imprints on the state of a person's skin, possibly compromising some of its functions. Age is a risk factor for the development of bed sores, but not the only factor nor the most important one; therefore, we need to develop prevention programs directed to all patients who spend long periods of time sedentary or bedridden. Prevention programs for bed sores must be based on the best evidence available and include a risk evaluation on these factors: suffering a lesion due to pressure, specific skin treatment, incontinence control, excessive humidity posture changes and the use of special surfaces to manage pressure during an increase in mobility or activity by the patient, local pressure reducing devices as well as paying attention to special situations. All of these care measures have to be developed based on a continuity of treatment among the institutions and caretakers involved with treating each patient.

Sore Throat: Diagnosis and Treatment

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... neck to check for swollen glands (lymph nodes) Listening to your or your child's breathing with a ... of your sore throat, these at-home care strategies can help you ease your symptoms: Rest. And ...

A β-cyclodextrin, polyethyleneimine and silk fibroin hydrogel containing Centella asiatica extract and hydrocortisone acetate: releasing properties and in vivo efficacy for healing of pressure sores.

Science.gov (United States)

Lee, M S; Seo, S R; Kim, J-C

2012-10-01

  Pressure sores are lesions caused by impaired blood flow. Conventional dressings can absorb exudates, but do not promote wound healing. A hydrogel composed of β-cyclodextrin (β-CD), polyethyleneimine (PEI) and silk fibroin (SF) was assessed for use in healing of pressure sores. The hydrogel was prepared by crosslinking β-CD-grafted PEI and SF using epichlorohydrin. The gel was then immersed in an aqueous solution of Centella asiatica extract (CAE) 0.7 mg/mL and/or hydrocortisone acetate (HCA) 0.5 mg/mL. The in vivo pressure sore-healing efficacy of the dry gel (with or without the drugs) was investigated in terms of the hyperplasia of epidermis and the number of neutrophils in the skin tissue. The specific loading of CAE was 0.0091 g/g of dry gel. The percentage of CAE released at 24 h at pH 3.0, 5.0 and 7.4 was approximately 63.9%, 55.0% and 44.4%, respectively. This pH-dependent release is possibly due to the degree of gel swelling, which decreased with increasing pH. The specific loading of HCA was 0.0050 g/g dry gel, and the percentage release of HCA at 24 h was around 20% at all three pH points. It is likely that HCA release is independent of pH. HCA is a hydrophobic compound, and therefore the release of HCA is affected by the partitioning of HCA between the β-CD cavity and the bulk water phase, but not by the degree of swelling of the hydrogel. The pressure sores treated with the hydrogel healed in 6 days, compared with 10 days for controls. In this study, a β-CD/PEI/SF hydrogel containing CAE and HCA reduced the healing time for pressure sores. © The Author(s). CED © 2012 British Association of Dermatologists.

How effective are treatments other than antibiotics for acute sore throat?

OpenAIRE

Thomas, M; Del Mar, C; Glasziou, P

2000-01-01

To estimate the benefits of treatments other than antibiotics for acute sore throat, and the differences between non-antibiotic interventions and controls in patient-perceived pain of sore throat, a systematic review of controlled trials in Medline and the Cochrane Library was carried out. Sixty-six randomised controlled trials (with or without additional antibiotics) were identified and 17 met the selection criteria. Twenty-two non-antibiotic managements for sore throat were compared. Their ...

[Plastic surgery treatment techniques for interdisciplinary therapy of pressure sores].

Science.gov (United States)

Müller, Karin; Becker, Frederic; Pfau, Matthias; Werdin, Frank

2017-06-01

Pressure sores in geriatric patients represent a challenge for all disciplines involved in the treatment process; however, the prerequisite for successful treatment is the elaboration of an interdisciplinary treatment concept. The treatment goals should be adapted to the individual needs of the patients including the life situation, general condition and local findings. In addition to general basic operative techniques, such as wound cleansing and conditioning, plastic and reconstructive surgery provides a wide range of highly specialized operative techniques for the treatment of these patients by which a definitive defect coverage can be achieved. The aim of this article is to raise awareness for these complex and highly specialized procedures for all disciplines participating in the treatment in order to improve the interdisciplinary cooperation and ultimately the quality of treatment.

A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres.

Science.gov (United States)

Bulfone, Giampiera; Marzoli, Ilaria; Quattrin, Rosanna; Fabbro, Carmen; Palese, Alvisa

2012-02-01

To explore the incidence of intraoperative pressure sores, the associated risk factors and the preventive strategies adopted by nurses, we adopted a longitudinal study in a 900-bed teaching hospital with multiple operating theatres, located in the North of Italy. Patients who underwent major surgery were evaluated four times: at the moment of operating theatre admission, at operating theatre discharge, and on their third and sixth postoperative day. Of the patients included (n = 102) who had an average age of 62.3 years (range 20-87), 12.7% (13/102) developed a pressure ulcer in the operating theatre; 46.1% (6/13) of these ulcers were still present on the third postoperative day. Some health conditions (diabetes mellitus, cardiac diseases) and intra-operative factors (lying on the operating table for more than 6.15 hours, intraoperative hypothermia) are associated with the occurrence of pressure sores.

[Effects of massage on delayed-onset muscle soreness].

Science.gov (United States)

Bakowski, Paweł; Musielak, Bartosz; Sip, Paweł; Biegański, Grzegorz

2008-01-01

Delayed onset muscle soreness (DOMS) is the pain or discomfort often felt 12 to 24 hours after exercising and subsides generally within 4 to 6 days. Once thought to be caused by lactic acid buildup, a more recent theory is that it is caused by inflammatory process or tiny tears in the muscle fibers caused by eccentric contraction, or unaccustomed training levels. Exercises that involve many eccentric contractions will result in the most severe DOMS. Fourteen healthy men with no history of upper arm injury and no experience in resistance training were recruited. The mean age, height, and mass of the subjects were 22.8 +/- 1.2 years, 178.3 +/- 10.3 cm, and 75.0 +/- 14.2 kg, respectively. Subjects performed 8 sets of concentric and eccentric actions of the elbow flexors with each arm according to Stay protocol. One arm received 10 minutes of massage 30 minutes after exercise, the contralateral arm received no treatment. Measurements were taken at 9 assessment times: pre-exercise and postexercise at 10 min, 6, 12, 24, 36, 48, 72 and 96 hours. Dependent variables were range of motion, perceived soreness and upper arm circumference. There was noticed difference in perceived soreness across time between groups. The analysis indicated that massage resulted in a 10% to 20% decrease in the severity of soreness, but the differences were not significant. Difference in range of motion and arm circumference was not observed. Massage administered 30 minutes after exercises could have a beneficial influence on DOMS but without influence on muscle swelling and range of motion.

Which medical device and/or which local treatment for prevention in patients with risk factors for pressure sores in 2012? Developing French guidelines for clinical practice.

Science.gov (United States)

Nicolas, B; Moiziard, A S; Barrois, B; Colin, D; Michel, J M; Passadori, Y; Ribinik, P

2012-10-01

Implementation of a prevention strategy after the identification of risk factors is essential at the entrance in a care unit or in a medical-social unit. Determine which medical devices and which treatments may be used in order to prevent pressure sore in 2012. Systematic review of the literature using databases: Pascal, Biomed, PubMed, and Cochrane library between 2000 and 2010. Nursing care including use of soft product, non-irritating for the cleaning, hydration of the skin with emollients, protection of fragile skin in case of incontinence by applying a skin protector and application of dressings in front of bony prominences to reduce shear forces, remain valid (level C). Nursing cares and use of dressing in patients with high risks of pressure sores are the responsibility of the nurses. The engagement of health care teams involves screening of risk factors and the knowledge of treatments and local devices. Local preventive treatment in a patient with risk factors of pressure sore is of great interest at entrance in a care unit or in a medical-social unit. Copyright © 2012. Published by Elsevier Masson SAS.

Prophylaxis of postintubation sore throat by the use of single puff inhalation of clomethasone dipropionate preoperatively

International Nuclear Information System (INIS)

Bashir, I.; Masood, N.

2014-01-01

Objective: The objective of this study was to asses the occurrence and severity of sore throat following endotracheal anesthesia and its reduction by beclomethasone inhalation. Study Design: A randomized controlled trial. Place and Duration of Study: This study was carried out at the main operation theatre, Combined Military Hospital Rawalpindi from October 2002 to April 2003. Patients and Methods: Two hundred patients undergoing general anaesthesia for elective surgery were included. Patients were randomly assigned to two groups of 100 patients each. The patients in group A were given one puff inhalation of beclomethasone before intubation while group B was control group. The patients were evaluated for occurrence and severity of postoperative sore throat by direct questions 6, 12, 24 and 48 hours after surgery. Results: In the beclomethasone group, 10 patients had sore throat as compared to 55 in control group (p<0.01). All 10 patients who experienced symptoms in beclomethasone group had mild sore throat while among the patients in the control group 22 had mild, 13 had moderate and 20 had severe sore throat. After 48 hours, no patient had the symptoms in the study group while 9 of the control group still suffered from sore throat. No drug related side effects were observed. Conclusion: Postoperative sore throat after general anaesthesia is common (occurrence rate of 55%). Beclomethasone inhaler is highly effective in the prevention of postoperative sore throat. It reduces both the occurrence and severity of sore throat. (author)

Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

Directory of Open Access Journals (Sweden)

H. L. Yang

2016-01-01

Full Text Available Background. Postoperative sore throat is one of the major complaints of general anesthesia in the postanesthesia care unit. This prospective study investigated the preventive effect of ketorolac tromethamine spray in postendotracheal-intubation-induced sore throat after general anesthesia. Methods. Surgical patients undergoing general anesthesia with endotracheal intubation were recruited from a medical center. Patients were randomly assigned to group K (treated with 5% ketorolac tromethamine spray or group D (treated with distilled water spray. Before intubation, each endotracheal tube was sprayed with the appropriate solution by physicians over the 20 cm length of the cuff. Each group comprised 95 patients fitting the inclusion and exclusion criteria for whom complete data sets were collected. The intensity of the sore throat was measured at 1, 3, 6, and 24 h after surgery, and data were compared. Results. The two groups had similar characteristics. Postoperative sore throat was significantly less frequent in group K than in group D (p<0.001 and the pain intensity was significantly lower in group K than in group D at each time point (all p<0.001. Conclusions. This study demonstrated that preanesthesia 5% ketorolac tromethamine spray could effectively decrease postendotracheal-intubation-induced sore throat in patients undergoing general anesthesia.

A New Option for the Reconstruction of Primary or Recurrent Ischial Pressure Sores: Hamstring-Adductor Magnus Muscle Advancement Flap and Direct Closure.

Science.gov (United States)

Burm, Jin Sik; Hwang, Jungil; Lee, Yung Ki

2018-04-01

Owing to the high recurrence rates of ischial pressure sores, surgeons should consider the possibility of future secondary flap surgery during flap selection. The purpose of this article is to present a new surgical option for the reconstruction of primary or recurrent ischial pressure sores using a simple hamstring-adductor magnus advancement flap and direct closure. After horizontal fusiform skin excision, complete bursa excision and ischiectomy were performed. The tenomuscular origin of the adductor magnus and the conjoined tenomuscular origin of the biceps femoris long head and semitendinosus were isolated and completely detached from the inferior border of the ischial tuberosity. They were then advanced in a cephalad direction without detachment of the distal tendon or muscle and securely affixed to the sacrotuberous ligament. The wound was directly closed without further incision or dissection. Twelve ischial pressure sores (6 primary and 6 recurrent; 12 patients) were surgically corrected. The follow-up period was 12 to 65 months. All patients healed successfully without early postoperative complications, such as hematoma, seroma, infection, wound dehiscence, or partial necrosis. Late complications included wound disruption 5 weeks after surgery that spontaneously healed in 1 case and recurrence 3 years later in another case. The new surgical option presented herein, which involves hamstring-adductor magnus advancement flap and direct closure, is a simple and reliable method for providing sufficient muscle bulk to fill the dead space and proper padding to the bone stump while preserving the main vascular perforators and pedicles as well as future surgical options.

Computed tomography of pressure sores, pelvic abscess, and osteomyelitis in patients with spinal cord injury

International Nuclear Information System (INIS)

Firooznia, H.; Rafii, M.; Golimbu, C.; Lam, S.; Sokolow, J.; Kung, J.S.

1982-01-01

Nine patients with spinal cord injury (SCI) and large pressure ulcers and other possible complications, were evaluated by computed tomography (CT), conventional radiography, tomography, bone scanning, gallium scanning, and sonography. CT revealed the depth, extent, and relationship of the ulcer-bed to the underlying structures in all 9 patients. CT also positively identified unsuspected intra- and extra-pelvic abscess and pelvic osteomyelitis in 4 patients each. Other modalities identified only 2 of these complications. We believe CT is the modality of choice for evaluation of these complications in SCI patients, because of its superior ability in evaluation of pressure sores and detection of pathologic changes in soft tissue and bone in the pelvic region

Quantification and localisation of damage in rat muscles after controlled loading; a new approach to study the aetiology of pressure sores

NARCIS (Netherlands)

Bosboom, E.M.H.; Bouten, C.V.C.; Oomens, C.W.J.; Straaten, van H.W.M.; Baaijens, F.P.T.; Kuipers, H.

2001-01-01

To obtain more insight in the aetiology of deep pressure sores, an animal model was developed to relate controlled externalloading to local muscle damage. The tibialis anterior muscle (TA) and overlying skin of a rat were compressed between indentorand tibia. Loads of 10, 70 and 250 kPa at skin

Marjolin's Ulcer Complicating a Pressure Sore: The Clock is Ticking.

Science.gov (United States)

Khan, Kamran; Giannone, Anna Lucia; Mehrabi, Erfan; Khan, Ayda; Giannone, Roberto E

2016-02-22

Malignant degeneration in any chronic wound is termed a Marjolin's ulcer (MU). The overall metastatic rate of MU is approximately 27.5%. However, the prognosis of MU specific to pressure sores is poor, with a reported metastatic rate of 61%. This is due to insidious, asymptomatic malignant degeneration, a lack of healthcare provider awareness, and, ultimately, delayed management. An 85-year-old white male was noted by his wound-care nurse to have a rapidly developing growth on his lower back over a period of 4 months. There was history of a non-healing, progressive pressure ulcer of the lower back for the past 10 years. On examination, there was a 4 × 4 cm pressure ulcer of the lower back, with a superimposed 1.5 × 2 cm growth in the superior region. There was an absence of palpable regional lymphadenopathy. Punch biopsy revealed squamous cell carcinoma consistent with Marjolin's ulcer. The ulcer underwent excision with wide margins, and a skin graft was placed. Due to the prompt recognition of an abnormality by the patient's wound-care nurse, metastasis was not evident on imaging. There are no signs of recurrence at 1-year follow-up. Marjolin's ulcer has a rapid progression from local disease to widespread metastasis. Therefore, it is essential that wound-care providers are aware of the clinical signs and symptoms of malignant degeneration in chronic wounds.

Acute effects of massage or active exercise in relieving muscle soreness

DEFF Research Database (Denmark)

Andersen, Lars L; Jay, Kenneth; Andersen, Christoffer H

2013-01-01

Massage is commonly believed to be the best modality for relieving muscle soreness. However, actively warming up the muscles with exercise may be an effective alternative. The purpose of this study was to compare the acute effect of massage with active exercise for relieving muscle soreness. Twenty...... healthy female volunteers (mean age 32 years) participated in this examiner-blind randomized controlled trial (ClinicalTrials.gov NCT01478451). The participants performed eccentric contractions for the upper trapezius muscle on a Biodex dynamometer. Delayed onset muscle soreness (DOMS) presented 48 hours...... later, at which the participants (a) received 10 minutes of massage of the trapezius muscle or (b) performed 10 minutes of active exercise (shoulder shrugs 10 × 10 reps) with increasing elastic resistance (Thera-Band). First, 1 treatment was randomly applied to 1 shoulder while the contralateral...

Difference between a Sore Throat, Strep, and Tonsillitis

Science.gov (United States)

... often called Hand, Foot, and Mouth disease ). Infectious mononucleosis (often called "Mono") can produce a sore throat, ... most young children who are infected with the mononucleosis virus have few or no symptoms. Strep Throat ...

Effects of intravenous diclofenac on postoperative sore throat in ...

African Journals Online (AJOL)

Effects of intravenous diclofenac on postoperative sore throat in patients undergoing laparoscopic surgery at Aga Khan University Hospital, Nairobi: A prospective, randomized, double blind controlled trial.

[Primary investigation on fumigation and moxibustion in treatment ulcer and sore of yin syndrome].

Science.gov (United States)

Zhu, Chao-Jun; Zhang, Zhao-Hui; Ma, Jing; Li, Pin-Chuan; Liu, Xian-Zhou; Yin, Yue; Tian, Ying

2011-09-01

To explore the fumigation and moxibustion therapy in treatment of ulcer and sore of yin syndrome. The fumigation and moxibustion therapy is the combination of fumigation and moxibustion, in which, smoking fumigation is provided with warming effect and the actions as moxibustion. This therapy works on the efficacy of both fumigation and moxibustion. In treatment, different herbal medicines can be selected flexibly, acting on dispersing yin and rescuing yang. The fumigation and moxibustion therapy can drain toxin and remove ulcer and sore. It contributes to the treatment of boils and chronic sores of yin syndrome and promotes wound healing.

The usefulness of a clinical 'scorecard' in managing patients with sore throat in general practice

Directory of Open Access Journals (Sweden)

Bakare Tony MO

2010-07-01

Full Text Available Abstract Background Objective: To evaluate the usefulness of a clinical scorecard in managing sore throat in general practice. Design: Validation study of scorecard for sore throat with a throat swab culture used as the 'gold standard'. Setting: A solo family practice in rural New South Wales, Australia Participants: Patients attending with sore throat. Methods Patients from the age of 5 years and above presenting with the main symptom of a sore throat, and who have not had any antibiotic treatment in the previous two weeks, were invited to participate in the study. The doctor completed a scorecard for each patient participating and took a throat swab for culture. Adult patients (> 16 yrs were asked to complete a patient satisfaction questionnaire, while guardians accompanying children (5 yr to Main outcome measures: 1. Ability of a new scorecard to differentiate between bacterial and non-bacterial sore throat. 2. Patients' trust in the scorecard. Results The scorecard has a sensitivity of 93.33%, a specificity of 63.16%, a positive predictive value of 50% and a negative predictive value of 96%. The sensitivity is better than other sore throat scorecards that have been published but with a slightly lower specificity. There was a high level of patient trust in the scorecard was (85.8% agreement. Patients also trusted their doctor's judgement based on the scorecard (90.6% agreement. Conclusions As the scorecard has a high sensitivity but only a moderate specificity, this means that it is more reliable for negative results, i.e. when the result suggests a viral infection. When the result favours a bacterial sore throat, then a high sensitivity can mean that there are a number of false positives. GPs can be confident in withholding antibiotics when the scorecard indicates a viral infection.

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...

ASPECTS REGARDING THE EFFECT OF ANTIINFLAMMATORY DRUGS ON DELAYED ONSET MUSCLE SORENESS

OpenAIRE

Honceriu C.; Hagiu B.A.

2013-01-01

The objectives of the study are to investigate the effects of using Diclofenac ointment for delayed onset muscle soreness. The research has been conducted on two groups of junior football players, males, the number of 9 each (control and treated), which has been induced by this type of muscle soreness with specific exercises. The treated group used Diclofenac gel for the relief of musculoskeletal pain. The evaluation of values of muscular strength (Squat Jump, Jump Countermovement, Free Jump,...

Pressure sores significantly increase the risk of developing a Fournier's gangrene in patients with spinal cord injury.

Science.gov (United States)

Backhaus, M; Citak, M; Tilkorn, D-J; Meindl, R; Schildhauer, T A; Fehmer, T

2011-11-01

Retrospective chart review. The aim of our study was to evaluate the mortality rate and further specific risk factors for Fournier's gangrene in patients with spinal cord injury (SCI). Division of Spinal Cord Injury, BG-University Hospital Bergmannsheil Bochum, Ruhr-University Bochum, Germany. All patients with a SCI and a Fournier's gangrene treated in our hospital were enrolled in this study. Following parameters were taken form patients medical records: age, type of SCI, cause of Fournier's gangrene, number of surgical debridements, length of hospital and intensive care unit stay, co morbidity factors and mortality rate. In addition, laboratory parameter including the laboratory risk indicator for necrotizing fasciitis (LRINEC) score and microbiological findings were analyzed. Clinical diagnosis was made via histological examination. A total of 16 male patients (15 paraplegic and one tetraplegic) were included in the study. In 81% of all cases, the origin of Fournier's gangrene was a pressure sore. The median LRINEC score on admission was 6.5. In the vast majority of cases, a polybacterial infection was found. No patient died during the hospital stay. The mean number of surgical debridements before soft tissue closure was 1.9 and after a mean time interval of 39.1 days wound closure was performed in all patients. Pressure sores significantly increase the risk of developing Fournier's gangrene in patients with SCI. We reported the results of our patients to increase awareness among physicians and training staff working with patients with a SCI in order to expedite the diagnosis.

Evaluation of the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) scoring system in elderly patients with pressure sores undergoing fasciocutaneous flap-reconstruction.

Science.gov (United States)

Mizumoto, Kazuo; Morita, Eishin

2009-01-01

The aim of the present study was to predict operative morbidity in elderly patients with deep pressure sores by using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) scoring system. Fifteen patients over 70 years old were retrospectively reviewed who had undergone gluteus maximus fasciocutaneous flap-reconstruction for pressure sores of the sacral region from 1 April 2005 to 31 March 2007. Complications were seen in six cases (40%) after operation. Four were wound infection, one was chest infection and another was septicemia. The subjects were divided into two groups by the presence (complicated group) or absence (non-complicated group) of postoperative complications. Each item of physiological scores, physiological score (PS), operative severity score (OS) and predicted morbidity rate (R) were calculated and compared between two groups. As a result, hemoglobin (P = 0.0276), PS (P = 0.0023) and R (P = 0.0078) differed significantly between the two groups. It is noteworthy that the PS were over 25 in all of the complicated group, but in only one of nine in the non-complicated group (P = 0.0014). Our study suggests that, for pressure sores in the sacral region in elderly patients, gluteus maximus fasciocutaneous flap-reconstruction can be employed in patients whose PS are under 24 in the POSSUM scoring system.

Pressure sores among malnourished necropsied adults - preliminary data Escaras de decúbito em adultos necropsiados com subnutrição - dados preliminares

Directory of Open Access Journals (Sweden)

Daniel Ferreira da Cunha

2000-06-01

Full Text Available Pressure sores are common among bedridden, elderly, or malnourished patients, and may occur in terminal ill patients because of impaired mobility, fecal or urinary incontinence, and decreased healing capacity. The aim of this study was to compare frequency of pressure sores between malnourished and non-malnourished necropsied adults. METHOD: All (n = 201 adults (age ³ 18 years autopsied between 1986 and 1996 at the Teaching Hospital of Triangulo Mineiro Medical School (Uberaba were eligible for the study. Gender, race, weight, height and main diagnoses were recorded. Ninety-six cases were excluded because of probable body water retention (congestive heart failure, hepatic insufficiency, nephrotic syndrome or pressure sores secondary to peripheral vascular ischemia. Body mass index (BMI was used to define malnourished (BMI 18.5kg/m² groups. RESULTS: Except for weight (42.5kg; range: 28-57 vs. 60; 36-134.5kg and BMI (16.9; range: 12.4-18.5 vs. 22.7; range: 18.5-54.6kg/m², respectively, there were no statistical differences among 43 malnourished and 62 non-malnourished cases in relation to age (54.9 ± 20.4 vs. 52.9 ± 17.9 years, percentage of white persons (74.4 vs. 64.5%, male gender (76.7 vs. 69.3% and main diagnoses. Five malnourished (11.6% and 7 (11.5% non-malnourished cases had pressure sores (p=0.89. CONCLUSION: Pressure sores were equally common findings in necropsied persons with protein-energy malnutrition, as assessed by body mass index.Escaras de decúbito são comuns em pacientes acamados, idosos e subnutridos e podem ocorrer em pacientes terminais devido à imobilidade, incontinência fecal e urinária e imunodepressão. Além disso, a contaminação das Escaras de decúbito aumentam o risco de sepsis e podem piorar o estado nutricional. O objetivo deste estudo foi comparar a freqüência de Escaras de decúbito entre adultos necropsiados com ou sem subnutrição. MÉTODO: Adultos (n=201 necropsiados no Hospital Escola da FMTM

Mouth Sores Caused by Cancer Treatment: How to Cope

Science.gov (United States)

... leading to sores and infections. Both chemotherapy and radiation can impair your body's germ-fighting system (immune system). With an impaired immune system, viruses, bacteria and fungi can more easily infect your mouth, ...

When a Sore Throat Is a More Serious Infection

Science.gov (United States)

... often called Hand, Foot, and Mouth disease). Infectious mononucleosis can produce a sore throat, often with marked ... most young children who are infected with the mononucleosis virus have few or no symptoms. Strep throat ...

Spotlight on Psoriasis: Preventing Patches of Itchy, Sore Skin

Science.gov (United States)

... Subscribe August 2016 Print this issue Spotlight on Psoriasis Preventing Patches of Itchy, Sore Skin En español ... Sun Damage Sun and Skin Wise Choices Avoid Psoriasis Triggers Factors that may trigger psoriasis or make ...

Evaluation of local muscle soreness treatment with anterior bite splint made of soft putty impression material

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Harry Laksono

2013-03-01

Full Text Available Background: Local muscle soreness is the most common temporomandibular disorders complaint of patients seeking treatment in the dental clinics. The emergency treatment that can be done in the clinics to manage this disorder is by making anterior bite splint. Anterior bite splint is usually made of acrylic, but currently there is a soft putty impression material that can also be used for making anterior bite splint. The effectiveness of soft putty anterior bite splint in local muscle soreness treatment still has not clear. Purpose: To determine the effectiveness of the soft putty impression material as a material used for making anterior bite splint in the treatment of local muscle soreness. Case: Six patients was reported five female patients aged 20-40 years old and one male patient aged 37 years old with local muscle soreness. Four female patients with a “click” sound on TMJ. Case management: Make differential diagnosis with screening history (anamnesis, clinical examination consists of extra oral examination such as muscle and temporomandibular joint palpation, measure the mandibular movement, end-feel, load test, intra oral examination and radiographic evaluation. Record the results and make the diagnosis. Make a soft putty anterior bite splint, adjusted and inserted in the maxillary anterior teeth. Record the results based on signs and symptoms. Conclusion: It can be concluded that anterior bite splint made of soft putty impression material is effective for treatment the local muscle soreness.Latar belakang: Salah satu tipe temporomandibular disorders yang paling sering dijumpai di klinik dokter gigi adalah local muscle soreness. Perawatan yang dapat dengan segera dilakukan di klinik untuk mengelola gangguan tersebut adalah dengan pembuatan anterior bite splint. Biasanya anterior bite splint terbuat dari akrilik, namun saat ini telah ada bahan cetak soft putty yang memungkinkan untuk dipakai sebagai bahan pembuatan anterior bite splint

Antibiotic prescribing in patients with self-reported sore throat

NARCIS (Netherlands)

Mehta, Nishchay; Schilder, Anne; Fragaszy, Ellen; E R Evans, Hannah; Dukes, Oliver; Manikam, Logan; Little, Paul; Smith, Sarah C; Hayward, Andrew

2017-01-01

OBJECTIVES: To investigate the predictors of general practitioner (GP) consultation and antibiotic use in those developing sore throat. METHODS: We conducted a prospective population-based cohort study on 4461 participants in two rounds (2010-11) from 1897 households. RESULTS: Participants reported

Muscle fascicle behavior during eccentric cycling and its relation to muscle soreness.

Science.gov (United States)

Peñailillo, Luis; Blazevich, Anthony J; Nosaka, Kazunori

2015-04-01

A single bout of eccentric exercise confers a protective effect against muscle damage and soreness in subsequent eccentric exercise bouts, but the mechanisms underpinning this effect are unclear. This study compared vastus lateralis (VL) muscle-tendon behavior between two eccentric cycling bouts to test the hypothesis that muscle-tendon behavior would be different between bouts and would be associated with the protective effect. Eleven untrained men (27.1 ± 7.0 yr) performed two bouts of eccentric cycling (ECC1 and ECC2) separated by 2 wk for 10 min at 65% of maximal concentric workload (191.9 ± 44.2 W) each. Muscle soreness (by visual analog scale) and maximal voluntary isometric contraction (MVC) torque of the knee extensors were assessed before and 1-2 d after exercise. Using ultrasonography, VL fascicle length and angle changes during cycling were assessed, and tendinous tissue (TT) length changes were estimated. VL EMG amplitude, crank torque, and knee joint angles were measured during cycling. Soreness was greater (P tendon behavior may be an important mechanism underpinning the protective effect.

Medicinal Plants for Healing Sores and Wounds among the ...

African Journals Online (AJOL)

Medicinal Plants for Healing Sores and Wounds among the Communities Surrounding Ungoye Forest, Kwazulu-Natal, South Africa. ... The focus was on the medicinal plants that grow in the Ungoye forest and around the homesteads. The survey ... Keywords: Traditional medicine, documentation, Ethno-survey, wounds.

Increased technetium uptake is not equivalent to muscle necrosis: scintigraphic, morphological and intramuscular pressure analyses of sore muscles after exercise

Science.gov (United States)

Crenshaw, A. G.; Friden, J.; Hargens, A. R.; Lang, G. H.; Thornell, L. E.

1993-01-01

A scintigraphic technique employing technetium pyrophosphate uptake was used to identify the area of skeletal muscle damage in the lower leg of four runners 24 h after an ultramarathon footrace (160 km). Most of the race had been run downhill which incorporated an extensive amount of eccentric work. Soreness was diffuse throughout the posterior region of the lower leg. In order to interpret what increased technetium uptake reflects and to express extreme endurance related damages, a biopsy was taken from the 3-D position of abnormal uptake. In addition, intramuscular pressures were determined in the deep posterior compartment. Scintigraphs revealed increased technetium pyrophosphate uptake in the medial portion of the gastrocnemius muscle. For 3698 fibres analysed, 33 fibres (1%) were necrotic, while a few other fibres were either atrophic or irregular shaped. A cluster of necrotic fibres occurred at the fascicular periphery for one subject and fibre type grouping occurred for another. Ultrastructural analysis revealed Z-line streaming near many capillaries and variously altered subsarcolemmal mitochondria including some with paracrystalline inclusions. The majority of the capillaries included thickened and irregular shaped endothelial cells. Intramuscular pressures of the deep posterior compartment were slightly elevated (12-15 mmHg) for three of the four subjects. Increased technetium uptake following extreme endurance running does not just reflect muscle necrosis but also subtle fibre abnormalities. Collectively, these pathological findings are attributed to relative ischaemia occurring during the race and during pre-race training, whereas, intramuscular pressure elevations associated with muscle soreness are attributed to mechanical stress caused by extensive eccentric work during the race.

APLIKASI PEMESANAN MAKANAN ONLINE BERBASIS WEB PADA RUMAH MAKAN PAGI SORE SIPIN JAMBI

Directory of Open Access Journals (Sweden)

Novhirtamely Kahar

2013-07-01

Full Text Available Rumah Makan Pagi Sore Sipin Jambi merupakan rumah makan yang menyediakan bermacam-macam menu makanan khas minang dan memiliki banyak pelanggan. Pemesanan makanan bagi pelanggan tetap jika jarak tempat tinggal dengan rumah makan berjauhan selama ini dilakukan melalui telepon. Cara tersebut memiliki kendala, salah satunya pelanggan tidak mengetahui daftar menu dan harga yang ditawarkan oleh rumah makan. Penelitian ini bertujuan untuk membangun aplikasi pemesanan makanan online sehingga penyampaian informasi menjadi cepat, akurat, memiliki jangkauan yang luas, serta dapat memesan makanan secara online. Sistem aplikasi pemesanan ini terdiri dari aplikasi untuk pelanggan dan admin. Aplikasi untuk pelanggan terdiri dari : Home, Profil, Menu, Paket Catering, Promotion, Info, dan Pemesanan. Aplikasi pemesanan untuk pelanggan terdiri dari Delivery Service, Paket Catering Service, dan Paket Catering Ruang Minang. Sedangkan aplikasi untuk admin terdiri dari olah data menu utama, transaksi, dan laporan. Untuk transaksi pembayaran dilakukan secara cash kepada bagian pengiriman. Sistem aplikasi ini dibangun dengan menggunakan PHP dan database MySQL. Dengan dibangunnya aplikasi ini, maka pelanggan dengan mudah mendapatkan informasi tentang Rumah Makan Pagi Sore Sipin Jambi dan dapat melakukan pemesanan makanan dimana saja dan kapan saja, sehingga dapat meningkatkan jumlah pelanggan dan berdampak pada peningkatan profit Rumah Makan Pagi Sore tersebut.Rumah Makan Pagi Sore Sipin Jambi merupakan rumah makan yang menyediakan bermacam-macam menu makanan khas minang dan memiliki banyak pelanggan. Pemesanan makanan bagi pelanggan tetap jika jarak tempat tinggal dengan rumah makan berjauhan selama ini dilakukan melalui telepon. Cara tersebut memiliki kendala, salah satunya pelanggan tidak mengetahui daftar menu dan harga yang ditawarkan oleh rumah makan. Penelitian ini bertujuan untuk membangun aplikasi pemesanan makanan online sehingga penyampaian informasi menjadi

Management of patients with sore throats in relation to guidelines: an interview study in Sweden.

Science.gov (United States)

Hedin, Katarina; Strandberg, Eva Lena; Gröndal, Hedvig; Brorsson, Annika; Thulesius, Hans; André, Malin

2014-12-01

To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews. Qualitative content analysis was used to analyse semi-structured interviews. Swedish primary care. A strategic sample of 25 GPs. Perceived management of sore throat patients. It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for bacterial infections and differential diagnosis whilst non-adherent GPs believed that in patients with a sore throat any bacterial infection should be identified and treated with antibiotics. Patient history and examination was mainly targeted by adherent GPs whilst for non-adherent GPs it was often redundant. Non-adherent GPs reported problems getting patients to abstain from antibiotics, whilst no such problems were reported in adherent GPs. This interview study of sore throat management in a strategically sampled group of Swedish GPs showed that while two-thirds were non-adherent and had a liberal attitude to antibiotics one-third were guideline adherent with a restricted view on antibiotics. Non-adherent GPs revealed significant knowledge gaps. Adherent GPs had discussed guidelines within the primary care team while non-adherent GPs had not. Guideline implementation thus seemed to be promoted by knowledge shared in team discussions.

Sports Mass Age Therapy on the Reduction of Delayed Onset Muscle Soreness of the Quadriceps Femoris

Directory of Open Access Journals (Sweden)

Boguszewski Dariusz

2014-12-01

Full Text Available Purpose. Massage therapy is one of most commonly applied treatments during athletic training. The aim of this study was to assess the effectiveness of sports massage therapy on reducing post-exercise quadriceps muscle soreness. Methods. A sample of 29 women aged 24-26 years was divided into an experimental group (n = 15 receiving classic sports massage therapy and a control group (n = 14 given no treatment. An exercise session consisting of five sets of deep squat jumps was administered after which lower limb power as assessed via the vertical jump test. Muscle soreness was assessed using the visual analogue scale (VAS and exercise intensity with the Borg Rating of Perceived Exertion Scale. Subsequent measurements of lower limb power and muscle soreness were performed 24, 48, 72 and 96 h after the exercise session. Differences between the measurements were assessed by the Friedman and least significant difference tests while between-group comparisons involved the Mann-Whitney U test. Results. The largest decrease in lower limb power was observed between the first measurement after the exercise session and 24 h later (p < 0.01. The smallest decrease in power was observed in the massage group. The highest levels of muscle soreness were noted 24 h post-exercise in the massage group and 48 h post-exercise in the control group. The experimental group showed a decrease in muscle soreness in each subsequent measurement, with the results close to zero on the VAS 96 h postexercise. Conclusions. Massage therapy quickened recovery and improved muscle efficiency post-exercise and may serve as an effective treatment of muscle soreness. The analgesic effect of massage suggests it should be widely applied in sport, physical therapy and rehabilitation.

A systematic review of complication and recurrence rates of musculocutaneous, fasciocutaneous, and perforator-based flaps for treatment of pressure sores.

Science.gov (United States)

Sameem, Mojib; Au, Michael; Wood, Thomas; Farrokhyar, Forough; Mahoney, James

2012-07-01

Management of pressure sores poses a significant reconstructive challenge for plastic surgeons. Currently, there is no consensus on whether musculocutaneous, fasciocutaneous, or perforator-based flaps provide superior results for treating pressure sores. The following databases were searched: Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, LILACS (January of 1950 to November of 2010), MEDLINE (January of 1950 to November of 2010), and EMBASE (January of 1980 to November of 2010). Only articles reporting on the use of musculocutaneous, fasciocutaneous, and perforator-based flaps were included. The primary study outcomes were complication and recurrence rates. Fifty-five articles were included in the final analysis (kappa = 0.78). From this total, 28 were categorized as pertaining to musculocutaneous flaps, 13 studied fasciocutaneous flaps, and 14 evaluated perforator-based flaps. The authors' review revealed recurrence and complication rates of 8.9 and 18.6 percent, respectively, following reconstruction with musculocutaneous flaps, 11.2 and 11.7 percent following reconstruction with fasciocutaneous flaps, and 5.6 and 19.6 percent following reconstruction with perforator-based flaps. Overall, statistical analysis revealed no significant difference in complication or recurrence rates among these three techniques. The authors' review revealed that there was no statistically significant difference with regard to recurrence or complication rates among musculocutaneous, fasciocutaneous, or perforator-based flaps. This suggests that surgeons performing such reconstructive procedures may choose to consider the advantages of a specific approach rather than the complication and recurrence rates. Therapeutic, IV.

Laser homeostatics on delayed onset muscle soreness

Energy Technology Data Exchange (ETDEWEB)

Liu, T C Y; Fu, D R; Liu, X G; Tian, Z X, E-mail: liutcy@scnu.edu.cn [Lab Laser Sports Medicine, South China Normal University, University Town, Guangzhou, GD 510006 (China)

2011-01-01

Delayed onset muscle soreness (DOMS) and its photobiomodulation were reviewed from the viewpoint of function-specific homeostasis (FSH) in this paper. FSH is a negative-feedback response of a biosystem to maintain the function-specific fluctuations inside the biosystem so that the function is perfectly performed. A stressor may destroy a FSH. A stress is a response of a biosystem to a stressor and may also be in stress-specific homeostasis (StSH). A low level light (LLL) is so defined that it has no effects on a function in its FSH or a stress in its StSH, but it modulate a function far from its FSH or a stress far from its StSH. For DOMS recovery, protein metabolism in the Z-line streaming muscular cell is the essential process, but the inflammation, pain and soreness are non-essential processes. For many DOMS phenomena, protein metabolism in the Z-line streaming muscular cell is in protein metabolism-specific homeostasis (PmSH) so that there are no effects of LLL although the inflammation can be inhibited and the pain can be relieved. An athlete or animal in the dysfunctional conditions such as blood flow restriction and exercise exhaustion is far from PmSH and the protein metabolism can be improved with LLL.

Rational Pharmacotherapy for Sore Throat in Children at Different Stages of the Assistance

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A.V. Zaychenko

2013-09-01

Full Text Available The article deals with one of the most pressing problems in pediatrics in the autumn and winter — a sore throat in children. The authors give its basic reasons, threatening symptoms that accompany sore throat, indicating an urgent need to visit a doctor, as well as the issues of treatment. It is noted that the most appropriate is the use of combination drugs that have complex (anti-microbial, anti-inflammatory, analgesic effect. The characteristics of Strepsils Kids preparation, developed specifically for use in children from 6 years, are given.

What is the best support surface in prevention and treatment, as of 2012, for a patient at risk and/or suffering from pressure ulcer sore? Developing French guidelines for clinical practice.

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Colin, D; Rochet, J-M; Ribinik, P; Barrois, B; Passadori, Y; Michel, J-M

2012-10-01

The use of support surfaces in the prevention and treatment of pressure ulcers prevention is an important part of care for a patient at risk and/or suffering from sore(s). Define which support surfaces to use in prevention and treatment of at-risk and/or pressure sore patients. A systematic review of the literature querying the several Pascal Biomed, PubMed and Cochrane Library databases from 2000 through 2010. RESULTS (GRADE A): In prevention, a structured foam mattress is more efficient than a standard hospital mattress. An alternating pressure mattress is more effective than a visco-elastic mattress limiting the occurrence heel pressure ulcers, but those that do occur are more serious. A low-air-loss bed is more efficient than a mixed pulsating air mattress in prevention of heel pressure ulcers. Some types of sheepskin can reduce sacral pressure ulcer incidence in orthopedic patients. Use of an overlay on an operating table limits the occurrence of peroperative and postoperative pressure ulcers. An air-fluidized bed improves pressure ulcer healing. The data in the literature are not always relevant and do not suffice to dictate a clinician's choices. We are compelled to recognize the methodological limitations of many studies, the lack of corporate interest in conducting such studies and the relatively small number of available trials. However, the effectiveness of some support surfaces reaches a sufficient level of evidence, especially when they are associated with postural, hydration and nutritional measures. Support surfaces are recommended in prevention and treatment of patients at risk and/or already suffering from pressure ulcer, and their use should constitute part of an overall preventive or curative strategy. Copyright © 2012. Published by Elsevier Masson SAS.

Delayed onset muscle soreness: No pain, no gain? The truth behind ...

African Journals Online (AJOL)

Delayed onset muscle soreness (DOMS) is muscle pain and stiffness that develops ... limited success in reducing the symptoms.1,4-6 The DOMS phenomenon ... Nutritional supplementation (antioxidants and L-carnitine) shows promise, but ...

Comparison of Effectiveness of Betamethasone gel Applied to the Tracheal Tube and IV Dexamethasone on Postoperative Sore Throat: A Randomized Controlled Trial.

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Tabari, Masumeh; Soltani, Ghasem; Zirak, Nahid; Alipour, Moammad; Khazaeni, Kamran

2013-09-01

Postoperative sore throat is a common complaint in patients with endotracheal intubation and has potentially dangerous complications. This randomized controlled trial study investigated the incidence of postoperative sore throat after general anesthesia when betamethasone gel is applied to a tracheal tube compared with when IV dexamethasone is prescribed. Two hundred and twenty five American Society of Anesthesiologist (ASA)-class I and II patients undergoing elective abdominal surgery with tracheal intubation were randomly divided into three groups: betamethasone gel, intravenous (IV) dexamethasone, and control groups. In the post-anesthesia care unit, a blinded anesthesiologist interviewed all patients regarding postoperative sore throat at 1,6, and 24 hours after surgery. The incidence of sore throat was significantly lower in the betamethasone gel group compared with the IV dexamethasone and control groups, 1, 6, and 24 hours after surgery. In the first day after surgery 10.7% of the betamethasone group had sore throat whereas 26.7% of the IV dexamethasone group and 30.7% of the control group had sore throat. Bucking before extubation was observed in 14(18.4%), 8(10.4%), and 9(12.2%) patients, in the IV dexamethasone, betamethasone gel, and control group, respectively. We concluded that wide spread application of betamethasone gel over tracheal tubes effectively mitigates postoperative sore throat, compared with IV dexamethasone application.

Comparison of Effectiveness of Betamethasone gel Applied to the Tracheal Tube and IV Dexamethasone on Postoperative sore Throat: A Randomized Controlled Trial

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Masoomeh Tabari

2013-10-01

Full Text Available Introduction: Postoperative sore throat is a common complaint in patients with endotracheal intubation and has potentially dangerous complications. This randomized controlled trial study investigated the incidence of postoperative sore throat after general anesthesia when betamethasone gel is applied to a tracheal tube compared with when IV dexamethasone is prescribed.   Materials and Methods: Two hundred and twenty five American Society of Anesthesiologist (ASA-class I and II patients undergoing elective abdominal surgery with tracheal intubation were randomly divided into three groups: betamethasone gel, intravenous (IV dexamethasone, and control groups. In the post-anesthesia care unit, a blinded anesthesiologist interviewed all patients regarding postoperative sore throat at 1,6, and 24 hours after surgery.   Results: The incidence of sore throat was significantly lower in the betamethasone gel group compared with the IV dexamethasone and control groups, 1, 6, and 24 hours after surgery. In the first day after surgery 10.7% of the betamethasone group had sore throat whereas 26.7% of the IV dexamethasone group and 30.7% of the control group had sore throat. Bucking before extubation was observed in 14(18.4%, 8(10.4%, and 9(12.2% patients, in the IV dexamethasone, betamethasone gel, and control group, respectively.   Conclusion:  We concluded that wide spread application of betamethasone gel over tracheal tubes effectively mitigates postoperative sore throat, compared with IV dexamethasone application.

Antioxidants for preventing and reducing muscle soreness after exercise.

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Ranchordas, Mayur K; Rogerson, David; Soltani, Hora; Costello, Joseph T

2017-12-14

Muscle soreness typically occurs after intense exercise, unaccustomed exercise or actions that involve eccentric contractions where the muscle lengthens while under tension. It peaks between 24 and 72 hours after the initial bout of exercise. Many people take antioxidant supplements or antioxidant-enriched foods before and after exercise in the belief that these will prevent or reduce muscle soreness after exercise. To assess the effects (benefits and harms) of antioxidant supplements and antioxidant-enriched foods for preventing and reducing the severity and duration of delayed onset muscle soreness following exercise. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, SPORTDiscus, trial registers, reference lists of articles and conference proceedings up to February 2017. We included randomised and quasi-randomised controlled trials investigating the effects of all forms of antioxidant supplementation including specific antioxidant supplements (e.g. tablets, powders, concentrates) and antioxidant-enriched foods or diets on preventing or reducing delayed onset muscle soreness (DOMS). We excluded studies where antioxidant supplementation was combined with another supplement. Two review authors independently screened search results, assessed risk of bias and extracted data from included trials using a pre-piloted form. Where appropriate, we pooled results of comparable trials, generally using the random-effects model. The outcomes selected for presentation in the 'Summary of findings' table were muscle soreness, collected at times up to 6 hours, 24, 48, 72 and 96 hours post-exercise, subjective recovery and adverse effects. We assessed the quality of the evidence using GRADE. Fifty randomised, placebo-controlled trials were included, 12 of which used a cross-over design. Of the 1089 participants, 961 (88.2%) were male and 128 (11.8%) were female. The age range for

Sore throat: effective communication delivers improved diagnosis, enhanced self-care and more rational use of antibiotics.

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van der Velden, A W; Bell, J; Sessa, A; Duerden, M; Altiner, A

2013-11-01

The majority of throat infections are of viral origin and resolve without antibiotic treatment. Despite this, antibiotic use for sore throat infections remains high, partly because it is difficult to determine when antibiotics may be useful, on the basis of physical findings alone. Antibiotics may be beneficial in bacterial throat infections under certain clinical and epidemiological circumstances; however, even many of those infections in which bacteria play a role do resolve just as quickly without antibiotics. Furthermore, non-medical factors such as patient expectations and patient pressure are also important drivers of antibiotic use. To address these issues, a behavioural change is required that can be facilitated by improved communication between primary healthcare providers and patients. In this article, we provide doctors, nurses and pharmacy staff, working in primary care or in the community, with a structured approach to sore throat management, with the aim of educating and empowering patients to self-manage their condition. The first component of this approach involves identifying and addressing patients' expectations and concerns with regard to their sore throat and eliciting their opinion on antibiotics. The second part is dedicated to a pragmatic assessment of the severity of the condition, with attention to red-flag symptoms and risk factors for serious complications. Rather than just focusing on the cause (bacterial or viral) of the upper respiratory tract infections as a rationale for antibiotic use, healthcare providers should instead consider the severity of the patient's condition and whether they are at high risk of complications. The third part involves counselling patients on effective self-management options and providing information on the expected clinical course. Such a structured approach to sore throat management, using empathetic, non-paternalistic language, combined with written patient information, will help to drive patient

How social media meet patients’ questions: YouTube™ review for mouth sores in children.

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Di Stasio, D; Romano, A; Paparella, R S; Gentile, C; Serpico, R; Minervini, G; Candotto, V; Laino, L

2018-01-01

Recurrent aphthous stomatitis (RAS) is one of the most common causes of mouth sores in children so the management of this condition is a matter of great importance. YouTube™ is increasingly being used by patients to obtain health-related information. The aim of this work is to examine the quality of information offered by YouTube™ about mouth sores in children (MSC). Searching the term ‘mouth sores in children’, (MSC) displayed 12.300 results. Of the top 60 videos analyzed, 31 were excluded following exclusion criteria. The major source of upload was from healthcare information channels (HC-41,38%), followed by individual users (HP-25.59%), healthcare professionals (IU-17.24%) and generalist information channels (HC-13.78%); 20.69% of them deal with predisposing factors, and related pathologies, the majority of these propose home remedies (60.72%) rather than topical analgesic drugs (21.43%), antimicrobials (7.14%) and topical steroids (3.57). Most of the videos analyzed were slightly useful (68.97%). Information about mouth sores in children on YouTube™ was poor regardless of the upload source. Analyzing health content on social platforms is a starting point for providing greater quality of health-related information.

A retrospective study: Multivariate logistic regression analysis of the outcomes after pressure sores reconstruction with fasciocutaneous, myocutaneous, and perforator flaps.

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Chiu, Yu-Jen; Liao, Wen-Chieh; Wang, Tien-Hsiang; Shih, Yu-Chung; Ma, Hsu; Lin, Chih-Hsun; Wu, Szu-Hsien; Perng, Cherng-Kang

2017-08-01

Despite significant advances in medical care and surgical techniques, pressure sore reconstruction is still prone to elevated rates of complication and recurrence. We conducted a retrospective study to investigate not only complication and recurrence rates following pressure sore reconstruction but also preoperative risk stratification. This study included 181 ulcers underwent flap operations between January 2002 and December 2013 were included in the study. We performed a multivariable logistic regression model, which offers a regression-based method accounting for the within-patient correlation of the success or failure of each flap. The overall complication and recurrence rates for all flaps were 46.4% and 16.0%, respectively, with a mean follow-up period of 55.4 ± 38.0 months. No statistically significant differences of complication and recurrence rates were observed among three different reconstruction methods. In subsequent analysis, albumin ≤3.0 g/dl and paraplegia were significantly associated with higher postoperative complication. The anatomic factor, ischial wound location, significantly trended toward the development of ulcer recurrence. In the fasciocutaneous group, paraplegia had significant correlation to higher complication and recurrence rates. In the musculocutaneous flap group, variables had no significant correlation to complication and recurrence rates. In the free-style perforator group, ischial wound location and malnourished status correlated with significantly higher complication rates; ischial wound location also correlated with significantly higher recurrence rate. Ultimately, our review of a noteworthy cohort with lengthy follow-up helped identify and confirm certain risk factors that can facilitate a more informed and thoughtful pre- and postoperative decision-making process for patients with pressure ulcers. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All

Parental contribution to over prescription of antibiotics for sore throat ...

African Journals Online (AJOL)

Introduction: Antibiotics are often prescribed by physicians for sore throat in children because of the danger of post streptococcal complications. The role of the parents in over prescription of antibiotics is less well known. Objective: To evaluate the knowledge, attitudes and practice of parents to antibiotic prescription for ...

Sore throat · vaginal discharge · labial ulcer · Dx?

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Caravelli, Ashley; Bhatnagar, Rupal; Ashaye, Adelola

2016-06-01

The patient complained of worsening vaginal pain and increased vaginal discharge, but reported resolution of her back and chest pain. She also said that a week earlier, she'd had a fever that reached 104° F and a sore throat. She denied urinary frequency/urgency, sexual activity, or sexual abuse.

Efficacy of flurbiprofen 8.75 mg lozenge in patients with a swollen and inflamed sore throat.

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Aspley, Sue; Shephard, Adrian; Schachtel, Emily; Sanner, Kathleen; Savino, Laurie; Schachtel, Bernard

2016-09-01

Sore throat is often over-treated with antibiotics, therefore there is a need for non-antibiotic treatments that provide effective relief. From the patient's point of view, symptoms of pharyngeal inflammation such as a "swollen" and "inflamed" throat are often considered the most bothersome; so, a non-steroidal anti-inflammatory drug could be an appropriate treatment. We investigated the efficacy and safety of flurbiprofen 8.75 mg lozenge in adults with a swollen and inflamed throat. We enrolled adults with moderate-to-severe sore throat and evidence of tonsillo-pharyngitis into a randomized, double-blind study. Patients received flurbiprofen 8.75 mg or placebo lozenges every 3-6 hours as needed (up to five lozenges in 24 hours) and rated their symptoms (sore throat pain, difficulty swallowing and the sensation of a swollen throat) on standard linear scales regularly over 24 hours. The efficacy of flurbiprofen lozenge was determined in patients reporting a swollen and inflamed throat at baseline, as well as those with relatively severe symptoms. ClinicalTrials.gov NCT01049334. The main outcome measures were the time-weighted summed differences in patient-reported sore throat pain, difficulty swallowing and swollen throat over 24 hours. Out of 204 patients, 124 (60.8%) described their throats as swollen and inflamed at baseline. Flurbiprofen lozenges provided greater relief than placebo over 24 hours: 79.8%, 99.6% and 69.3% (for sore throat pain, difficulty swallowing and swollen throat, respectively, all P ≤ 0.01). These outcomes were more substantial in patients with relatively severe symptoms. No serious or unexpected adverse events occurred. Flurbiprofen 8.75 mg lozenge appears to provide effective, well-tolerated relief of sore throat, difficulty swallowing and swollen throat in adults with a swollen and inflamed throat, as well as those with relatively severe symptoms. A limitation of these findings is that, while predetermined, these are

Efficacy of flurbiprofen 8.75 mg spray in patients with sore throat due to an upper respiratory tract infection: A randomised controlled trial.

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de Looze, Ferdinandus; Russo, Marc; Bloch, Mark; Montgomery, Barney; Shephard, Adrian; Smith, Gary; Aspley, Sue

2016-06-01

Viral infections cause most cases of pharyngitis (sore throat); consequently, antibiotics are generally not warranted. However, a treatment targeting pain and inflammation, e.g. a topical non-steroidal anti-inflammatory spray, may be helpful for patients. To evaluate the efficacy and safety of flurbiprofen 8.75 mg spray. This randomised, double-blind, parallel group study was conducted at six community-based clinical research centres in Australia and two in New Zealand. Adults with sore throat due to upper respiratory tract infection (onset ≤ four days) took one dose of flurbiprofen (n = 249) or placebo spray (n = 256); after six hours, they could re-dose every three-six hours as required, for three days (max. five doses/day). The primary endpoint was the area under the change from baseline curve in throat soreness from zero-two hours (AUC0-2h). The change from baseline in other sore throat symptoms also assessed efficacy. The mean AUC0-2h for throat soreness was significantly greater with flurbiprofen spray (-1.82; 95% CI: -1.98 to 1.65) compared with placebo (-1.13; 95% CI: -1.27 to 0.99) (P flurbiprofen spray compared with placebo from the first time-points assessed (five minutes for throat soreness/difficulty swallowing, 20 minutes for sore throat pain intensity and 30 minutes for swollen throat) for up to six hours (P Flurbiprofen spray provides rapid and long-lasting relief from sore throat symptoms, and is well-tolerated over three days.

EFFECT OF CAFFEINE ON THE AMOUNT OF PERCEIVED PAIN, JOINT RANGE OF MOTION AND EDEMA AFTER DELAYED MUSCLE SORENESS

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Karabalaeifar Sara

2013-01-01

Full Text Available Delayed onset muscle soreness usually occurs after doing a new unusual physical activity, especially when, associated with repeated eccentric contractions and then it gradually disappears. There is not an extensive agreement in the case of treatment method of soreness signs quick reduction. This research was carried out with the aim of investigation caffeine consumption effect to find a good way in order to reduce the signs of delayed onset muscle soreness. In this semi-experimental with Double-blind design, 16 female volleyball player with an age average of 22.5+2.5 in 2 homogeneous 8 subject control and experimental group were studied. In this research, the effect of caffeine existing in coffee in 5 stages (24h before exercise, 12h before, immediately before exercise, after exercise and 12h after it and 1mg per 1kg of body weight on amount of perceived pain and range of motion of the joint and edema due to delay onset muscle soreness because of 50 jumps and lands of a 1 meter stage was investigated. The results showed that caffeine consumption has a meaningful effect on reduction of all the expressed signs after eccentric contractions. So it is recommended that physio thrapysts, doctors and athletes use this method to reduce delayed onset muscle soreness consequences after the injury.

Flurbiprofen 8.75 mg lozenges for treating sore throat symptoms: a randomized, double-blind, placebo-controlled study.

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Schachtel, Bernard P; Shephard, Adrian; Shea, Timothy; Sanner, Kathleen; Savino, Laurie; Rezuke, Jeanne; Schachtel, Emily; Aspley, Sue

2016-11-01

This study assessed multiple doses of flurbiprofen 8.75 mg lozenges for the relief of three prominent symptoms of acute pharyngitis: pain intensity (primary end point), difficulty swallowing and swollen throat. A total of 204 patients (102 in each group) with confirmed pharyngitis (onset ≤4 days) were randomly assigned to take up to five flurbiprofen or placebo lozenges every 3-6 h, for 7 days. Using validated rating scales (sore throat pain intensity, difficulty swallowing and swollen throat) patients rated their symptoms for the duration of the study. Over the first 24 h, patients treated with flurbiprofen lozenges reported significantly greater reductions in sore throat pain (47%) as well as difficulty swallowing (66%) and swollen throat (40%) compared with placebo (all p flurbiprofen lozenges provide effective relief of sore throat pain intensity as well as difficulty swallowing and swollen throat.

Watermelon juice: potential functional drink for sore muscle relief in athletes.

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Tarazona-Díaz, Martha P; Alacid, Fernando; Carrasco, María; Martínez, Ignacio; Aguayo, Encarna

2013-08-07

l-Citrulline is an excellent candidate to reduce muscle soreness, and watermelon is a fruit rich in this amino acid. This study investigated the potential of watermelon juice as a functional drink for athletes. An in vitro study of intestinal absorption of l-citrulline in Caco-2 cells was performed using unpasteurized (NW), pasteurized (80 °C for 40 s) watermelon juice (PW) and, as control, a standard of l-citrulline. l-citrulline bioavailability was greater when it was contained in a matrix of watermelon and when no heat treatment was applied. In the in vivo experiment (maximum effort test in a cycloergometer), seven athletes were supplied with 500 mL of natural watermelon juice (1.17 g of l-citrulline), enriched watermelon juice (4.83 g of l-citrulline plus 1.17 g from watermelon), and placebo. Both watermelon juices helped to reduce the recovery heart rate and muscle soreness after 24 h.

Comparative study of patients suffering sore throat after general anesthesia using laryngeal mask airway and cuffed pharyngeal tube in adults

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Hassani V

2001-09-01

Full Text Available Post-operative sore throat is one of the most common complications and complaints of patients after general anesthesia especially in operations that need endotracheal intubations. Its causes are: size of endotracheal tube and type of its cuff, inadequate airway humidification, trauma during intubation and suctioning, high flow of inspiratory gases, surgical manipulation of airway and adjacent organs, ect. Use of instruments with less invasion to upper respiratory tract, for example, face mask and airway, LMA or CPT are methods, used for decreasing the rate of post-operative sore throat. This study was performed to compare the rate of sore throat after general anesthesia between Laryngeal Mask Airway (LMA and Cuffed Pharyngeal Tube (CPT. From the patients, 120 ASA: PS-I cases, were selected, who were candidates for elective surgery of Orthopedics, Urology, General surgery and Gynecology in Hazrat Rasool-Akram Hospital Complex in the year 2000. Their operation were performed in supine position and did not need muscle relaxation and the patients had spontaneous breathing. Duration of surgery was less than 2 hours. The patients were randomly allocated into two groups: LMA was used for one group and CPT for others. Immediately after operation, in the recovery room and at 6, 12, 18 and 24 hours after removing the tube, the patients were asked about sore throat and the results were recorded in the related sheets. The results was 31.7 percent of patients in group LMA and 0 percent of patients in group CPT, had sore throat. There were significant difference between groups (LMA and CPT in presentation of sore throat (P<0.001.

Soreness during non-music activities is associated with playing-related musculoskeletal problems: an observational study of 731 child and adolescent instrumentalists

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Sonia Ranelli

2014-06-01

Full Text Available Question: Is exposure to non-music-related activities associated with playing-related musculoskeletal problems in young instrumentalists? Is non-music-activity-related soreness associated with playing-related musculoskeletal problems in this group of instrumentalists? Design: Observational study using a questionnaire and physical measures. Participants: 859 instrumentalists aged 7 to 17 years from the School of Instrumental Music program. Results: Of the 731 respondents who completed the questionnaire adequately, 412 (56% experienced instrument-playing problems; 219 (30% had symptoms severe enough to interfere with normal playing. Children commonly reported moderate exposure to non-music-related activities, such as watching television (61%, vigorous physical activity (57%, writing (51% and computer use (45%. Greater exposure to any non-music activity was not associated with playing problems, with odds ratios ranging from 1.01 (95% CI 0.7 to 1.5 for watching television to 2.08 (95% CI 0.5 to 3.3 for intensive hand activities. Four hundred and seventy eight (65% children reported soreness related to non-music activities, such as vigorous physical activity (52%, writing (40%, computer use (28%, intensive hand activities (22%, electronic game use (17% and watching television (15%. Non-music-activity-related soreness was significantly associated with instrument playing problems, adjusting for gender and age, with odds ratios ranging from 2.6 (95% CI 1.7 to 3.9 for soreness whilst watching television, to 4.3 (95% CI 2.6 to 7.1 for soreness during intensive hand activities. Conclusion: Non-music-activity-related soreness co-occurs significantly with playing problems in young instrumentalists. The finding of significant co-occurrence of music and non-music-related soreness in respondents in this study suggests that intervention targets for young instrumentalists could include risk factors previously identified in the general child and adolescent

Soreness during non-music activities is associated with playing-related musculoskeletal problems: an observational study of 731 child and adolescent instrumentalists.

Science.gov (United States)

Ranelli, Sonia; Straker, Leon; Smith, Anne

2014-06-01

Is exposure to non-music-related activities associated with playing-related musculoskeletal problems in young instrumentalists? Is non-music-activity-related soreness associated with playing-related musculoskeletal problems in this group of instrumentalists? Observational study using a questionnaire and physical measures. 859 instrumentalists aged 7 to 17 years from the School of Instrumental Music program. Of the 731 respondents who completed the questionnaire adequately, 412 (56%) experienced instrument-playing problems; 219 (30%) had symptoms severe enough to interfere with normal playing. Children commonly reported moderate exposure to non-music-related activities, such as watching television (61%), vigorous physical activity (57%), writing (51%) and computer use (45%). Greater exposure to any non-music activity was not associated with playing problems, with odds ratios ranging from 1.01 (95% CI 0.7 to 1.5) for watching television to 2.08 (95% CI 0.5 to 3.3) for intensive hand activities. Four hundred and seventy eight (65%) children reported soreness related to non-music activities, such as vigorous physical activity (52%), writing (40%), computer use (28%), intensive hand activities (22%), electronic game use (17%) and watching television (15%). Non-music-activity-related soreness was significantly associated with instrument playing problems, adjusting for gender and age, with odds ratios ranging from 2.6 (95% CI 1.7 to 3.9) for soreness whilst watching television, to 4.3 (95% CI 2.6 to 7.1) for soreness during intensive hand activities. Non-music-activity-related soreness co-occurs significantly with playing problems in young instrumentalists. The finding of significant co-occurrence of music and non-music-related soreness in respondents in this study suggests that intervention targets for young instrumentalists could include risk factors previously identified in the general child and adolescent population, as well as music-specific risk factors. This is an

Diabetes: Good Diabetes Management and Regular Foot Care Help Prevent Severe Foot Sores

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Amputation and diabetes: How to protect your feet Good diabetes management and regular foot care help prevent severe foot sores that ... and may require amputation. By Mayo Clinic Staff Diabetes complications can include nerve damage and poor blood ...

Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures

Science.gov (United States)

Pearcey, Gregory E. P.; Bradbury-Squires, David J.; Kawamoto, Jon-Erik; Drinkwater, Eric J.; Behm, David G.; Button, Duane C.

2015-01-01

Context: After an intense bout of exercise, foam rolling is thought to alleviate muscle fatigue and soreness (ie, delayed-onset muscle soreness [DOMS]) and improve muscular performance. Potentially, foam rolling may be an effective therapeutic modality to reduce DOMS while enhancing the recovery of muscular performance. Objective: To examine the effects of foam rolling as a recovery tool after an intense exercise protocol through assessment of pressure-pain threshold, sprint time, change-of-direction speed, power, and dynamic strength-endurance. Design: Controlled laboratory study. Setting: University laboratory. Patients or Other Participants: A total of 8 healthy, physically active males (age = 22.1 ± 2.5 years, height = 177.0 ± 7.5 cm, mass = 88.4 ± 11.4 kg) participated. Intervention(s): Participants performed 2 conditions, separated by 4 weeks, involving 10 sets of 10 repetitions of back squats at 60% of their 1-repetition maximum, followed by either no foam rolling or 20 minutes of foam rolling immediately, 24, and 48 hours postexercise. Main Outcome Measure(s): Pressure-pain threshold, sprint speed (30-m sprint time), power (broad-jump distance), change-of-direction speed (T-test), and dynamic strength-endurance. Results: Foam rolling substantially improved quadriceps muscle tenderness by a moderate to large amount in the days after fatigue (Cohen d range, 0.59 to 0.84). Substantial effects ranged from small to large in sprint time (Cohen d range, 0.68 to 0.77), power (Cohen d range, 0.48 to 0.87), and dynamic strength-endurance (Cohen d = 0.54). Conclusions: Foam rolling effectively reduced DOMS and associated decrements in most dynamic performance measures. PMID:25415413

An Intelligent FPGA Based Anti-Sweating System for Bed Sore Prevention in a Clinical Environment

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K. S. Jaichandar

2011-01-01

Full Text Available Bed sores, a common problem among immobile patients occur as a result of continuous sweating due to increase in skin to bed surface temperature in patients lying on same posture for prolonged period. If left untreated, the skin can break open and become infected. Currently adopted methods for bed sores prevention include: use of two hourly flip chat for repositioning patient or use of air fluidized beds. However, the setbacks of these preventive measures include either use of costly equipment or wastage of human resources. This paper introduces an intelligent low cost FPGA based anti-sweating system for bed sores prevention in a clinical environment. The developed system consists of bed surface implanted temperature sensors interfaced with an FPGA chip for sensing the temperature change in patient’s skin to bed surface. Based on the temperature change, the FPGA chip select the - mode (heater/cooler and speed of the fan module. Furthermore, an alarm module was implemented to alert the nurse to reposition the patient only if patient’s skin to bed surface temperature exceeds a predefined threshold thereby saving human resources. By integrating the whole system into a single FPGA chip, we were able to build a low cost compact system without sacrificing processing power and flexibility.

Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial

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2014-09-26

SEP 2014 2. REPORT TYPE Final 3. DATES COVERED 4. TITLE AND SUBTITLE Ear acupuncture for acute sore throat. A randomized controlled trial...Auncular Acupuncture is a low risk option for acute pain control •Battlefield acupuncture (BFA) IS a specific auncular acupuncture technique •BFA IS...Strengths: Prospect1ve RCT •Weaknesses Small sample stze. no sham acupuncture performed, patients not blinded to treatment •Th1s study represents an

Stakeholders' views of recurrent sore throat, tonsillitis and their management: a qualitative interview study for the NAtional Trial of Tonsillectomy IN Adults (NATTINA Part 1).

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McSweeney, L A; Rousseau, N S; Wilson, J A; Wilkes, S; Haighton, C A

2017-04-01

To determine the impact of recurrent sore throats and tonsillitis in adults and stakeholder views of treatment pathways. Qualitative semistructured interview design reporting novel data from a feasibility study for a UK national trial of tonsillectomy in adults. Nine study sites linked to ear, nose and throat departments in National Health Service hospitals located across the United Kingdom. Fifteen patients, 11 general practitioners and 22 ear, nose and throat staff consented to in-depth interviews, which were analysed using a framework analysis approach. Views of stakeholder groups. Recurrent sore throats were reported to severely impact patients' family, work and social life. Ear, nose and throat staff stated that patients faced increasing barriers to secondary care service access. General practitioners were under pressure to reduce 'limited clinical value' surgical procedures. The findings from this study suggest that there is a disconnect between the attitudes of the stakeholders and the reality of recurrent sore throat, tonsillectomy procedures and service provision. More evidence for the role of tonsillectomy is needed from randomised controlled trials to determine whether it should continue to be ranked as a procedure of limited clinical effectiveness. © 2016 John Wiley & Sons Ltd.

Evidence for antibiotic use for sore throat and URTI in general practice

African Journals Online (AJOL)

banzi

508 C M E September 2003 Vol.21 No.9. There is a common misconception among many people that antibiotics are necessary for common colds and their symptoms. Evidence- based medicine can provide a rational approach to this problem. Evidence for antibiotic use for sore throat and URTI in general practice. G T J KA ...

Utility of the sore throat pain model in a multiple-dose assessment of the acute analgesic flurbiprofen: a randomized controlled study.

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Schachtel, Bernard; Aspley, Sue; Shephard, Adrian; Shea, Timothy; Smith, Gary; Schachtel, Emily

2014-07-03

The sore throat pain model has been conducted by different clinical investigators to demonstrate the efficacy of acute analgesic drugs in single-dose randomized clinical trials. The model used here was designed to study the multiple-dose safety and efficacy of lozenges containing flurbiprofen at 8.75 mg. Adults (n=198) with moderate or severe acute sore throat and findings of pharyngitis on a Tonsillo-Pharyngitis Assessment (TPA) were randomly assigned to use either flurbiprofen 8.75 mg lozenges (n=101) or matching placebo lozenges (n=97) under double-blind conditions. Patients sucked one lozenge every three to six hours as needed, up to five lozenges per day, and rated symptoms on 100-mm scales: the Sore Throat Pain Intensity Scale (STPIS), the Difficulty Swallowing Scale (DSS), and the Swollen Throat Scale (SwoTS). Reductions in pain (lasting for three hours) and in difficulty swallowing and throat swelling (for four hours) were observed after a single dose of the flurbiprofen 8.75 mg lozenge (Pflurbiprofen-treated patients experienced a 59% greater reduction in throat pain, 45% less difficulty swallowing, and 44% less throat swelling than placebo-treated patients (all Pflurbiprofen 8.75 mg lozenges were shown to be an effective, well-tolerated treatment for sore throat pain. Other pharmacologic actions (reduced difficulty swallowing and reduced throat swelling) and overall patient satisfaction from the flurbiprofen lozenges were also demonstrated in this multiple-dose implementation of the sore throat pain model. This trial was registered with ClinicalTrials.gov, registration number: NCT01048866, registration date: January 13, 2010.

Combined V-Y Fasciocutaneous Advancement and Gluteus Maximus Muscle Rotational Flaps for Treating Sacral Sores

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Hyun Ho Han

2016-01-01

Full Text Available The sacral area is the most common site of pressure sore in bed-ridden patients. Though many treatment methods have been proposed, a musculocutaneous flap using the gluteus muscles or a fasciocutaneous flap is the most popular surgical option. Here, we propose a new method that combines the benefits of these 2 methods: combined V-Y fasciocutaneous advancement and gluteus maximus muscle rotational flaps. A retrospective review was performed for 13 patients who underwent this new procedure from March 2011 to December 2013. Patients’ age, sex, accompanying diseases, follow-up duration, surgical details, complications, and recurrence were documented. Computed tomography was performed postoperatively at 2 to 4 weeks and again at 4 to 6 months to identify the thickness and volume of the rotational muscle portion. After surgery, all patients healed within 1 month; 3 patients experienced minor complications. The average follow-up period was 13.6 months, during which time 1 patient had a recurrence (recurrence rate, 7.7%. Average thickness of the rotated muscle was 9.43 mm at 2 to 4 weeks postoperatively and 9.22 mm at 4 to 6 months postoperatively (p=0.087. Muscle thickness had not decreased, and muscle volume was relatively maintained. This modified method is relatively simple and easy for reconstructing sacral sores, provides sufficient padding, and has little muscle donor-site morbidity.

Effects of acupuncture on symptoms and muscle function in delayed-onset muscle soreness.

Science.gov (United States)

Hübscher, Markus; Vogt, Lutz; Bernhörster, Marcus; Rosenhagen, Andreas; Banzer, Winfried

2008-10-01

This study was done to investigate the effects of a standardized acupuncture treatment on symptoms and muscle function in exercise-induced delayed-onset muscle soreness (DOMS). A prospective, randomized, controlled, observer and subject-blinded trial was undertaken. Twenty-two (22) healthy subjects (22-30 years; 10 males and 12 females) were randomly assigned to three treatment groups: real acupuncture (deep needling at classic acupuncture points and tender points; n = 7), sham-acupuncture (superficial needling at nonacupuncture points; n = 8), and control (no needling; n = 7). DOMS of the nondominant elbow-flexors was experimentally induced through eccentric contractions until exhaustion. The outcome measures were pain perception (visual analogue scale; VAS; range: 0-10 cm), mechanical pain threshold (MPT; pressure algometer), and maximum isometric voluntary force (MIVF; force transducer). Treatment was applied immediately, 24 and 48 hours after DOMS induction. Measurements of MPT and MIVF were made prior to DOMS induction as well as before and after every treatment session. VAS data were acquired after DOMS induction as well as pre- and post-treatment. Final pain, MPT, and MIVF measurements were performed 72 hours after DOMS induction. Following nonparametric testing, there were no significant differences between groups in outcome measures at baseline. After 72 hours, pain perception (VAS) was significantly lower in the acupuncture group compared to the sham acupuncture and control subjects. However, the mean MPT and MIVF scores were not significantly different between groups. Although acupuncture seemed to have no effects on mechanical pain threshold and muscle function, it proved to reduce perceived pain arising from exercise-induced muscle soreness.

Colgajo en hacha de tensor de fascia lata para úlceras por presión trocantereas Hatchet-Shaped fascia lata tensor flap for the treatment of trochanteric pressure sores

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W. Calderón

2010-12-01

Full Text Available Las úlceras trocantéreas por presión representan un problema importante a nivel extra e intrahospitalario. Existen múltiples opciones terapéuticas, ya sean colgajos randomizados, musculocutáneos, fasciocutáneos o libres. Presentamos la técnica quirúrgica del colgajo en hacha de tensor de fascia lata para el tratamiento de esta patología. Consiste en el diseño de un colgajo en V con irrigación por su base superior, que contacta con la úlcera por uno de sus extremos, simulando la forma de un hacha. Resecamos la úlcera hasta obtener un lecho vital, resecando además el hueso prominente dicho hasta un plano en que se visualice tejido sano. Levantamos y rotamos el colgajo cubriendo el defecto. Finalmente se realiza el cierre primario en VY sin tensión. La zona donante permite un cierre primario sin tensión. Mantenemos drenajes durante 10 días. Este colgajo permite obtener una buena cobertura para úlceras trocantéreas por decúbito con un adecuado resultado cosmético. Recogemos una casuística de 17 úlceras tratadas mediante el colgajo descrito; como complicaciones se presentaron 3 seromas, resueltos con sistema de cierre con presión negativa externa e interna; 2 casos de dehiscencia de sutura y 2 hematomas resueltos en pabellón de cirugía. Creemos pertinente conocer este colgajo que debe estar siempre presente dentro de las posibilidades terapéuticas para pacientes con úlceras trocantereas por decúbito.The trochanteric pressure sore it´s an important intra and extrahospitalary problem. There are different therapeutic options for this pathology, for example random, musculocutaneous, fasciocutaneous or free flaps. We present the hatchet-shaped fascia lata tensor flap to treat this kind of lesions. We design a V flap with irrigation in the superior base, having one of the extreme in contact with the sore. The shape of the flap is a hatchet. It´s important to get a vital bed resecting affected tissues and prominent bone; then

Evaluation of the effectiveness of kinesiotaping in reducing delayed onset muscle soreness of the biceps brachii

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Boguszewski Dariusz

2016-07-01

Full Text Available biological regeneration in athletes. The aim of this study was to evaluate the effectiveness of the application of lymphatic kinesiotaping in reducing delayed onset muscle soreness of biceps brachii.

Delayed onset muscle soreness : treatment strategies and performance factors.

Science.gov (United States)

Cheung, Karoline; Hume, Patria; Maxwell, Linda

2003-01-01

Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted.A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of

[Prescribing antibiotics for sore throat: a persistent habit].

Science.gov (United States)

Damoiseaux, Roger A M J; Venekamp, Roderick P

2015-01-01

Recently the revision of the guideline of the Dutch College of General Practitioners on sore throat has been published. Again, one of the key messages is restricting the use of antibiotics. In the Netherlands general practitioners prescribe antibiotics in 50% of cases of tonsillitis. Although there has been a decrease in the number of antibiotic prescriptions for tonsillitis in the last 30 years, they are still being prescribed twice as often as is recommended by the guideline. The beliefs of both patient and doctor play an important role in prescribing and better communication might help to improve the situation. Public campaigns can also help by providing the best knowledge on the effectiveness of antibiotics to the public.

EFFECTS OF TWO DIFFERENT DOSAGE OF BCAA SUPPLEMENTATION ON SERUM INDICES OF MUSCLE DAMAGE AND SORENESS IN SOCCER PLAYERS

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Payam Mohamad-Panahi

2013-06-01

Full Text Available The purpose of this study was to investigation of the effects of two different dose of BCAA supplementation on serum indices of muscle damage and soreness in soccer players. 30 male soccer players (age: 20.2+-0.6 yr participated as subjects in this study. Subjects were randomly divided into three groups (double-blind design. All subjects performed lower- body resistance exercise (6 sets, 10 repetitions, 70% 1RM. The BCAA was given at doses of 200 and 450 mg.kg -1 BW for supplemental groups 1 and 2, respectively, 30 minutes before and after to exercise tests and carbohydrate was given at dose of 200 mg.kg -1 BW for placebo group. To identify enzymes activity (IU/L, venous blood samples were collected 30 min prior to exercise and at 24 and 48 hrs post exercise. Data were statistically analyzed using repeated measures ANOVA and Bonfferoni test. Baseline CK, CK-MB and muscle soreness were determined 30 minutes before the exercise test. Baseline serum values for CK, CK-MB and baseline muscle soreness were not different between groups in the 30 minutes before the exercise test (p>0/05. However, there were significant increases between the pre-exercise and post-exercise values for CK, CK-MB and muscle soreness from 24 hrs to 48 hrs post-test (p<0/05, but there were no significant differences between two groups (p< 0.05(. These results suggested that two different dosages of BCAA supplementation did not affect muscle damage and muscle sureness during resistance exercise bout in soccer players.

Design of a Novel Two-Component Hybrid Dermal Scaffold for the Treatment of Pressure Sores.

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Sharma, Vaibhav; Kohli, Nupur; Moulding, Dale; Afolabi, Halimat; Hook, Lilian; Mason, Chris; García-Gareta, Elena

2017-11-01

The aim of this study is to design a novel two-component hybrid scaffold using the fibrin/alginate porous hydrogel Smart Matrix combined to a backing layer of plasma polymerized polydimethylsiloxane (Sil) membrane to make the fibrin-based dermal scaffold more robust for the treatment of the clinically challenging pressure sores. A design criteria are established, according to which the Sil membranes are punched to avoid collection of fluid underneath. Manual peel test shows that native silicone does not attach to the fibrin/alginate component while the plasma polymerized silicone membranes are firmly bound to fibrin/alginate. Structural characterization shows that the fibrin/alginate matrix is intact after the addition of the Sil membrane. By adding a Sil membrane to the original fibrin/alginate scaffold, the resulting two-component scaffolds have a significantly higher shear or storage modulus G'. In vitro cell studies show that dermal fibroblasts remain viable, proliferate, and infiltrate the two-component hybrid scaffolds during the culture period. These results show that the design of a novel two-component hybrid dermal scaffold is successful according to the proposed design criteria. To the best of the authors' knowledge, this is the first study that reports the combination of a fibrin-based scaffold with a plasma-polymerized silicone membrane. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Resting energy expenditure and body composition in bedridden institutionalized elderly women with advanced-stage pressure sores.

Science.gov (United States)

Sergi, Giuseppe; Coin, Alessandra; Mulone, Silvana; Castegnaro, Eugenio; Giantin, Valter; Manzato, Enzo; Busetto, Luca; Inelmen, Emine Meral; Marin, Sara; Enzi, Giuliano

2007-03-01

Our study investigated nutritional status, body composition, and resting energy expenditure (REE) in elderly patients with advanced-stage pressure sores (PS), in addition to researching any hypermetabolic condition and its relationship with PS size. The study involved 52 institutionalized bedridden elderly women (aged 83.7 +/- 6.3 years), divided into two groups: 23 with advanced-stage (stage 3 and 4) PS and 29 without PS. Albumin, prealbumin, and retinol-binding protein were measured in all patients, and fat-free mass (FFM) and fat mass (FM) were obtained by dual-energy x-ray absorptiometry (DEXA). REE was measured by indirect calorimetry and predicted with the Harris-Benedict formula. PS area and volume were also measured. The elderly women with and without PS were comparable in age, FFM, and FM. Mean albumin, prealbumin, and retinol-binding protein values were lower in cases with PS. Unadjusted mean REE was significantly higher in patients with PS (1212.3 +/- 236.7 vs 1085.5 +/- 161.3 kcal/d; p 110% of the predicted REE, was seen in 74% of patients with PS and 38% of controls. The difference between measured and predicted REE (DeltaREE) correlated with PS volume (r = 0.58; p elderly women are associated with a hypermetabolic state that is influenced by the volume of the PS.

Cold-water immersion (cryotherapy for preventing and treating muscle soreness after exercise

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Chris Bleakley

Full Text Available BACKGROUND: Many strategies are in use with the intention of preventing or minimizing delayed onset muscle soreness and fatigue after exercise. Cold-water immersion, in water temperatures of less than 15 °C, is currently one of the most popular interventional strategies used after exercise. OBJECTIVES: To determine the effects of cold-water immersion in the management of muscle soreness after exercise. SEARCH METHODS: In February 2010, we searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library (2010, Issue 1, Medline, Embase, Cumulative Index to Nursing and Allied Health (CINAHL, British Nursing Index and archive (BNI, and the Physiotherapy Evidence Database (PEDro. We also searched the reference lists of articles, handsearched journals and conference proceedings and contacted experts. In November 2011, we updated the searches of Central (2011, Issue 4, Medline (up to November Week 3 2011, Embase (to 2011 Week 46 and CINAHL (to 28 November 2011 to check for more recent publications. SELECTION CRITERIA: Randomized and quasi-randomized trials comparing the effect of using cold-water immersion after exercise with: passive intervention (rest/no intervention, contrast immersion, warm-water immersion, active recovery, compression, or a different duration/dosage of cold-water immersion. Primary outcomes were pain (muscle soreness or tenderness (pain on palpation, and subjective recovery (return to previous activities without signs or symptoms. DATA COLLECTION AND ANALYSIS: Three authors independently evaluated study quality and extracted data. Some of the data were obtained following author correspondence or extracted from graphs in the trial reports. Where possible, data were pooled using the fixed-effect model. MAIN RESULTS: Seventeen small trials were included, involving a total of 366 participants. Study quality was low. The temperature, duration and

Blood flow after contraction and cuff occlusion is reduced in subjects with muscle soreness after eccentric exercise

DEFF Research Database (Denmark)

Souza-Silva, Eduardo; Wittrup Christensen, Steffan; Hirata, Rogerio Pessoto

2018-01-01

Purpose: Delayed onset muscle soreness (DOMS) occur within 1-2 days after eccentric exercise but the mechanism mediating hypersensitivity is unclear. This study hypothesized that eccentric exercise reduces the blood flow response following muscle contractions and cuff occlusion, which may result...... anterior muscle. All measures were done bilaterally at day-0 (pre-exercise), day-2 and day-6 (post-exercise). Subjects scored the muscle soreness on a Likert scale for 6 days. Results: Eccentric exercise increased Likert scores at day-1 and day-2 compared with day-0 (P... in accumulated algesic substances being a part of the sensitization in DOMS. Methods: Twelve healthy subjects (5 women) performed dorsiflexion exercise (5 sets of 10 repeated eccentric contractions) in one leg, while the contralateral leg was the control. The maximal voluntary contraction (MVC) of the tibialis...

Interleukin-6 and Delayed Onset Muscle Soreness Do Not Vary during the Menstrual Cycle

Science.gov (United States)

Chaffin, Morgan E.; Berg, Kris E.; Meendering, Jessica R.; Llewellyn, Tamra L.; French, Jeffrey A.; Davis, Jeremy E.

2011-01-01

The purpose of this study was to determine if a difference in interleukin-6 (IL-6) and delayed onset muscles soreness (DOMS) exists in two different phases of the menstrual cycle. Nine runners performed one 75-min high-intensity interval running session during the early follicular (EF) phase and once during the midluteal (ML) phase of the…

Pain relief of sore throat with a new anti-inflammatory throat lozenge, ibuprofen 25 mg: A randomised, double-blind, placebo-controlled, international phase III study.

Science.gov (United States)

Bouroubi, Athmane; Donazzolo, Yves; Donath, Franck; Eccles, Ron; Russo, Marc; Harambillet, Nadine; Gautier, Stéphanie; Montagne, Agnès

2017-09-01

The aim of this study was to compare the efficacy and safety of a new oromucosal ibuprofen form, ibuprofen 25 mg lozenge, in single and repeat dosing for up to 4 days, to the matched placebo, in the treatment of acute sore throat pain in adults. In this randomised, double-blind, placebo-controlled trial, adult patients with non-streptococcal sore throat and signs of moderate-to-severe associated pain (≥5 on the objective Tonsillo-Pharyngitis Assessment 21-point scale and ≥60 mm on the subjective 0-100 mm visual analogue Sore Throat Pain Intensity Scale [STPIS]) were assigned ibuprofen 25 mg (n=194) or matching placebo (n=191) lozenge treatment. Efficacy was assessed (at the investigating centre up to 2 hours after first dosing, then on an ambulatory basis) by parameters derived from patient's scores on scales of pain relief, pain intensity, and global efficacy assessment. The primary efficacy end-point was the time-weighted TOTal PAin Relief (TOTPAR) over 2 hours after first dosing using the Sore Throat Relief Scale (STRS). Safety and local tolerability were assessed. Ibuprofen 25 mg was superior to placebo on numerous pain relief parameters; TOTPAR was significantly higher with ibuprofen 25 mg over 2 hours after first dosing (Ppain (n=128), after an average 4 days (Prelief of sore throat pain and is as well tolerated as placebo. ClinicalTrials.gov, NCT01785862. © 2017 John Wiley & Sons Ltd.

Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults.

Science.gov (United States)

Costello, Joseph T; Baker, Philip R A; Minett, Geoffrey M; Bieuzen, Francois; Stewart, Ian B; Bleakley, Chris

2015-09-18

Recovery strategies are often used with the intention of preventing or minimising muscle soreness after exercise. Whole-body cryotherapy, which involves a single or repeated exposure(s) to extremely cold dry air (below -100 °C) in a specialised chamber or cabin for two to four minutes per exposure, is currently being advocated as an effective intervention to reduce muscle soreness after exercise. To assess the effects (benefits and harms) of whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, the British Nursing Index and the Physiotherapy Evidence Database. We also searched the reference lists of articles, trial registers and conference proceedings, handsearched journals and contacted experts.The searches were run in August 2015. We aimed to include randomised and quasi-randomised trials that compared the use of whole-body cryotherapy (WBC) versus a passive or control intervention (rest, no treatment or placebo treatment) or active interventions including cold or contrast water immersion, active recovery and infrared therapy for preventing or treating muscle soreness after exercise in adults. We also aimed to include randomised trials that compared different durations or dosages of WBC. Our prespecified primary outcomes were muscle soreness, subjective recovery (e.g. tiredness, well-being) and adverse effects. Two review authors independently screened search results, selected studies, assessed risk of bias and extracted and cross-checked data. Where appropriate, we pooled results of comparable trials. The random-effects model was used for pooling where there was substantial heterogeneity. We assessed the quality of the evidence using GRADE. Four laboratory-based randomised controlled trials were included. These reported results for 64

The value of pressure ulcer risk assessment and interface pressure measurements in patients: A nursing perspective

NARCIS (Netherlands)

J.T.M. Weststrate

2005-01-01

textabstractPressure sores in an intensive care unit 35 and related variables: a descriptive study Prevalence of pressure ulcers, risk factors 47 and the use of pressure-relieving mattresses in ICU patients The clinical relevance of the Waterlow 61 Pressure Sore Risk Scale in the ICU The

The Effects of Eccentric Contraction Duration on Muscle Strength, Power Production, Vertical Jump, and Soreness.

Science.gov (United States)

Mike, Jonathan N; Cole, Nathan; Herrera, Chris; VanDusseldorp, Trisha; Kravitz, Len; Kerksick, Chad M

2017-03-01

Mike, JN, Cole, N, Herrera, C, VanDusseldorp, T, Kravitz, L, and Kerksick, CM. The effects of eccentric contraction duration on muscle strength, power production, vertical jump, and soreness. J Strength Cond Res 31(3): 773-786, 2017-Previous research has investigated the effects of either eccentric-only training or comparing eccentric and concentric exercise on changes related to strength and power expression, but no research to date has investigated the impact of altering the duration of either the concentric or the eccentric component on these parameters. Therefore, the purpose of this study was to assess the duration of eccentric (i.e., 2-second, 4-second vs. 6-second) muscle contractions and their effect on muscle strength, power production, vertical jump, and soreness using a plate-loaded barbell Smith squat exercise. Thirty college-aged men (23 ± 3.5 years, 178 ± 6.8 cm, 82 ± 12 kg, and 11.6 ± 5.1% fat) with 3.0 ± 1.0 years of resistance training experience and training frequency of 4.3 ± 0.9 days per week were randomized and assigned to 1 of 3 eccentric training groups that incorporated different patterns of contraction. For every repetition, all 3 groups used 2-second concentric contractions and paused for 1 second between the concentric and eccentric phases. The control group (2S) used 2-second eccentric contractions, whereas the 4S group performed 4-second eccentric contractions and the 6S group performed 6-second eccentric contractions. All repetitions were completed using the barbell Smith squat exercise. All participants completed a 4-week training protocol that required them to complete 2 workouts per week using their prescribed contraction routine for 4 sets of 6 repetitions at an intensity of 80-85% one repetition maximum (1RM). For all performance data, significant group × time (G × T) interaction effects were found for average power production across all 3 sets of a squat jump protocol (p = 0.04) while vertical jump did not reach

Blood flow after contraction and cuff occlusion is reduced in subjects with muscle soreness after eccentric exercise

DEFF Research Database (Denmark)

Souza-Silva, Eduardo; Wittrup Christensen, Steffan; Hirata, Rogerio Pessoto

2018-01-01

Purpose: Delayed onset muscle soreness (DOMS) occur within 1-2 days after eccentric exercise but the mechanism mediating hypersensitivity is unclear. This study hypothesized that eccentric exercise reduces the blood flow response following muscle contractions and cuff occlusion, which may result ...

Effect of silver sulfadiazine treat in Ⅲ-Ⅳ period pressure sores%磺胺嘧啶银治疗Ⅲ～Ⅳ期压疮的疗效观察

Institute of Scientific and Technical Information of China (English)

曹燕文; 顾宏华

2015-01-01

目的：探讨磺胺嘧啶银在压疮患者中的应用效果。方法：2012年1月～2013年10月收治住院患者124例，将其随机等分为对照组和试验组，对照组采用庆大霉素治疗压疮，试验组采用磺胺嘧啶银治疗压疮。比较两组患者的疗效。结果：试验组患者疗效优于对照组（P＜0．05）。结论：对患者采用磺胺嘧啶银治疗，疗程短，治愈率高，疗效显著，符合现代伤口换药湿性愈合的理念。%Objective:To investigate the therapeutic effects of silver sulfadiazine in pressure sores .Methods:124 patients who were admitted to hospital in Jan.2012-Oct.2013.were randomly divided into control group and experimental group .The control group using gentamicin treatment of pressure sores on patients,the experimental group using silver sulfadiazine treatment .Results:The experimental group was significantly better than the control group .Conclu-sion:Patients with silver sulfadiazine treatment had some advontages,such as short course,high cure rate,a significant effect,in line with current wound dressing moist healing concept.

Effects of winter military training on energy balance, whole-body protein balance, muscle damage, soreness, and physical performance.

Science.gov (United States)

Margolis, Lee M; Murphy, Nancy E; Martini, Svein; Spitz, Marissa G; Thrane, Ingjerd; McGraw, Susan M; Blatny, Janet-Martha; Castellani, John W; Rood, Jennifer C; Young, Andrew J; Montain, Scott J; Gundersen, Yngvar; Pasiakos, Stefan M

2014-12-01

Physiological consequences of winter military operations are not well described. This study examined Norwegian soldiers (n = 21 males) participating in a physically demanding winter training program to evaluate whether short-term military training alters energy and whole-body protein balance, muscle damage, soreness, and performance. Energy expenditure (D2(18)O) and intake were measured daily, and postabsorptive whole-body protein turnover ([(15)N]-glycine), muscle damage, soreness, and performance (vertical jump) were assessed at baseline, following a 4-day, military task training phase (MTT) and after a 3-day, 54-km ski march (SKI). Energy intake (kcal·day(-1)) increased (P balance was lower (P military training provide the basis for future studies to evaluate nutritional strategies that attenuate protein loss and sustain performance during severe energy deficits.

Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Jianmin Guo

2017-09-01

Full Text Available Purpose: The purpose of this systematic review and meta-analysis was to evaluate the effects of massage on alleviating delayed onset of muscle soreness (DOMS and muscle performance after strenuous exercise.Method: Seven databases consisting of PubMed, Embase, EBSCO, Cochrane Library, Web of Science, CNKI and Wanfang were searched up to December 2016. Randomized controlled trials (RCTs were eligible and the outcomes of muscle soreness, performance (including muscle maximal isometric force (MIF and peak torque and creatine kinase (CK were used to assess the effectiveness of massage intervention on DOMS.Results: Eleven articles with a total of 23 data points (involving 504 participants satisfied the inclusion criteria and were pooled in the meta-analysis. The findings demonstrated that muscle soreness rating decreased significantly when the participants received massage intervention compared with no intervention at 24 h (SMD: –0.61, 95% CI: –1.17 to –0.05, P = 0.03, 48 h (SMD: –1.51, 95% CI: –2.24 to –0.77, P < 0.001, 72 h (SMD: –1.46, 95% CI: –2.59 to –0.33, P = 0.01 and in total (SMD: –1.16, 95% CI: –1.60 to –0.72, P < 0.001 after intense exercise. Additionally, massage therapy improved MIF (SMD: 0.56, 95% CI: 0.21–0.90, P = 0.002 and peak torque (SMD: 0.38, 95% CI: 0.04–0.71, P = 0.03 as total effects. Furthermore, the serum CK level was reduced when participants received massage intervention (SMD: –0.64, 95% CI: –1.04 to –0.25, P = 0.001.Conclusion: The current evidence suggests that massage therapy after strenuous exercise could be effective for alleviating DOMS and improving muscle performance.

Effects of protein supplements on muscle damage, soreness and recovery of muscle function and physical performance: a systematic review.

Science.gov (United States)

Pasiakos, Stefan M; Lieberman, Harris R; McLellan, Tom M

2014-05-01

Protein supplements are frequently consumed by athletes and recreationally-active individuals, although the decision to purchase and consume protein supplements is often based on marketing claims rather than evidence-based research. To provide a systematic and comprehensive analysis of literature examining the hypothesis that protein supplements enhance recovery of muscle function and physical performance by attenuating muscle damage and soreness following a previous bout of exercise. English language articles were searched with PubMed and Google Scholar using protein and supplements together with performance, exercise, competition and muscle, alone or in combination as keywords. Inclusion criteria required studies to recruit healthy adults less than 50 years of age and to evaluate the effects of protein supplements alone or in combination with carbohydrate on performance metrics including time-to-exhaustion, time-trial or isometric or isokinetic muscle strength and markers of muscle damage and soreness. Twenty-seven articles were identified of which 18 dealt exclusively with ingestion of protein supplements to reduce muscle damage and soreness and improve recovery of muscle function following exercise, whereas the remaining 9 articles assessed muscle damage as well as performance metrics during single or repeat bouts of exercise. Papers were evaluated based on experimental design and examined for confounders that explain discrepancies between studies such as dietary control, training state of participants, sample size, direct or surrogate measures of muscle damage, and sensitivity of the performance metric. High quality and consistent data demonstrated there is no apparent relationship between recovery of muscle function and ratings of muscle soreness and surrogate markers of muscle damage when protein supplements are consumed prior to, during or after a bout of endurance or resistance exercise. There also appears to be insufficient experimental data

Impact of thermal loading and other water quality parameters on the epizootiology of red-sore disease in centrarchids. Progress report, December 1, 1977--November 30, 1978

Energy Technology Data Exchange (ETDEWEB)

Esch, G.W.; Hazen, T.C.

1978-07-01

The implications from these studies are varied, sometimes clear and sometimes less so, for many of the results have raised new and even more critical questions. Thus, our data clearly show that Aeromonas hydrophila is the etiological agent for red-sore disease. Furthermore, they suggest that the effects of temperature are twofold, first in increasing the density of the pathogen in the water column and then in affecting the physiology of the host organism to such an extent as to increase the probability of acquiring the pathogen. On the other hand, organic loading, suggested by other investigators as being important in red-sore disease, was not identified as being significant in the present study. However, if organic loading, or any of its consequences, can be shown to induce stress, then it may be as important in other systems as temperature is in Par Pond. Thus it is quite conceivable that it (organic loading), or some other water quality parameter, may create conditions conducive to increasing densities of A. hydrophila while simultaneously producing water quality characteristics which would lead to stress in fish, and then to increasing the probability of fish acquiring red-sore disease. An enigmatic observation (see Hazen, 1978, for details) is that A. hydrophila has been recovered from a variety of habitats throughout the U.S., yet red-sore disease is known to occur only in the southeast. This peculiar distribution pattern raises several important questions regarding the epizootiology of red-sore, not the least of which is the possibility of there existing differentially virulent strains of A. hydrophila and/or more or less susceptible populations of potential hosts in various parts of the country. Other significant questions are related to the variability in amplitude of red-sore disease from one year to the next among bass in Par Pond, the mode of entry of the pathogen into largemouth bass, and the basic, cellular mechanisms of stress in largemouth bass.

Impact of thermal loading and other water quality parameters on the epizootiology of red-sore disease in centrarchids. Progress report, December 1, 1977--November 30, 1978

International Nuclear Information System (INIS)

Esch, G.W.; Hazen, T.C.

1978-07-01

The implications from these studies are varied, sometimes clear and sometimes less so, for many of the results have raised new and even more critical questions. Thus, our data clearly show that Aeromonas hydrophila is the etiological agent for red-sore disease. Furthermore, they suggest that the effects of temperature are twofold, first in increasing the density of the pathogen in the water column and then in affecting the physiology of the host organism to such an extent as to increase the probability of acquiring the pathogen. On the other hand, organic loading, suggested by other investigators as being important in red-sore disease, was not identified as being significant in the present study. However, if organic loading, or any of its consequences, can be shown to induce stress, then it may be as important in other systems as temperature is in Par Pond. Thus it is quite conceivable that it (organic loading), or some other water quality parameter, may create conditions conducive to increasing densities of A. hydrophila while simultaneously producing water quality characteristics which would lead to stress in fish, and then to increasing the probability of fish acquiring red-sore disease. An enigmatic observation (see Hazen, 1978, for details) is that A. hydrophila has been recovered from a variety of habitats throughout the U.S., yet red-sore disease is known to occur only in the southeast. This peculiar distribution pattern raises several important questions regarding the epizootiology of red-sore, not the least of which is the possibility of there existing differentially virulent strains of A. hydrophila and/or more or less susceptible populations of potential hosts in various parts of the country. Other significant questions are related to the variability in amplitude of red-sore disease from one year to the next among bass in Par Pond, the mode of entry of the pathogen into largemouth bass, and the basic, cellular mechanisms of stress in largemouth bass

Influence of ginger and cinnamon intake on inflammation and muscle soreness endued by exercise in Iranian female athletes

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Nafiseh Shokri Mashhadi

2013-01-01

Conclusions: Administration of ginger and cinnamon in athlete women for six weeks did not show any significant change in the IL-6 level, but showed a decrease in muscle soreness in the cinnamon and ginger groups.

Supplementation with a Polyphenol-Rich Extract, TensLess® , Attenuates Delayed Onset Muscle Soreness and Improves Muscle Recovery from Damages After Eccentric Exercise.

Science.gov (United States)

Romain, Cindy; Freitas, Tomás T; Martínez-Noguera, Francisco J; Laurent, Caroline; Gaillet, Sylvie; Chung, Linda H; Alcaraz, Pedro E; Cases, Julien

2017-11-01

High-intensity exercises are known to provoke delayed onset muscle soreness (DOMS). Delayed onset muscle soreness typically occurs within the first 24 h, peaks between 24 and 72 h, and can last as long as 5-7 days post-exercise. Delayed onset muscle soreness is a multifactorial process involving both mechanical and biochemical components, associated with clinical features that may limit range of motion, and athletes seek for effective recovery strategies to optimize future training sessions. TensLess ® is a food supplement developed to help manage post-exercise recovery. The supplement has been investigated on 13 recreationally active athletes of both sex, during a randomized, double-blind, and crossover clinical investigation, including a 3-week washout period. The clinical investigation was based on the study of TensLess ® effects for DOMS management and on the reduction of associated muscle damages following an eccentric exercise protocol. Supplementation with TensLess ® induced significant decrease in DOMS perception (-33%; p = 0.008) as of the first 24 h; this was significantly correlated with a lowered release of muscle damage-associated biomarkers, namely myoglobin, creatinine, and creatine kinase, for the whole length of the recovery period. Taken together, these positive results clearly indicate that post-exercise supplementation with TensLess ® may preserve myocytes and reduce soreness following eccentric exercise-induced damages, and, accordingly, significantly shorten muscle recovery. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Epidemiologia e tratamento das úlceras de pressão: experiência de 77 casos Epidemiological profile and treatment of pressure sores: experience with 77 cases

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Márcio Paulino Costa

2005-01-01

crompression due to sitting, lying or wearing brace in a heathy person results in discomfort and pain due to local isquemia. The normal protective pahtways are interrupted, however, in paraplegics, quadriplegic or the signals are ignored in severely de hibilitade, eldery or chronic ill patients. The pressure sore develops in these patients. Few papers have been done in Brazil abour pressure sores, despite economic problem envolved with. The purpose of this paper is to evaluate the epidemiology, treatment and complications of pressure sores in the Hospital das Clínicas (University of São Paulo from February 1997 to March 1999 in the Orthopedics Institute. A prospective study has been done. Data were evaluated as to the sex, age, sites, classification, type of treatment employed, length of stay and complications. The treatment was evaluated by the success rate and recurrence rate . The average follow-up period was 1 year and a half, ranging from 6 month to 2 years. 77 pressure sores in 45 patients were apraised. 36 men and 9 women, age range 17-64, mean 34,78 years. Of the patients, 100% had severe spinal cord injuries, and most of them victims of gun shot (60%. 93,3% of the wound were chronic (present longer than 3 months. 77,92% were treated by surgical procedures, and most of them with myocutaneous flaps (45%. The success rate changed with the site of the lesion: 80% trochanter, 84% sacrum and 66,6% ischium. The recurrence rate was 25%. The complication rate also changed with the site of the lesion: 84% trocanter, 64% sacrum and 50% isquium.

The influence of an artificial playing surface on injury risk and perceptions of muscle soreness in elite Rugby Union.

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Williams, S; Trewartha, G; Kemp, S P T; Michell, R; Stokes, K A

2016-01-01

This prospective cohort study investigated the influence of an artificial playing surface on injury risk and perceptions of muscle soreness in elite English Premiership Rugby Union players. Time loss (from 39.5 matches) and abrasion (from 27 matches) injury risk was compared between matches played on artificial turf and natural grass. Muscle soreness was reported over the 4 days following one match played on each surface by 95 visiting players (i.e., normally play on natural grass surfaces). There was a likely trivial difference in the overall injury burden relating to time-loss injuries between playing surfaces [rate ratio = 1.01, 90% confidence interval (CI): 0.73-1.38]. Abrasions were substantially more common on artificial turf (rate ratio = 7.92, 90% CI: 4.39-14.28), although the majority of these were minor and only two resulted in any reported time loss. Muscle soreness was consistently higher over the 4 days following a match on artificial turf in comparison with natural grass, although the magnitude of this effect was small (effect sizes ranging from 0.26 to 0.40). These results suggest that overall injury risk is similar for the two playing surfaces, but further surveillance is required before inferences regarding specific injury diagnoses and smaller differences in overall injury risk can be made. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Avaliação dos pacientes portadores de lesão por pressão internados em hospital geral Assessment of patients with pressure sores admitted in a tertiary care center

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Adriana Moro

2007-08-01

Full Text Available OBJETIVOS: Determinar a prevalência e analisar o perfil dos portadores de lesão por pressão, enfocando fatores de risco, características clínicas e demográficas dos pacientes internados em hospital geral e estádio e localização das lesões no corpo. MÉTODOS: Estudo transversal observacional não controlado. Foram observados diariamente os pacientes internados em hospital geral no período de abril a junho de 2005, a fim de identificar todos os casos de lesão por pressão. Os pacientes acometidos foram avaliados através de um questionário padronizado e a Escala de Braden foi aplicada para definir o risco de desenvolvimento das lesões. RESULTADOS: Do total de 690 pacientes internados durante o período referido, observou-se uma prevalência de 5,9% de portadores de lesão por pressão, equivalente a 41 pacientes. Desses, 63,9% eram idosos. A média do tempo de internação foi de 18 dias. Observou-se que o setor de clínica médica e a Unidade de Terapia Intensiva (UTI apresentaram prevalência de 41,5%. Quanto à localização das lesões, 73,1% apresentavam-na em região sacral, e o grau mais evidenciado foi o estádio II, perfazendo um total de 58,5%. De acordo com a Escala de Braden, a maioria (80,4% apresentava alto risco para o desenvolvimento das lesões, comparado com 9,7% dos pacientes com risco moderado e 7,4% com baixo risco. CONCLUSÃO: Os pacientes acometidos apresentaram alto risco de desenvolver lesões por pressão. A prevalência dessas e o perfil clínico e demográfico dos pacientes acometidos estão de acordo com os dados encontrados na literatura.BACKGROUND: To determine the prevalence and analyze the profile of patients with pressure sores, focusing on risk factors, the patients' clinical characteristics at a tertiary care center, as well as stage and location of the lesions on the body. METHODS: This was a cross sectional not controlled observational study, all patients admitted from April to June of 2005 were

Marine oil dietary supplementation reduces delayed onset muscle soreness after a 30 km run

OpenAIRE

Baum, Klaus; Telford, Richard D; Cunningham, Ross B

2013-01-01

Klaus Baum,1 Richard D Telford,2 Ross B Cunningham,3 1Trainingsinstitut Prof Baum, Köln, Germany; 2College of Medicine, Biology, and Environment, Australian National University, Canberra, ACT, Australia; 3The Fenner School of Environment and Society, Australian National University, Canberra, ACT, Australia Objective: Runners are prone to delayed onset muscle soreness (DOMS) during long distance training. This especially holds for unaccustomed training volumes at moderate to high int...

Histopathology of red-sore disease (aeromonas hydrophila) in naturally and experimentally infected largemouth bass micropterus salmoides(lacepede)

Energy Technology Data Exchange (ETDEWEB)

Huizinga, H W [Illinois State Univ., Normal; Esch, G W; Hazen, T C

1979-01-01

The histopathology of red-sore disease, caused by the gram-negative bacterium, Aeromonas hydrophila, is described for largemouth bass, Micropterus salmoides. Externally, lesions range from those affecting a few scales (pin-point), to those associated with extensive chronic ulcerations; there is focal hemorrhage, oedema and dermal necrosis which exposes underlying muscles producing infiltration of mononuclear and granulocytic inflammatory cells. Internally, the liver and kidneys are foci for toxic products produced by A. hydrophila with, in the most severe cases, complete destruction of the structural integrity of both organs. Pathological changes were not serious in either the spleen or heart, even in cases with massive damage in the liver and kidney. Internal and external lesions were similar in both natural and experimentally induced infections. The pathobiology of red-sore disease in bass was postulated to be linked to elevated water temperature stimulating increased metabolism, decreased body condition and stress, leading to the increased production of corticosteroids and the concommitant rise in susceptibility to infection.

Effects of cryotherapy on muscle damage markers and perception of delayed onset muscle soreness after downhill running: A Pilot study

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M. Rossato

2015-06-01

Conclusion: Use of cryotherapy after exercise with eccentric contractions was effective to reestablish the level of biochemical markers of muscle damage and reduce muscle soreness and pain perception in subjects submitted to downhill running.

Comparing the effect of ketamine and benzydamine gargling with placebo on post-operative sore throat: A randomized controlled trial

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Seyed Hamid Reza Faiz

2014-01-01

Full Text Available Background: Air way intubation for general anesthesia usually leads to sore throat after surgery. Ketamine plays an important role to block a number of receptors related to pain. Benzydamine hydrochloride is a non-steroidal anti-inflammatory drug that has been used to improve oropharyngeal disorders. In this study, it was intended to compare the effect of gargling different solutions before the surgery on post-operative sore throat (POST in patients who underwent general anesthesia for hysterectomy. Materials and Methods: A total of 60 patients who underwent the elective hysterectomy were entered to the randomized controlled trial regarding to the eligibility criteria. Patients were simply randomly allocated to three groups and received one code. Every code was representative for a specific drug: 20 cc normal saline (control group or 1.5 mg benzydamine in 20 cc solution or 20 mg ketamine in 20 cc solutions. All the research teams were blinded to the received solutions. POST was evaluated with numerical rating scale. The data were entered to SPSS software and analysis of variance (ANOVA and Kruskal-Wallis one-way analysis of variance test, were performed. Results: The mean ages of ketamine, benzydamine, and normal saline recipients were not significantly different. The trend of the severity of sore throat during the first 24 h after the operation in ketamine recipients was significantly lower than the other two groups (P < 0.001. Conclusion: The pain scale after surgery was reduced by using both ketamine and benzydamine, but the ketamine effect was more noticeable.

The Effect of Pharyngeal Packing during Nasal Surgery on the Incidence of Post Operative Nausea, Vomiting, and Sore Throat

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Ali Karbasfrushan

2014-10-01

Full Text Available Introduction: Nausea and vomiting after ear, nose and throat (ENT surgery is one of the most common and notable problems facing anesthesiologists in this area. This study was conducted to determine the effect of a pharyngeal pack on the severity of nausea, vomiting, and sore throat among patients after ear, pharynx, and throat surgeries.   Materials and Methods: This randomized clinical study was performed in 140 patients (61 men and 79 women; age range, 20–40 years who had undergone nasal surgery in 2010. Patients were divided into two groups: the first group were treated using a pharyngeal pack (case group and the second group were managed without a pharyngeal pack (control group. Statistical analysis was performed using the Chi-square test and the Mann-Whitney U test. SPSS software was used for data analysis.   Results: The mean severity of nausea and vomiting in the two groups was 2.057, 1.371 and 1.100, respectively, with no significant differences between groups. However, the mean severity of sore throat was 1.714 in the group with the pharyngeal pack and 1.385 in the group without pharyngeal pack (P=0.010.   Conclusion:  Not only does a pharyngeal pack in ENT surgery not reduce the extent and severity of nausea and vomiting, but it also increases the severity of sore throat in patients when leaving the recovery room and discharging hospital.

Gargling with Ketamine Attenuates the Postoperative Sore Throat

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A Rudra

2009-01-01

Full Text Available Postoperative sore throat (POST is a common complication of anaesthesia with endotracheal tube that affects patient satisfaction after surgery. Therefore, this complication remains to be resolved in patients undergoing endotra-cheal intubation. The aim of the study was to compare the effectiveness of ketamine gargles with placebo in prevent-ing POST after endotracheal intubation. Forty patients scheduled for elective surgery under general anaesthesia were randomized into: Group C, water 30 ml; Group K, ketamine 50 mg in water 29 ml. Patients were asked to gargle this mixture for 40 seconds, 5 minutes before induction of anaesthesia. POST was graded at 4, 8 and 24 hours after operation on a four-point scale (0-3. In the Control group POST occurred more frequently, when compared with patients belonging to Ketamine group, at 4, 8, and 24 hours and significantly more patients suffered severe POST in Control group at 8 and 24 hours compared with Ketamine group (P< 0.05. We demonstrated that gargling with ketamine significantly attenuated POST, with no drug-related side effects were observed.

Penicillin for acute sore throat : randomised double blind trial of seven days versus three days treatment or placebo in adults

NARCIS (Netherlands)

Zwart, S; Sachs, APE; Ruijs, GJHM; Gubbels, JW; Hoes, AW; de Melker, RA

2000-01-01

Objective To assess whether treatment with penicillin for three days and the traditional treatment for seven days were equally as effective at accelerating resolution of symptoms in patients with sore throat compared with placebo. Design Randomised double blind placebo controlled trial. Setting 43

Randomized clinical study comparing Compeed (R) cold sore patch to acyclovir cream 5% in the treatment of herpes simplex labialis

DEFF Research Database (Denmark)

Karlsmark, T.; Goodman, J.J.; Drouault, Y.

2008-01-01

Background Hydrocolloid technology has been proven effective in treating dermal wounds. A previous study showed that a newly developed thin hydrocolloid patch [Compeed (R) cold sore patch (CSP)] provided multiple wound-healing benefits across all stages of a herpes simplex labialis (HSL) outbreak...

Importance of diagnostic laboratory methods of beta hemolytic streptococcus group A in comparison with clinical findings in the diagnosis of streptococcal sore throat and unnecessary antibacterial therapy

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Peiman Eini

2012-04-01

Full Text Available Background: Streptococcus Pyogenes (group A streptococcus, GAS is the most important cause of bacterial pharyngitis in children and adolescents. Acute pharyngitis is one of the most common conditions in all ages but it is most common in children. Over diagnosis of acute pharyngitis represents one of the major causes of antibiotic abuse. The goal of this study is to make an estimate of the frequency of group A streptococcus in sore throat patients in Farshchian hospital emergency department and clinic in Hamadan. Methods: For estimation of the clinical features role in diagnosis of streptococcal sore throat, we took samples of 100 patients with average age of 32.96±29.86 years with sore throat. We took samples from pharynx and used standard methods of bacteriology in order to detect streptococcus. Results: Group A Streptococcus (GAS accounts for 3 percent of all cases of pharyngitis. Clinically, all of the patients had sore throat. The percent breakdowns are as follows: 30% had exudate, 78% had fever, 8% had lymphadenopathy and 7.7 percent of exudative pharyngitis was streptococcal. The cost for unnecessary antibiotic therapy for every single patient who had negative pharynx culture was approximately 32160 Rails. Conclusion: The low frequency of streptococcus pharyngitis in treated patients reveal that diagnosis based on clinical features is not reliable. We recommend use of other diagnostic methods such as Rapid Antigen Detection Tests (RATs. Only reliable and scientific protocols for antibiotic to therapy.

The etiology of pressure ulcers : skin deep or muscle bound?

NARCIS (Netherlands)

Bouten, C.V.C.; Oomens, C.W.J.; Baaijens, F.P.T.; Bader, D.L.

2003-01-01

Pressure sores are areas of soft tissue breakdown resulting from sustained mechanical loading of the skin and underlying tissues that affect the quality of life of many individuals. Despite considerable efforts to prevent pressure sores, prevalence figures are unacceptably high. This can at least

Protocol for north of England and Scotland study of tonsillectomy and adeno-tonsillectomy in children (NESSTAC). A pragmatic randomised controlled trial comparing surgical intervention with conventional medical treatment in children with recurrent sore throats.

Science.gov (United States)

Bond, John; Wilson, Janet; Eccles, Martin; Vanoli, Alessandra; Steen, Nick; Clarke, Ray; Zarod, Andrew; Lock, Catherine; Brittain, Katie; Speed, Chris; Rousseau, Nikki

2006-08-09

Uncertainties surrounding the effectiveness and cost-effectiveness of childhood tonsillectomy for recurrent sore throat led the NHS Health Technology Assessment Programme to commission this research to evaluate the effectiveness and cost-effectiveness of tonsillectomy and adeno-tonsillectomy in comparison with standard non-surgical management in children aged under 16 with recurrent throat infections. The aim is to evaluate if tonsillectomy and adeno-tonsillectomy reduces the number of episodes of sore throats among children to a clinically significant extent. A simple prospective pragmatic randomised controlled trial with economic analysis and prospective cohort study of non-trial participants comparing surgical intervention with conventional medical treatment. The treatment arm will receive tonsillectomy and adeno-tonsillectomy while in the control arm non-surgical conventional medical treatment only will be used. The primary outcome measure will be reported number of episodes of sore throat over two years with secondary outcomes measures of reported number of episodes of sore throat, otitis media and upper respiratory tract infection which invoke a GP consultation; reported number of symptom-free days; reported severity of sore throats and surgical and anaesthetic morbidity. The study will take place in five hospitals in the UK. The trial population will be 406 children aged 4-15 on their last birthday with recurrent sore throat referred by primary care to the 5 otolaryngology departments. The duration of the study is seven years (July 2001-July 2008). As with all pragmatic randomised controlled trials it is impossible to control the external environment in which the research is taking place. Since this trial began a number of factors have arisen which could affect the outcome including; a reduction in the incidence of respiratory tract infections, marked socio-economic differences in consultation rates, the results from the National Prospective Tonsillectomy

Protocol for north of England and Scotland study of tonsillectomy and adeno-tonsillectomy in children (NESSTAC. A pragmatic randomised controlled trial comparing surgical intervention with conventional medical treatment in children with recurrent sore throats

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Lock Catherine

2006-08-01

Full Text Available Abstract Background Uncertainties surrounding the effectiveness and cost-effectiveness of childhood tonsillectomy for recurrent sore throat led the NHS Health Technology Assessment Programme to commission this research to evaluate the effectiveness and cost-effectiveness of tonsillectomy and adeno-tonsillectomy in comparison with standard non-surgical management in children aged under 16 with recurrent throat infections. The aim is to evaluate if tonsillectomy and adeno-tonsillectomy reduces the number of episodes of sore throats among children to a clinically significant extent. Methods/design A simple prospective pragmatic randomised controlled trial with economic analysis and prospective cohort study of non-trial participants comparing surgical intervention with conventional medical treatment. The treatment arm will receive tonsillectomy and adeno-tonsillectomy while in the control arm non-surgical conventional medical treatment only will be used. The primary outcome measure will be reported number of episodes of sore throat over two years with secondary outcomes measures of reported number of episodes of sore throat, otitis media and upper respiratory tract infection which invoke a GP consultation; reported number of symptom-free days; reported severity of sore throats and surgical and anaesthetic morbidity. The study will take place in five hospitals in the UK. The trial population will be 406 children aged 4–15 on their last birthday with recurrent sore throat referred by primary care to the 5 otolaryngology departments. The duration of the study is seven years (July 2001- July 2008. Discussion As with all pragmatic randomised controlled trials it is impossible to control the external environment in which the research is taking place. Since this trial began a number of factors have arisen which could affect the outcome including; a reduction in the incidence of respiratory tract infections, marked socio-economic differences in

[The practice guideline 'Sore throat' (second revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology

NARCIS (Netherlands)

Marres, H.A.M.

2008-01-01

In this comment, the practice guideline 'Sore throat' (second revision) is discussed. This guideline, composed by the Dutch College of General Practitioners, offers general practitioners a well-appreciated overview of the common practices regarding diagnostic tests and treatment of pharyngitis and

Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain

Science.gov (United States)

León-Hernández, Jose V.; Martín-Pintado-Zugasti, Aitor; Frutos, Laura G.; Alguacil-Diego, Isabel M.; de la Llave-Rincón, Ana I.; Fernandez-Carnero, Josue

2016-01-01

ABSTRACT Background Dry needling (DN) and percutaneous electrical nerve stimulation (PENS) are widely used techniques in the treatment of myofascial pain. Objective To investigate the immediate and short-term effects of the combination of DN and PENS compared to DN alone on the upper trapezius muscle. Method This is a 72-hour follow-up single-blinded randomized controlled trial. Sixty-two volunteer patients with chronic myofascial neck pain with active Myofascial Trigger Points (MTrPs) in the upper trapezius muscle were recruited. Randomization was performed, and 31 patients received DN treatment (DN group) and 31 received DN and PENS (DN+PENS group). The primary outcomes were neck disability index (NDI) and visual analog scale for pain for both post-needling soreness (PNS) and neck pain intensity (NPI). Pressure pain threshold (PPT) and cervical range of motion (CROM) were the secondary outcomes. Results We detected between-group differences in NPI and PNS in favor of the DN+PENS group immediately after treatment. No between-group differences in NDI were observed. Conclusion PENS application after dry needling treatment is more effective than dry needling alone for decreasing soreness in the short term and improving neck pain intensity immediately in patients with myofascial chronic neck pain. PMID:27410163

The effect of topical thiocolchicoside in preventing and reducing the increase of muscle tone, stiffness, and soreness: A real-life study on top-level road cyclists during stage competition.

Science.gov (United States)

Gervasi, Marco; Sisti, Davide; Benelli, Piero; Fernández-Peña, Eneko; Calcabrini, Cinzia; Rocchi, Marco B L; Lanata, Luigi; Bagnasco, Michela; Tonti, Andrea; Vilberto, Stocchi; Sestili, Piero

2017-07-01

In professional road cyclists, the majority of overuse injuries affect the lower limbs and are mostly represented by contractures or muscle shortening, characterized by an increase of tone and stiffness and a variation of elasticity. Treatment and prevention of these specific conditions may include physical, supplementary, and pharmacologic support. The aim of this real-life study was to determine: first, the alterations of tone, stiffness, elasticity, and soreness of rectus femoris (RF) and biceps femoris (BF) in top class cyclists engaged in 3 multistage races, and second, whether any variable in the management of the athletes may affect the prevention and/or reduction of such alterations.Twenty-three professional cyclists competing in 3 international, cycling stage races were assessed. Athletes could receive, upon the approval of the medical staff, physical, dietary, and/or pharmacological management which could include treatments with topical over-the-counter myorelaxants to prevent and/or reduce muscle contractures. MyotonPro was used to daily measure tone, stiffness, and elasticity in RF and BF in relaxed and contracted state after every stage. In parallel, BF and RF soreness was also assessed with a Likert scale.All athletes received the same general massage management; none of them received dietary supplements; some of the athletes were treated with a topical myorelaxant thiocolchicoside (TCC 0.25%) foam 3 times daily. TCC was identified as the only variable able to affect these muscle parameters in the cyclists. Tone, stiffness (regardless of the state), and soreness significantly increased over time either in BF or RF in all athletes. In the group of athletes that used TCC (n = 11; TCC+) the increase in tone, stiffness, and soreness was significantly lower than in the group not receiving TCC (n = 12; No-TCC). Elasticity varied coherently with tone and stiffness.A very intense and protracted sport activity increases muscular tone, stiffness, and

Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study.

Science.gov (United States)

Akhtar, Moneeb; Van Heukelom, Paul G; Ahmed, Azeemuddin; Tranter, Rachel D; White, Erinn; Shekem, Nathaniel; Walz, David; Fairfield, Catherine; Vakkalanka, J Priyanka; Mohr, Nicholas M

2018-02-22

Telemedicine allows patients to connect with healthcare providers remotely. It has recently expanded to evaluate low-acuity illnesses such as pharyngitis by using patients' personal communication devices. The purpose of our study was to compare the telemedicine-facilitated physical examination with an in-person examination in emergency department (ED) patients with sore throat. This was a prospective, observational, blinded diagnostic concordance study of patients being seen for sore throat in a 60,000-visit Midwestern academic ED. A telemedicine and a face-to-face examination were performed independently by two advanced practice providers (APP), blinded to the results of the other evaluator. The primary outcome was agreement on pharyngeal redness between the evaluators, with secondary outcomes of agreement and inter-rater reliability on 14 other aspects of the pharyngeal physical examination. We also conducted a survey of patients and providers to evaluate perceptions and preferences for sore throat evaluation using telemedicine. Sixty-two patients were enrolled, with a median tonsil size of 1.0. Inter-rater agreement (kappa) for tonsil size was 0.394, which was worse than our predetermined concordance threshold. Other kappa values ranged from 0 to 0.434, and telemedicine was best for detecting abnormal coloration of the palate and tender superficial cervical lymph nodes (anterior structures), but poor for detecting abnormal submandibular lymph nodes or asymmetry of the posterior pharynx (posterior structures). In survey responses, telemedicine was judged easier to use and more comfortable for providers than patients; however, neither patients nor providers preferred in-person to telemedicine evaluation. Telemedicine exhibited poor agreement with the in-person physical examination on the primary outcome of tonsil size, but exhibited moderate agreement on coloration of the palate and cervical lymphadenopathy. Future work should better characterize the importance of

Pressure sores–a constant problem for plegic patients and a permanent challenge for plastic surgery

Science.gov (United States)

Marinescu, S; Florescu, IP; Jecan, C

2010-01-01

Pressure sores–a constant problem for plegic patients and a permanent challenge for plastic surgery Pressure sores can be defined as lesions caused by unrelieved pressure resulting in damage of the underlying tissue. They represent a common problem in the pathology of plegic patients and, plastic surgery has a significant role in their treatment. Pressure sores occur over bony prominences and so, they are most commonly seen at the sacrum and trochanters in paralyzed patients and at ischium for the patients who sit in a wheelchair for a long time. For these patients, surgical treatment is very important because on one hand, it stops the loss of nutrients and proteins at the site of the pressure sore, and on the other hand, it permits the initiation of neuromuscular recuperation treatment much faster. PMID:20968200

Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management).

Science.gov (United States)

Little, Paul; Hobbs, F D Richard; Moore, Michael; Mant, David; Williamson, Ian; McNulty, Cliodna; Cheng, Ying Edith; Leydon, Geraldine; McManus, Richard; Kelly, Joanne; Barnett, Jane; Glasziou, Paul; Mullee, Mark

2013-10-10

To determine the effect of clinical scores that predict streptococcal infection or rapid streptococcal antigen detection tests compared with delayed antibiotic prescribing. Open adaptive pragmatic parallel group randomised controlled trial. Primary care in United Kingdom. Patients aged ≥ 3 with acute sore throat. An internet programme randomised patients to targeted antibiotic use according to: delayed antibiotics (the comparator group for analyses), clinical score, or antigen test used according to clinical score. During the trial a preliminary streptococcal score (score 1, n=1129) was replaced by a more consistent score (score 2, n=631; features: fever during previous 24 hours; purulence; attends rapidly (within three days after onset of symptoms); inflamed tonsils; no cough/coryza (acronym FeverPAIN). Symptom severity reported by patients on a 7 point Likert scale (mean severity of sore throat/difficulty swallowing for days two to four after the consultation (primary outcome)), duration of symptoms, use of antibiotics. For score 1 there were no significant differences between groups. For score 2, symptom severity was documented in 80% (168/207 (81%) in delayed antibiotics group; 168/211 (80%) in clinical score group; 166/213 (78%) in antigen test group). Reported severity of symptoms was lower in the clinical score group (-0.33, 95% confidence interval -0.64 to -0.02; P=0.04), equivalent to one in three rating sore throat a slight versus moderate problem, with a similar reduction for the antigen test group (-0.30, -0.61 to -0.00; P=0.05). Symptoms rated moderately bad or worse resolved significantly faster in the clinical score group (hazard ratio 1.30, 95% confidence interval 1.03 to 1.63) but not the antigen test group (1.11, 0.88 to 1.40). In the delayed antibiotics group, 75/164 (46%) used antibiotics. Use of antibiotics in the clinical score group (60/161) was 29% lower (adjusted risk ratio 0.71, 95% confidence interval 0.50 to 0.95; P=0.02) and in the

Pressure Sores

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... to strengthen your muscles and improve your overall health. Talk to your doctor if physical activity is hard for you. He or she ... and Wellness Staying Healthy Healthy Living Travel Occupational Health First Aid and ... Pets and Animals myhealthfinder Food and Nutrition Healthy Food ...

Urban sores. On the interaction between segregation, urban decay and deprived neighbourhoods

DEFF Research Database (Denmark)

Andersen, Hans Skifter

Most European countries have experienced special problems that have emerged in certain more or less well-defined parts of cities called de-prived or depressed urban neighbourhoods. These problems were initially found in the oldest urban areas with the lowest quality housing. Since the beginning...... of the 1980s, however, in Europe they have also emerged in newer social housing estates outside city centres. These neighbourhoods display visible physical and social problems that can disfigure the perhaps otherwise attractive urban landscape. They could in severe cases even be termed sores on the face...... of the city. They are often perceived by the public as places that are not inhabited or frequented by decent people – they are seen as ‘places of exclusion’. The purpose of this book is to contribute to a deeper understanding of why such neighbourhoods come to exist and the impacts they have on cities. Urban...

Efficacy of flurbiprofen 8.75 mg delivered as a spray or lozenge in patients with sore throat due to upper respiratory tract infection: a randomized, non-inferiority trial in the Russian Federation

Directory of Open Access Journals (Sweden)

Radkova E

2017-07-01

Full Text Available Eugenia Radkova,1 Natalia Burova,2 Valeria Bychkova,3 Robert DeVito4 1OCT Clinical Trials, Saint Petersburg, Russia; 2Federal State Establishment Clinical Diagnostic Medical Center, Saint Petersburg, Russia; 3Reckitt Benckiser (Russia, Moscow, Russia; 4Reckitt Benckiser, Parsippany, NJ, USA Objective: To assess the efficacy of flurbiprofen 8.75 mg delivered as a spray or lozenge in patients with sore throat due to upper respiratory tract infection (URTI.Materials and methods: This multicenter, double-blind, double-dummy, non-inferiority study randomized 440 adults with recent-onset, moderate-to-severe sore throat due to URTI to a single dose of either flurbiprofen 8.75 mg spray (n=218 or flurbiprofen 8.75 mg lozenge (n=222. The presence or absence of beta-hemolytic streptococci (A or C was confirmed by culture tests (throat swab. The primary efficacy end point was the difference from baseline to 2 hours post-dose in sore throat pain intensity scale (STPIS pain intensity difference [PID] 2h, a validated 100 mm visual analog scale (from 0=“no pain” to 100=“severe pain”, with a non-inferiority margin of −6 mm. Secondary end points included STPIS PID at 1 hour (STPIS PID 1h and over 2 hours (STPIS sum of sore throat pain intensity differences [SPID]0–2h and ratings of patient satisfaction and investigator assessment of drug efficacy at 2 hours. Safety (adverse events [AEs] was also assessed.Results: Reductions in sore throat pain intensity at 2 hours (STPIS PID 2h were similar for spray (least square mean −40.51 and lozenge (−40.10 (difference: 0.41, 95% confidence interval [95% CI] −3.20, 4.01, with non-inferiority demonstrated. Subgroup analyses showed similar efficacy (STPIS PID 2h for patients testing positive or negative for Strep A or C. There was no significant difference between spray and lozenge in STPIS PID 1h or STPIS SPID0–2h, and patient satisfaction and investigators’ assessment of efficacy at 2�

[Heel pressure ulcers. Comparative study between heel protective bandage and hydrocellular dressing with special form for the heel].

Science.gov (United States)

Torra i Bou, Joan-Enric; Rueda López, Justo; Camañes, Gemma; Herrero Narváez, Elias; Blanco Blanco, Joan; Martínez-Esparza, Elvira Hernández; Aneas Alcántara, Jesús; Verdú Soriano, José

2002-05-01

The heels, together with the sacra area, are one of the most frequent spots where pressure sores appear here in Spain. Any preventive measure against pressure sores on heels needs be oriented towards two main objectives: effective relief of pressure and its compatibility with localized care and skin inspection in order to detect lesions early on at least once a day. The authors planned a comparative, multi-centered, open, labeled and controlled study in which patients were assigned to two groups receiving these treatments: one received traditional preventive pressure sore treatment and a protective bandage on their heels while the other used a special Allevyn Heel hydrocellular dressing to protect their heels. The patients took part in this study over an eight week period. The response variable used to determine the effectiveness of the preventive measure in this study was the appearance of pressure sores. At the beginning, 130 patients were included in this study, 65 in each one of the treatment groups. In the bandage group, 50 patients finished this study while 61 in the dressing group finished this study. The appearance of pressure sores in the protective bandage group occurred in 44% of the patients, 22 out of 50, while in the dressing group, the occurrence rate was 3.3%, 2 out of 61 patients with a value of "ji" squared p pressure sore brought us a value of relative risk of 13.42 (IC 95%: 3.31-54.3) in the group wearing the protective bandage compared to the group wearing the dressing. The results of this study allow us to accept as valid the alternate hypothesis that there exist significant statistical differences between both treatment methods in favor of the Allevyn Heel dressing instead of the protective heel bandage. The use of this dressing, even though it is more expensive a priori than the protective bandage, in terms of unit cost for the product, has proven to be more effective in preventing pressure sores, and cheaper than the protective bandage if

Comparison of the Characteristics and Performance of Flurbiprofen 8.75 mg Spray for Sore Throat.

Science.gov (United States)

Veale, David; Shephard, Adrian; Adams, Verity; Lidster, Charlotte

2017-01-01

Sore throat sprays provide targeted relief by delivering the active ingredient directly to the site of pain. Different sprays vary in characteristics, thus affecting delivery of the active ingredient to the throat, which can impact compliance. The characteristics and performance of FLURBIPROFEN 8.75 mg SPRAY were compared with 12 other sprays. Parameters assessed included spray angle and pattern, droplet size distribution, shot weight uniformity and shot weight throughout life. Among all sprays tested WICK Sulagil Halsspray had the smallest spray angle (46°) and also the smallest diameter spray pattern (X=32.8 mm; Y=34.4 mm). Thiovalone® Buccal Spray Suspension had both the largest spray angle (82°) and largest diameter spray pattern (X=62.6 mm; Y=78.0 mm). Hasco Sept® Aerosol Spray had the smallest droplet size (Dv90=118.4 μm) whereas OKi infiammazione e dolore® 0.16% spray had the largest (Dv90=214.34 μm). In terms of shot weight uniformity, TANTUM® VERDE GOLA 0.25% spray showed the least variation (2% RSD) between shots and UNIBEN Aerosol Spray the most (23.4% RSD). Shot weight throughout life studies showed that FLURBIPROFEN 8.75 mg SPRAY had the least deviation from shot weight (1.77%) whereas OKi infiammazione e dolore® 0.16% spray deviated the most (44.9%). FLURBIPROFEN 8.75 mg SPRAY had the second smallest spray angle/pattern and droplet size distribution and also the least variation in shot weight. Different sore throat sprays vary in different attributes, affecting delivery of the active ingredient. FLURBIPROFEN 8.75 mg SPRAY performed well overall, ranking first among all sprays tested, and providing a dose which is targeted and uniformly delivered throughout the life of the bottle. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Kvalitetssikring af trykspor og tryksår i en dansk sygehuspopulation

DEFF Research Database (Denmark)

Hammershøy, E M; Sperling, Lene; Henriksen, Tine Brink

1994-01-01

Seven hospital departments were enrolled in the first step in a quality assurance process regarding pressure sores. A total of 2317 patients representative of a Danish hospital population were included. At the time of admission 2.2% had pressure sores and 1.1% pressure marks (point prevalence......), and during hospitalization 2.9% developed pressure sores pressure sores and 1.1% pressure marks (point prevalence), and during hospitalization 2.9% developed pressure sores and 1.4% pressure marks (absolute incidence). The incidence of pressure sores and pressure marks varied between the department from 0......-11.3% and from 0 to 7.7% respectively. The relative risk (RR) of developing pressure sores was highest (RR 11.7) for patients who had pressure marks on admittance. Other significant risk factors were admission to one specific surgical department compared to the reference department (RR 7.9), age > 81 years...

Antibiotic prescription strategies for acute sore throat: a prospective observational cohort study.

Science.gov (United States)

Little, Paul; Stuart, Beth; Hobbs, F D Richard; Butler, Chris C; Hay, Alastair D; Delaney, Brendan; Campbell, John; Broomfield, Sue; Barratt, Paula; Hood, Kerenza; Everitt, Hazel; Mullee, Mark; Williamson, Ian; Mant, David; Moore, Michael

2014-03-01

Data from trials suggest that antibiotics reduce the risk of complications of sore throat by at least 50%, but few trials for complications have been done in modern settings, and datasets of delayed antibiotic prescription are underpowered. Observational evidence is important in view of poor compliance with antibiotic treatment outside trials, but no prospective observational cohort studies have been done to date. We generated a large prospective cohort from the DESCARTE study, and the PRISM component of DESCARTE, of 12,829 adults presenting with sore throat (≤ 2 weeks duration) in primary care. Our follow-up of the cohort was based on a detailed and structured review of routine medical records, and analysis of the comparison of three antibiotic prescription strategies (no antibiotic prescription, immediate antibiotic prescription, and delayed antibiotic prescription) to control for the propensity to prescribe antibiotics. Information about antibiotic prescription was recorded in 12,677 individuals (4805 prescribed no antibiotics, 6088 prescribed antibiotics immediately, and 1784 prescribed delayed antibiotics). We documented by review of patients' notes (n=11,950) the development of suppurative complications (eg, quinsy, impetigo and cellulitis, otitis media, and sinusitis) or reconsultation with new or non-resolving symptoms). We used multivariate analysis to control for variables significantly related to the propensity to prescribe antibiotics and for clustering by general practitioner. 164 (1.4%) of the 11,950 patients with information available developed complications; otitis media and sinusitis were the most common complications (101 patients [62%]). Compared with no antibiotic prescription, immediate antibiotic prescription was associated with fewer complications (adjusted risk ratio [RR] 0.62, 95% CI 0.43-0.91, estimated number needed to treat [NNT 193) as was delayed prescription of antibiotics (0.58, 0.34-0.98; NNT 174). 1787 of the 11,950 patients (15

Effects of a High Protein and Omega-3-Enriched Diet with or Without Creatine Supplementation on Markers of Soreness and Inflammation During 5 Consecutive Days of High Volume Resistance Exercise in Females

Directory of Open Access Journals (Sweden)

Sara Hayward, Colin D. Wilborn, Lem W. Taylor, Stacie L. Urbina, Jordan J. Outlaw, Cliffa A. Foster, Michael D. Roberts

2016-12-01

Full Text Available We examined if two different dietary interventions affected markers of soreness and inflammation over a 5-day high-volume resistance training protocol in females that resistance-trained 8 weeks prior. Twenty-eight females (age: 20 ± 1 yr; body mass: 63.5 ± 1.6 kg, height: 1.67 ± 0.01 m completed 4 weeks of pre-training (weeks 1-4 followed by a subsequent 4-week training period along with a dietary intervention (weeks 5-8. Dietary interventions from weeks 5-8 included: a no intervention (CTL, n = 10 b a higher-protein diet supplemented with hydrolyzed whey protein (50 g/d and omega-3 fatty acids (900 mg/d (DI, n = 8, and c the DI condition as well as creatine monohydrate (5 g/d (DI+C, n = 10. During week 9, participants resistance-trained for five consecutive days whereby 8 sets of 10 target repetitions at 70% one repetition maximum (1RM were performed each day for bench press, back squat, deadlift, and hip-thrusters with the intent of eliciting muscle soreness and inflammation. Prior to and 24 h following each of the 5 bouts muscle soreness (DOMS was assessed via questionnaire, and fasting blood was obtained and analyzed for serum cortisol, interleukin-6 (IL-6 and C-reactive protein (CRP. No group*time (G*T or time effects were observed for training volume over the 5-d overreaching protocol. Furthermore, no group*time (G*T or time effects were observed for serum cortisol, IL-6 or CRP, and DOMS actually decreased in all groups 24 h following the fifth day training bout. This study demonstrates that, regardless of protein, omega-3 fatty acid and/or creatine supplementation, 5 days of consecutive resistance training does not alter perceived muscle soreness, training volume, and/or markers of inflammation in novice resistance-trained females.

The Effect of Eccentric Exercise-Induced Delayed-Onset Muscle Soreness on Positioning Sense and Shooting Percentage in Wheelchair Basketball Players

Directory of Open Access Journals (Sweden)

Mehmet Akif Serinken

2013-12-01

Full Text Available Background: Eccentric exercise is defined as a type of exercise in which the muscle produces power by extending. In contrast to isometric and concentric exercises, eccentric muscle activity is much more effective mechanically; however, it may expose the muscle to soreness. Delayed-Onset Muscle Soreness (DOMS emerges a couple of hours after an eccentric activity, especially in individuals who are not used to this kind of exercise, and causes a temporary decrease in muscle performance, joint movement angle and muscle power, and also a temporary increase in the blood creatine kinase (CK activity. Aims: This study investigates the effect of DOMS on the upper extremities motor performance by conducting an eccentric exercise load on the elbow flexor muscles. Study design: Cross sectional study. Methods: The study included 10 wheelchair basketball players. First, the participants underwent blood CK activity, positioning sense, muscle pain, shooting performance measurements tests at the base, and after 30 minutes and 24 and 48 hours. Then, one week later, the one-repetition-maximums of biceps curls were determined in order to define the intensity of the eccentric exercise. An eccentric exercise protocol which would cause DOMS was applied to all players. All tests were replaced with acute exhaustive eccentric exercise; the same tests were repeated in the same order after the exercise. Blood CK activity was measured by taking an earlobe capillary blood sample. The muscle pain level was measured by using a Visual Analogue Scale (VAS. Positioning sense loss was assessed via goniometer at 30º, 60º and 90º degrees horizontally. Results: The study found a statistically significant increase in blood CK activity and positioning sense loss, and a decrease in the pressure-pain threshold, as well as the shooting percentages in the exercise group when compared with the control. Conclusion: These findings suggest that DOMS negatively affects the upper extremities

The effect of alternative graphical displays used to present the benefits of antibiotics for sore throat on decisions about whether to seek treatment: a randomized trial.

Science.gov (United States)

Carling, Cheryl L L; Kristoffersen, Doris Tove; Flottorp, Signe; Fretheim, Atle; Oxman, Andrew D; Schünemann, Holger J; Akl, Elie A; Herrin, Jeph; MacKenzie, Thomas D; Montori, Victor M

2009-08-01

We conducted an Internet-based randomized trial comparing four graphical displays of the benefits of antibiotics for people with sore throat who must decide whether to go to the doctor to seek treatment. Our objective was to determine which display resulted in choices most consistent with participants' values. This was the first of a series of televised trials undertaken in cooperation with the Norwegian Broadcasting Company. We recruited adult volunteers in Norway through a nationally televised weekly health program. Participants went to our Web site and rated the relative importance of the consequences of treatment using visual analogue scales (VAS). They viewed the graphical display (or no information) to which they were randomized and were asked to decide whether to go to the doctor for an antibiotic prescription. We compared four presentations: face icons (happy/sad) or a bar graph showing the proportion of people with symptoms on day three with and without treatment, a bar graph of the average duration of symptoms, and a bar graph of proportion with symptoms on both days three and seven. Before completing the study, all participants were shown all the displays and detailed patient information about the treatment of sore throat and were asked to decide again. We calculated a relative importance score (RIS) by subtracting the VAS scores for the undesirable consequences of antibiotics from the VAS score for the benefit of symptom relief. We used logistic regression to determine the association between participants' RIS and their choice. 1,760 participants completed the study. There were statistically significant differences in the likelihood of choosing to go to the doctor in relation to different values (RIS). Of the four presentations, the bar graph of duration of symptoms resulted in decisions that were most consistent with the more fully informed second decision. Most participants also preferred this presentation (38%) and found it easiest to understand (37

Predictive Value of Braden Risk Factors in Pressure Ulcers of Outpatients With Spinal Cord Injury

Directory of Open Access Journals (Sweden)

Fariba Sadeghi Fazel

2018-02-01

Full Text Available Pressure Ulcers (PUs remain among the most common complications after traumatic spinal cord Injuries (SCIs. The main goal of risk factor assessment with different tools has been to provisionally estimate the chance of developing pressure ulcers in patients with Spinal Cord Injury (SCI. Braden tool has been of good predictive value and most commonly employed in hospital communities for risk assessment of pressure sore development. The objective of this study was to determine the Braden risk factors as well as the prevalence of pressure injuries in SCI patients. This cross-sectional study was performed from June 2013 to December 2015 on 163 consecutive referred outpatients with chronic traumatic SCI in our tertiary SCI rehabilitation clinic. We assessed pressure induced skin injuries as well as their Braden risk factors and analyzed their association with stage and location of Pressure Ulcer (PU and calculated prevalence of PU. One hundred and sixty-three patients out of 580 were found to have active pressure sores, with a prevalence of 28.1%. In the multiple models, only the Braden scale had significant association with the presence of active pressure sore. Patients with severe and moderate Braden scores were 2.36 and 1.82 times, more at risk of pressure sore development, as compared with those having mild scores (P≤0.01. It may be deduced that in various stages of SCI rehabilitation, the Braden scale may be calculated, and patients with moderate and severe risks (according to Braden sale may need more attention and/or inpatient care for PU prevention.  

No Differences Between Alter G-Trainer and Active and Passive Recovery Strategies on Isokinetic Strength, Systemic Oxidative Stress and Perceived Muscle Soreness After Exercise-Induced Muscle Damage.

Science.gov (United States)

Cooke, Matthew B; Nix, Carrie M; Greenwood, Lori D; Greenwood, Mike C

2018-03-01

Cooke, MB, Nix, C, Greenwood, L, and Greenwood, M. No Differences Between Alter G-Trainer and Active and Passive Recovery Strategies on Isokinetic Strength, Systemic Oxidative Stress and Perceived Muscle Soreness After Exercise-Induced Muscle Damage. J Strength Cond Res 32(3): 736-747, 2018-The incidence of muscle injuries is prevalent in elite sport athletes and weekend warriors and strategies that safely and effectively hasten recovery are highly desirable. The purpose of this study was to examine the differences between 3 recovery methods after eliciting muscle damage in recreationally active men relative to maximal isokinetic contractions, perceived muscle soreness, and psychological mood states. Twenty-five recreationally active men (22.15 ± 3.53 years, 75.75 ± 11.91 kg, 180.52 ± 7.3 cm) were randomly matched by V[Combining Dot Above]O2 peak (53.86 ± 6.65 ml·kg·min) and assigned to one of 3 recovery methods: anti-gravity treadmill (G-Trainer) (N = 8), conventional treadmill (N = 8) or static stretching (N = 9). Recovery methods were performed 30 minutes, 24, 48, and 72 hours after a 45-minute downhill run. Following eccentrically biased running, no significant differences were noted in isokinetic knee flexion and extension peak torque, systemic markers of muscle damage, oxidative stress and lipid peroxidation such as serum creatine kinase (CK), superoxide dismutase (SOD), and malondialdehyde (MDA), respectively, and subjective ratings of perceived muscle soreness between recovery methods. The G-Trainer group did however display a higher mood state as indicated by the Profile of Mood State global scores at 24 hours postexercise when compared to the conventional treadmill recovery group (p = 0.035). The improved mood state after the use of the anti-gravity treadmill may provide clinical relevance to other populations.

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Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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Preventing Pressure Sores

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Bedsores (Pressure Sores)

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... the need to change position. Poor nutrition and hydration. People need enough fluids, calories, protein, vitamins and minerals in their daily diet to maintain healthy skin and prevent the breakdown of tissues. Medical conditions ...

Preventing Pressure Sores

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Preventing Pressure Sores

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Amylmetacresol/2,4-dichlorobenzyl alcohol, hexylresorcinol, or carrageenan lozenges as active treatments for sore throat

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Morokutti-Kurz M

2017-02-01

Full Text Available Martina Morokutti-Kurz, Christine Graf, Eva Prieschl-Grassauer Marinomed Biotechnologie GmbH, Vienna, Austria Abstract: Up to 80% of sore throats are caused by viruses. Several over the counter products are available which provide symptomatic, not causal relief. For such lozenges, containing the antiseptics and local anesthetics amylmetacresol (AMC and 2,4-dichlorobenzyl alcohol (DCBA or hexylresorcinol (HR, recently an additional virucidal effect was published. Therefore, we tested a set of Strepsils® lozenges, containing either HR (Max [#2] or AMC/DCBA (Original [#3], Extra Strong [#4], Warm [#5], Orange and Vitamin C [#6], Sugar free Lemon [#7], Children/Strawberry [#8] and Soothing Honey and Lemon [#9] for their antiviral efficiency against representatives of respiratory viruses known to cause sore throat: human rhinovirus (HRV 1a, HRV8, influenza virus A H1N1n, Coxsackievirus A10, and human coronavirus (hCoV OC43. The lozenges were tested head to head with Coldamaris® lozenges (#1, which contain the patented antiviral iota-carrageenan. None of the tested AMC/DCBA or HR containing lozenges shows any antiviral effectiveness against HRV8 at the tested concentrations, whereas all are moderately active against HRV1a. Only lozenge #5 shows any activity against hCoV OC43 and Coxsackievirus A10 at the tested concentrations. Similarly, only lozenge #3 is moderately active against influenza A H1N1n virus. The data indicates that neither the isolated effect of the active ingredients nor the pH but rather one or more of the excipients of the specific formulations are responsible for the antiviral effect of some of the AMC/DCBA or HR containing lozenges. In contrast, carrageenan-containing lozenges are highly active against all viruses tested. In another experiment, we showed that binding and inactivation of virus particles by iota-carrageenan are fast and highly effective. During the residence time of the lozenge in the mouth, the viral titer is

Marine oil dietary supplementation reduces delayed onset muscle soreness after a 30 km run

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Baum K

2013-05-01

Full Text Available Klaus Baum,1 Richard D Telford,2 Ross B Cunningham,3 1Trainingsinstitut Prof Baum, Köln, Germany; 2College of Medicine, Biology, and Environment, Australian National University, Canberra, ACT, Australia; 3The Fenner School of Environment and Society, Australian National University, Canberra, ACT, Australia Objective: Runners are prone to delayed onset muscle soreness (DOMS during long distance training. This especially holds for unaccustomed training volumes at moderate to high intensities. We investigated the effects of a marine oil complex, PCSO-524®, derived from the New Zealand green-lipped mussel (formulated as Lyprinol® and Omega XL® on DOMS after a 30 km training run. Methods: Initially, peak oxygen uptake of 32 distance runners (4 female, 28 male; median age 45 years, range 28–53 was measured on a treadmill with a 1.5 km hour-1 increase every 4 minutes starting from 8.5 km hour-1. At least 1-week after this initial test, they participated in a 30 km road run at a speed corresponding to about 70% of their individual peak oxygen uptake on a flat terrain. Before and after (0, 24, and 48 hours the run, blood concentration of creatine kinase (CK were measured and pain sensation was determined (pain scale from 0 = no pain to 10 = extremely painful. Runners were then matched in pairs based on maximal CK and peak oxygen uptake, and allocated randomly into two different groups. One group was supplemented with 400 mg per day of PCSO-524® for 11 weeks, the other group with an olive oil placebo. After that period, CK and pain sensations were remeasured following a second 30 km run at the same speed and on the same terrain. Results: The general pattern of soreness in the PCSO-524® supplemented group was reduced by 1.1 units (standard error 0.41 compared to the placebo (P < 0.05, the effects being greater in lesser trained runners (P < 0.05. CK levels were positively associated with pain sensation (P < 0.05, but trends toward lower CK in the

Herbs and natural supplements in the prevention and treatment of delayed-onset muscle soreness

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Abbas Meamarbashi

2017-01-01

Full Text Available Objective:  Unaccustomed and intense eccentric exercise is a common cause of delayed-onset muscle soreness (DOMS. There are multiple remedies for the treatment of DOMS, but its clinical and laboratory pieces of evidence are scarce. Currently, the treatments proposed for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and other alternatives. To find a holistic treatment with effective pain relief and minimum side effects, complementary and alternative medicine, including herbal therapies, plays a main role.Methods: In this review, the existing published studies investigating the efficacy of herbal and natural supplementation therapies for the prevention or treatment of side effects, symptoms, and signs of DOMS are summarized.Results: Previous studies have documented the efficacy of herbal therapies to treat pain, inflammation, as well as laboratory and clinical side effects of DOMS.Conclusion: The use of herbs in DOMS seems safer and has lower side effects than pharmacotherapy. However, the potential for side effects and drug interactions should be considered.

[The treatment of decubitus lesions].

Science.gov (United States)

Fugazza, G; Moroni, S; Bona, F

1995-01-01

The authors present a plan for pharmacological treatment of pressure sores in patients affected by neurological pathologies: cerebrovascular accidents, head injuries, spinal cord injuries. This plan is easily applicable to all pressure sores included between first and third degree of the Reuler and Cooney classification. Authors identified some drugs specifically usefull in different cutaneous lesion degrees. Skin lesions and employed medicines are described as follows: Erythema: semi occlusive bandage with porous adsorbing membrane. This dressing must be left in for five days at least. Excoriation: bactericidal or bacteriostatic medicines if it's situated in a non pressed area while the same dressing utilized for erythema if it's localized in a pressed area. Pressure sores: if there is local infection cleanse the wound from bacterial defilement using topic antibiotics apply compresses with vitamin C if the cutaneous lesion is larger than deeper, Cadexomero lodico if it's deeper than larger. Fistulas: wadding with tablets of collagen. Necrobiosis: complete or partial surgical removal of eschar preceded by the use of enzymatic drugs when eschar is firmly adherent to subcutaneous tissues. The first group collects 9 patients with stroke and head injury: 8 with sacral and 1 with heel pressure sores. First degree pressure sores heal within 45 days and third degree lesions within 160 days. The second group collects 10 spinal cord injury patients mostly with complete lesion among which: 7 sacral, 1 heel, 1 ischiatic and 1 malleolar lesions. First degree pressure sores heal within 30 days, third degree pressure sores heal within 200 days. Healing time are considered acceptable. Pressure sores recovery swiftness can be related to different factors such as pressure sores sterness, neurological pathology and arising of clinical complication (hyperthermia, infections, low serum albumin values, etc).

Giant Cell Fibroblastoma: A Case Report

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Mohd Jaseem Hassan

2012-05-01

Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.

Nasogastric Tube Placement Errors and Complications in Pediatric Intensive Care Unit: A Case Report

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Mahin Seyedhejazi

2011-11-01

Full Text Available Nasal ala pressure sores are among complications of nasogastric tube in Pediatric Intensive Care Unit (PICU. The severity of the injury is usually minor and easily ignored. However, the complication could be easily avoided. This is a case of nasal ala sore after the place-ment of nasal enteral tube in a pediatric intensive care unit in our center. A 5-month-old female with pulmonary hypertension secondary to bronchiectasis with nasal ala pressure sore were reported. She was hospitalized in pediatric intensive care unit at Tabriz Children Hospital in 2010.After 53 days of PICU hospitalization she had nasal ala sore. Conclusion: We know that nasal ala pressure sores could easily be avoided when preventive procedures were performed during nasogastric tube insertion.

Production of bacteriocin-like inhibitory substances (BLIS by Streptococcus salivarius strains isolated from the tongue and throat of children with and without sore throat Produção de substâncias inibidoras semelhantes à bacteriocina por cepas de Streptococcus salivarius, isoladas da língua e garganta de crianças com e sem dor de garganta

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Vera Fantinato

1999-12-01

Full Text Available Streptococcus salivarius strains, isolated from children with and without sore throat, were tested for bacteriocin production against Streptococcus pyogenes. S. salivarius strains producing bacteriocin-like inhibitory substances (BLIS against S. pyogenes were more frequently found in children without sore throat. These results suggest that these children may be protected against sore throat by the presence of BLIS-positive S. salivarius strains.Cepas de Streptococcus salivarius, isoladas de crianças com e sem dor de garganta, foram testadas quanto à produção de bacteriocina contra Streptococcus pyogenes. Os resultados mostraram que as crianças que não tinham dor de garganta possuiam, na boca, cepas de bactérias produtoras de substâncias inibidoras semelhantes à bacteriocina contra S. pyogenes.

21 CFR 880.5550 - Alternating pressure air flotation mattress.

Science.gov (United States)

2010-04-01

... body pressure. The device is used to prevent and treat decubitus ulcers (bed sores). (b) Classification... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Alternating pressure air flotation mattress. 880... Personal Use Therapeutic Devices § 880.5550 Alternating pressure air flotation mattress. (a) Identification...

Application of Acoustic Radiation Force Impulse (ARFI) Elastography in Imaging of Delayed Onset Muscle Soreness (DOMS): A Comparative Analysis With 3T MRI.

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Hotfiel, Thilo; Kellermann, Marion; Swoboda, Bernd; Wildner, Dane; Golditz, Tobias; Grim, Casper; Raithel, Martin; Uder, Michael; Heiss, Rafael

2017-05-17

DOMS is one of the most common reasons for impaired muscle performance in sports and is associated with reduced muscle strength and frequently observed both in professional and recreational athletes. To emphasize the diagnostic value of Acoustic Radiation Force Impulse (ARFI) in imaging of Delayed Onset Muscle Soreness by comparing findings to high-resolution 3T MRI T2 weighted sequences. Case series. Laboratory environment. Fifteen healthy students (7 female, 8 male, age 24 ± 4 years, height 178 ± 10 cm, body weight 67 ± 12 kg). ARFI values, represented as shear wave velocities (SWV) of the gastrocnemius muscle (GM) and soleus muscle (SM), as well as conventional ultrasound, high-resolution 3T MRI, creatine kinase activity, extension range of the ankle joint, calf circumference and muscle soreness were assessed before (baseline) and 60 hours after (post-intervention, PI) a standardized eccentric exercise. ARFI SWV values of the GM revealed a statistically significant decrease of 19.1% between baseline (2.2 ± 0.26 m/s) and PI (1.78 ± 0.24 m/s); p = 0.008. At follow-up, the MRI investigations showed intramuscular oedema for the GM in all participants corresponding to a significant raise in T2 signal intensity (p = 0.001) and in T2-time values (p = 0.004). ARFI elastography seems to be an additional sensitive diagnostic modality in the diagnostic work up of DOMS. Intramuscular SWV could represent an additional imaging marker for the assessment and monitoring of ultrastructural muscle injuries and therefore be helpful for individual training composition in elite sports.

[Decubitus ulcer in the calcaneus region: rapid development, difficult recovery].

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Fugazza, G; Bona, F

1996-03-01

Heel pressure sores frequently arise in patients kept in bed for a long time independently of their primary disease. In account of this event the authors completed a study concerning possible mutual relations between heel pressure sores and primary disease of the patients; to validate the pharmacological treatment in less severe sores and the surgical resolution in more serious cutaneous lesions. In the last 3 years (1992-1995) at the Rehabilitation Centre of Montescano the authors have treated 39 patients suffering from 63 different severe cutaneous lesions: from phlycten to deep necrosis. The therapeutic plane utilized pharmacological treatment for 1st, 2nd, 3rd degree pressure sores, and surgical treatment for 4th degree. Pharmacological treatment included: enzymatic drugs, bactericidal and bacteriostatic medicines and cicatrizing substances. Different healing times were related to different pressure sore severity. Surgical treatment consisted of transposition of flap into wound defect. This system caused considerable reduction in resolution times. The authors noticed how easily pressure sores arise in the heel region, and how difficultly they heal. This is probably connected with particular anatomical and vascular characteristics of this region.

Improvements in throat function and qualities of sore throat from locally applied flurbiprofen 8.75 mg in spray or lozenge format: findings from a randomized trial of patients with upper respiratory tract infection in the Russian Federation

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Burova N

2018-06-01

Full Text Available Natalia Burova,1 Valeria Bychkova,2 Adrian Shephard3 1Federal State Establishment Clinical Diagnostic Medical Center, Saint Petersburg, Russia; 2Reckitt Benckiser (Russia, Moscow, Russia; 3Reckitt Benckiser Healthcare International Ltd, Slough, Berkshire, UK Objective: To assess the speed of relief provided by flurbiprofen 8.75 mg spray and lozenge and their effect on many of the different qualities and characteristics of throat pain and discomfort, and the many articulations of the broad term “sore throat” (ST. Patients and methods: Four hundred and forty adults with recent-onset, moderate-to-severe ST due to upper respiratory tract infection (URTI were randomized to a single dose of either flurbiprofen 8.75 mg spray (n=218 or flurbiprofen 8.75 mg lozenge (n=222. Throat swabs for bacterial culture were taken at baseline. ST relief was assessed at 1 minute, 1 and 2 hours post-dose using the Sore Throat Relief Rating Scale. The change from baseline at 1 and 2 hours post-dose in difficulty swallowing and swollen throat was assessed using the difficulty swallowing scale and the swollen throat scale, respectively. Patients’ experience of URTI symptoms was assessed using a URTI questionnaire at baseline and 2 hours post-dose. The change in Qualities of Sore Throat Index, a 10-item index of qualities of ST, from baseline at 2 hours post-dose was also measured. Results: ST relief was evident in the spray and the lozenge treatment groups at 1 minute, 1 and 2 hours post-dose (P>0.05. In both groups, scores for difficulty swallowing and swollen throat significantly improved at 1 and 2 hours post-dose compared with baseline. At 2 hours post-dose, the number of patients experiencing URTI symptoms that can be attributed to or associated with ST decreased relative to baseline. The mean change from baseline to 2 hours post-dose for each individual score on the Qualities of Sore Throat Index showed significant improvements for flurbiprofen spray and

Guillain-Barre Syndrome

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... thinners and wearing support stockings may be recommended. Pressure sores. Being immobile also puts you at risk of developing bedsores (pressure sores). Frequent repositioning may help avoid this problem. Relapse. ...

How wounds heal

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... How puncture wounds heal; How burns heal; How pressure sores heal; How lacerations heal ... bleed. For example, burns, some puncture wounds, and pressure sores do not bleed. Once the scab forms, your ...

Factors Associated With Treatment Failure of Infected Pressure Sores.

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Jugun, Kheeldass; Richard, Jean-Christophe; Lipsky, Benjamin A; Kressmann, Benjamin; Pittet-Cuenod, Brigitte; Suvà, Domizio; Modarressi, Ali; Uçkay, Ilker

2016-08-01

In this study, we assess interdisciplinary surgical and medical parameters associated to recurrences of infected pressure ulcers. There is a little in the published literature regarding factors associated with the outcome of treatment of infected pressure ulcers. We undertook a single-center review of spinal injured adults hospitalized for an infected pressure ulcer or implant-free osteomyelitis and reviewed the literature on this topic from 1990-2015. We found 70 lesions in 31 patients (52 with osteomyelitis) who had a median follow-up of 2.7 years (range, 4 months to 19 years). The median duration of antibiotic therapy was 6 weeks, of which 1 week was parenteral. Clinical recurrence after treatment was noted in 44 infected ulcers (63%), after a median interval of 1 year. In 86% of these recurrences, cultures yielded a different organism than the preceding episode. By multivariate analyses, the following factors were not significantly related to recurrence: number of surgical interventions (hazard ratio 0.9, 95% confidence interval 0.5-1.5); osteomyelitis (hazard ratio 1.5; 0.7-3.1); immune suppression; prior sacral infections, and duration of total (or just parenteral) antibiotic sue. Patients with antibiotic treatment for 12 weeks (χ test; P = 0.90). In patients with infected pressure ulcers, clinical recurrence occurs in almost two-thirds of lesions, but in only 14% with the same pathogen(s). The number of surgical debridements, flap use, or duration of antibiotic therapy was not associated with recurrence, suggesting recurrences are caused by reinfections caused by other extrahospital factors.

Rola pielęgniarki w profilaktyce i leczeniu odleżyn = The role of the nurse in the prevention and treatment of pressure ulcers

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Elżbieta Chrzan

2016-12-01

• Wyraźnie brakuje w literaturze naukowej pielęgniarskich prac empirycznych z zakresu problematyki i leczenia odleżyn, które pozwoliłyby na weryfikację skuteczności sposobów i metod postępowania w praktyce zawodowej.     Summary   Prevention and treatment of pressure ulcers are extremely significant problem in nursing care. Bed sores are a source of additional health complications of the patient, are a source of pain and suffering, as well as common financial problems. The purpose of this work is to identify the role played by the nurse in the prevention and treatment of pressure ulcers and the response to the questions of concern: the root Problem: the importance of nursing care in the prevention and treatment of pressure ulcers? Specific problems: what range of preventive activities may take a nurse in preventing pressure ulcers? What is the role of the nurse in the treatment of pressure ulcers? Whether gender, age and diagnosis are important in the treatment of pressure ulcers? Whether the patient's length of stay in hospital has an impact on the progress in the treatment of pressure ulcers? What brings standardization against bed sores stationary care prevention? In response to the above questions it took the following hypothesis: Hypothesis: Nurse full leading role in in prevention against bed sores. and treatment of pressure ulcers. Hypothesis: Sound at a high level of nursing care effectively prevents patients with pressure ulcers. Nurse has a significant impact on therapeutic effects in the process of treatment of pressure ulcers. Age, sex and diagnosis of the patient are variables, which have a significant impact on the treatment of pressure ulcers. Duration of hospitalization, understood as a time of specialized, comprehensive, individual and multilateral treatment of pressure ulcers, has a beneficial effect on progress in the treatment of pressure ulcers. Standardization of nursing care in prevention and treatment of pressure ulcers raises

Multiple sclerosis - discharge

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... check your skin every day for signs of pressure sores . Look closely at: Heels Ankles Knees Hips Tailbone ... Back of your head Learn how to prevent pressure sores . Staying Healthy Keep up to date with your ...

臀下动脉穿支蒂复合组织瓣修复骶尾部巨大褥疮的解剖与临床应用%Anatomy study and clinical applications of complex tissue flap pedicled with inferior gluteal artery perforator for repairing giant sacrococcygeal pressure sore

Institute of Scientific and Technical Information of China (English)

谢昀; 林建华; 叶君健; 郑和平

2014-01-01

Objective To discuss the technical feasibility and clinical effectiveness of using complex tissue flap pedicled with inferior gluteal artery perforator for repair giant sacrococcygeal pressure sore.Methods Thirty embalmed lower limbs of adult cadavers perfused with red latex were used for anatomical study,and the followings were observed:①The course,branche and distribution of gluteal artery.②The course and distribution of the posterior femoral cutaneous nerve.③Anastomosis between the posterior cutaneous branch of gluteal artery and nutrient vessels of the posterior femoral cutaneous nerve.8 cases aging from 17 years to 56 years were completed during May 2007 to July 2013,6 cases were males and 2 cases were females.The sizes of pressure sore with the depth to Ⅳ degree were ranged from 16 cm × 9 cm to 22 cm × 10 cm.The sizes of flaps were harvested from 32 cm × 10 cm to 25 cm × 9 cm.Results The gluteal artery crossed the edge of the piriformis,the main stem was (3.1 ± 0.4) mm in diameter and gave out 2-5 muscular branches to supply the gluteus maximus.The posterior femoral cutaneous nerve crossed the edge of gluteus maximus and descended between biceps femoris and semitendinosus.Perforating deep fascia point located was (5.9 ± 0.8) cm above the line between medial and lateral femoral epicondyle.The constant anastomosis were formed by the posterior cutaneous branch of gluteal artery,the obturator artery perforator and the direct popliteal artery perforator around the posterior femoral cutaneous nerve.The complex flap survived successfully in all patients.Sutures were removed at 14 days postoperatively and the wounds healed well.All supplied areas were closed by directly suturing.Recurrent sacrococcygeal pressure sore was not observed in all cases with satisfied appearance and normal color during the outpatient follow-up period from 5 months to 5 years.Conclusion The united flap of gluteal myocutaneous flap and the posterior femoral cutaneous

Hip fracture surgeries

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... clearly. Sometimes, surgery can make this problem worse. Pressure sores ( pressure ulcers or bed sores) from being in bed or ... the hospital for 3 to 5 days. Full recovery will take from 3 to 4 months to ...

Support surfaces for pressure ulcer prevention

OpenAIRE

McInnes, E; Bell-Syer, SE; Dumville, JC; Legood, R; Cullum, NA

2008-01-01

Background Pressure ulcers (also known as bedsores, pressure sores, decubitus ulcers) are areas of localised damage to the skin and underlying tissue due to pressure, shear or friction. They are common in the elderly and immobile and costly in financial and human terms. Pressure-relieving beds, mattresses and seat cushions are widely used as aids to prevention in both institutional and non-institutional settings. Objectives This systematic review seeks to answer the following questions: (1) t...

Effect of hydrotherapy on the signs and symptoms of delayed onset muscle soreness.

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Vaile, Joanna; Halson, Shona; Gill, Nicholas; Dawson, Brian

2008-03-01

This study independently examined the effects of three hydrotherapy interventions on the physiological and functional symptoms of delayed onset muscle soreness (DOMS). Strength trained males (n = 38) completed two experimental trials separated by 8 months in a randomised crossover design; one trial involved passive recovery (PAS, control), the other a specific hydrotherapy protocol for 72 h post-exercise; either: (1) cold water immersion (CWI: n = 12), (2) hot water immersion (HWI: n = 11) or (3) contrast water therapy (CWT: n = 15). For each trial, subjects performed a DOMS-inducing leg press protocol followed by PAS or one of the hydrotherapy interventions for 14 min. Weighted squat jump, isometric squat, perceived pain, thigh girths and blood variables were measured prior to, immediately after, and at 24, 48 and 72 h post-exercise. Squat jump performance and isometric force recovery were significantly enhanced (P < 0.05) at 24, 48 and 72 h post-exercise following CWT and at 48 and 72 h post-exercise following CWI when compared to PAS. Isometric force recovery was also greater (P < 0.05) at 24, 48, and 72 h post-exercise following HWI when compared to PAS. Perceived pain improved (P < 0.01) following CWT at 24, 48 and 72 h post-exercise. Overall, CWI and CWT were found to be effective in reducing the physiological and functional deficits associated with DOMS, including improved recovery of isometric force and dynamic power and a reduction in localised oedema. While HWI was effective in the recovery of isometric force, it was ineffective for recovery of all other markers compared to PAS.

Serum biochemical activities and muscular soreness in transported goats administered with ascorbic acid during the hot-dry season

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Ndazo S Minka

2010-12-01

Full Text Available The effects of handling, loading and 12 h of road transportation during the hot-dry season on muscular metabolism of 20 experimental goats administered orally with 100 mg/kg body weight of ascorbic acid (AA dissolved in 10 ml of sterile water, and other 20 control goats given equivalent of sterile water 40 min prior to transportation were investigated. The result obtained post-transportation showed that handling, loading and transportation were stressful to the goats, especially the control goats and resulted into muscular damage and the development of delayed-onset-muscular-soreness (DOMS, which may lead to dark-firm-dry (DFD syndrome meat with undesirable effects on its quality. In the experimental goats administered AA such transportation effects were minimal or completely abolished. The result demonstrated that AA reduced the incidence of DOMS and muscular damage in transported goats, therefore it may be used to improve the welfare and quality of meat obtained from goats subjected to long period of road transportation under adverse climatic conditions.

Electrical stimulation-induced Gluteal and Hamstring muscle activation can reduce sitting pressure in individuals with a spinal cord injury

NARCIS (Netherlands)

Janssen, T. W J; De Koning, A.; Legemate, K. J A; Smit, C. A J

2010-01-01

Individuals with spinal cord injury (SCI) are at high risk of developing pressure sores, in part due to high sitting pressures under the buttocks. PURPOSE: To evaluate the effect of ES-induced activation of the gluteal and hamstring muscles on the sitting pressure in individuals with SCI. METHODS:

Influence of fatigue, stress, muscle soreness and sleep on perceived exertion during submaximal effort.

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Haddad, Monoem; Chaouachi, Anis; Wong, Del P; Castagna, Carlo; Hambli, Mourad; Hue, Olivier; Chamari, Karim

2013-07-02

The aim of this study was to assess the effects of the Hooper's Index variations (i.e., self-ratings of fatigue, stress, delayed onset muscle soreness (DOMS), and sleep) on rating of perceived exertion during a 10 min submaximal exercise training session (RPE-10 min) and then check the stability and the internal consistency of RPE-10 min. Seventeen junior soccer players took part in this study. The individual Hooper's indices taken before each training session were correlated with RPE-10 min during a constant intensity and duration effort (10 min) using Pearson product moment correlation. Intraclass correlation (ICC) was used to assess the internal consistency of the RPE-10 min. All individual correlations between RPE-10 min and quality of sleep and quantity of fatigue, stress, and DOMS were non-significant (p>0.05). No significant correlations were resulted between RPE-10 min and Hooper's Index in all athletes. The ICC of RPE-10 min was 0.77 thus demonstrating internal consistency. The results of the present study demonstrated the objectivity and utility of RPE as a psychological tool for monitoring training during traditional soccer training. Therefore, the results of the present study suggest that fatigue, stress, DOMS and sleep are not major contributors of perceived exertion during traditional soccer training without excessive training loads. It seems that psychobiological factors other than fatigue, stress, DOMS and sleep may have mediated the 10 min exercise perceptual intensity. © 2013.

The Effects of Pre-Exercise Ginger Supplementation on Muscle Damage and Delayed Onset Muscle Soreness.

Science.gov (United States)

Matsumura, Melissa D; Zavorsky, Gerald S; Smoliga, James M

2015-06-01

Ginger possesses analgesic and pharmacological properties mimicking non-steroidal antiinflammatory drugs. We aimed to determine if ginger supplementation is efficacious for attenuating muscle damage and delayed onset muscle soreness (DOMS) following high-intensity resistance exercise. Following a 5-day supplementation period of placebo or 4 g ginger (randomized groups), 20 non-weight trained participants performed a high-intensity elbow flexor eccentric exercise protocol to induce muscle damage. Markers associated with muscle damage and DOMS were repeatedly measured before supplementation and for 4 days following the exercise protocol. Repeated measures analysis of variance revealed one repetition maximum lift decreased significantly 24 h post-exercise in both groups (p ginger group (p = 0.002), and improved at 72 (p = 0.021) and 96 h (p = 0.044) only in the placebo group. Blood creatine kinase significantly increased for both groups (p = 0.015) but continued to increase only in the ginger group 72 (p = 0.006) and 96 h (p = 0.027) post-exercise. Visual analog scale of pain was significantly elevated following eccentric exercise (p ginger. In conclusion, 4 g of ginger supplementation may be used to accelerate recovery of muscle strength following intense exercise but does not influence indicators of muscle damage or DOMS. Copyright © 2015 John Wiley & Sons, Ltd.

Compression garments and exercise: no influence of pressure applied.

Science.gov (United States)

Beliard, Samuel; Chauveau, Michel; Moscatiello, Timothée; Cros, François; Ecarnot, Fiona; Becker, François

2015-03-01

Compression garments on the lower limbs are increasingly popular among athletes who wish to improve performance, reduce exercise-induced discomfort, and reduce the risk of injury. However, the beneficial effects of compression garments have not been clearly established. We performed a review of the literature for prospective, randomized, controlled studies, using quantified lower limb compression in order to (1) describe the beneficial effects that have been identified with compression garments, and in which conditions; and (2) investigate whether there is a relation between the pressure applied and the reported effects. The pressure delivered were measured either in laboratory conditions on garments identical to those used in the studies, or derived from publication data. Twenty three original articles were selected for inclusion in this review. The effects of wearing compression garments during exercise are controversial, as most studies failed to demonstrate a beneficial effect on immediate or performance recovery, or on delayed onset of muscle soreness. There was a trend towards a beneficial effect of compression garments worn during recovery, with performance recovery found to be improved in the five studies in which this was investigated, and delayed-onset muscle soreness was reportedly reduced in three of these five studies. There is no apparent relation between the effects of compression garments worn during or after exercise and the pressures applied, since beneficial effects were obtained with both low and high pressures. Wearing compression garments during recovery from exercise seems to be beneficial for performance recovery and delayed-onset muscle soreness, but the factors explaining this efficacy remain to be elucidated. Key pointsWe observed no relationship between the effects of compression and the pressures applied.The pressure applied at the level of the lower limb by compression garments destined for use by athletes varies widely between

A traditional Chinese herbal formula improves pressure ulcers in paraplegic patients: A randomized, parallel-group, retrospective trial.

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Liu, Xin; Meng, Qingxi; Song, Hua; Zhao, Tingbao

2013-06-01

In this study, the efficacy of a novel Chinese herbal formula, cure rot and flat sore ointment (CRFSO), in the management of stage IV pressure ulcers, and the effect of simultaneous comprehensive rehabilitation in improving the outcome were evaluated. A total of 35 paraplegic patients with stage IV pressure ulcers who underwent reconstruction and inpatient rehabilitation from January 2004 to September 2010 were included in the study. Arnebia root oil (ARO) was used on 16 patients with 11 ulcers (stage IV). The remaining 19 patients with 20 ulcers (stage IV) received a traditional Chinese herbal formula (CRFSO). After 28 days of treatment, the wound healing results, in particular, the healing rate, effectiveness rate, improvement rate and no response rate were evaluated. Six patients from the ARO group sought other types of therapy due to their own consideration of poor efficacy. After 28 days of treatment, the wound healing result and no response rate demonstrated a statistically significant difference (P<0.005) between the two groups, suggesting that the novel Chinese herbal formula is an effective treatment for pressure sores in paraplegic patients. All outcome variables demonstrated significant improvement in the CRFSO group compared with the ARO group after 28 days of treatment, with a higher healing rate (85% in the CRFSO group and 45.45% in the ARO group) and lower no response rate (5% in the CRFSO group and 18.18% in the ARO group). The traditional Chinese herbal formula improved pressure sores in paraplegic patients effectively and inpatient rehabilitation was also significantly improved.

Labor Pain

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... you a medication to maintain your lower blood pressure. Sore back – Your lower back may be sore where ... Treatment Opioid Treatment Preparing for Surgery Risks Preparation Recovery About Resources Stories Policymakers Media ASA Member Toolkit ...

[Fasciocutaneous flap reliable by deep femoral artery perforator for the treatment of ischial pressure ulcers].

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Gebert, L; Boucher, F; Lari, A; Braye, F; Mojallal, A; Ismaïl, M

2018-04-01

The surgical management of pressure ulcers in the paraplegic or quadriplegic population is marked by the high risk of recurrence in the long-term. In the current era of perforator flaps, newer reconstructive options are available for the management of pressure ulcers, decreasing the need to use the classically described muscular or musculocutaneous locoregional flaps. The coverage of ischial sores described in this article by a pedicled flap based on a deep femoral artery perforator, appears to be an effective first-line reconstructive option for the management of limited size pressure ulcers. A number of fifteen paraplegic or quadriplegic patients having at least one ischial bed sore with underlying osteomyelitis were included in this series. The approximate location of the deep femoral artery perforator was initially identified using the "The Atlas of the perforator arteries of the skin, the trunk and limbs", which was confirmed, with the use of a Doppler device. A fasciocutaneous transposition flap was elevated, with the pivot point based on the cutaneous bridge centered on the perforator, and then transposed to cover the area of tissue loss. The donor site was closed primarily. A total of fifteen patients were operated from November 2015 to November 2016. The series comprised of 16 first presentations of a stage 4 pressure ulcers associated with underlying osteomyelitis that were subsequently reconstructed by the pedicled deep femoral artery perforator flap. The healing rate and functional results were both satisfactory. Fasciocutaneous flap reliable by deep femoral artery perforator appears to have a promising role in the treatment of ischial pressure sores. It is an attractive option to spare the use of musculocutaneous flaps in the area. Thus this flap could be used as a first-line option to cover ischial pressure ulcers of limited size. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The Internal Pudendal Artery Perforator Thigh Flap: A New Freestyle Pedicle Flap for the Ischial Region

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Ichiro Hashimoto, MD

2014-05-01

Conclusions: The perforator vessels of the internal pudendal artery are very close to the ischial tuberosity. Blood flow to the flap is reliable when careful debridement of the pressure sore is performed. The iPap thigh flap is a new option for soft-tissue defects in the ischial region, including ischial pressure sores.

Landmarks for Sacral Debridement in Sacral Pressure Sores.

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Choo, Joshua H; Wilhelmi, Bradon J

2016-03-01

Most cases of sacral osteomyelitis arising in the setting of sacral pressure ulcers require minimal cortical debridement. When faced with advanced bony involvement, the surgeon is often unclear about how much can safely be resected. Unfamiliarity with sacral anatomy can lead to concerns of inadvertent entry into the dural space and compromise of future flap options. A cadaveric study (n = 6), in which a wide posterior dissection of the sacrum, was performed. Relationships of the dural sac to bony landmarks of the posterior pelvis were noted. The termination of the dural sac was found in our study to occur at the junction of S2/S3 vertebral bodies, which was located at a mean distance of 0.38 ± 0.16 cm distal to the inferior-most extent of the posterior superior iliac spine (PSIS). The mean thickness of the posterior table of sacrum at this level was 1.7 cm at the midline and 0.5 cm at the sacral foramina. The PSIS is a reliable landmark for localizing the S2/S3 junction and the termination of the dural sac. Sacral debridement medial to the sacral foramina above the level of PSIS must be conservative whenever possible. If aggressive debridement is necessary above this level, the surgeon must be alert to the possibility of dural involvement.

Phytochemical, Antimicrobial, and Toxicological Evaluation of Traditional Herbs Used to Treat Sore Throat

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Arifa Mehreen

2016-01-01

Full Text Available The in vitro antibacterial activities of 29 traditional medicinal plants used in respiratory ailments were assessed on multidrug resistant Gram-positive and Gram-negative bacteria isolated from the sore throat patients and two reference strains. The methanolic, n-hexane, and aqueous extracts were screened by the agar well diffusion assay. Bioactive fractions of effective extracts were identified on TLC coupled with bioautography, while their toxicity was determined using haemolytic assay against human erythrocytes. Qualitative and quantitative phytochemical analysis of effective extracts was also performed. Methanolic extract of 18 plants showed antimicrobial activity against test strains. Adhatoda vasica (ZI = 17–21 mm, MIC: 7.12–62.5 μg/mL, Althaea officinalis (ZI = 16–20 mm, MIC: 15.62–31.25 μg/mL, Cordia latifolia (ZI = 16–20 mm, MIC: 12.62–62.5 μg/mL, Origanum vulgare (ZI = 20–22 mm, MIC: 3–15.62 μg/mL, Thymus vulgaris (ZI = 21–25 mm, MIC: 7.81–31.25 μg/mL, and Ziziphus jujuba (ZI = 14–20 mm, MIC: 7.81–31.25 μg/mL showed significant antibacterial activity. Alkaloid fractions of Adhatoda vasica, Cordia latifolia, and Origanum vulgare and flavonoid fraction of the Althaea officinalis, Origanum vulgare, Thymus Vulgaris, and Ziziphus jujuba exhibited antimicrobial activity. Effective plant extracts show 0.93–0.7% erythrocyte haemolysis. The results obtained from this study provide a scientific rationale for the traditional use of these herbs and laid the basis for future studies to explore novel antimicrobial compounds.

Phytochemical, Antimicrobial, and Toxicological Evaluation of Traditional Herbs Used to Treat Sore Throat

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Mehreen, Arifa; Waheed, Muzzamil; Liaqat, Iram; Arshad, Najma

2016-01-01

The in vitro antibacterial activities of 29 traditional medicinal plants used in respiratory ailments were assessed on multidrug resistant Gram-positive and Gram-negative bacteria isolated from the sore throat patients and two reference strains. The methanolic, n-hexane, and aqueous extracts were screened by the agar well diffusion assay. Bioactive fractions of effective extracts were identified on TLC coupled with bioautography, while their toxicity was determined using haemolytic assay against human erythrocytes. Qualitative and quantitative phytochemical analysis of effective extracts was also performed. Methanolic extract of 18 plants showed antimicrobial activity against test strains. Adhatoda vasica (ZI = 17–21 mm, MIC: 7.12–62.5 μg/mL), Althaea officinalis (ZI = 16–20 mm, MIC: 15.62–31.25 μg/mL), Cordia latifolia (ZI = 16–20 mm, MIC: 12.62–62.5 μg/mL), Origanum vulgare (ZI = 20–22 mm, MIC: 3–15.62 μg/mL), Thymus vulgaris (ZI = 21–25 mm, MIC: 7.81–31.25 μg/mL), and Ziziphus jujuba (ZI = 14–20 mm, MIC: 7.81–31.25 μg/mL) showed significant antibacterial activity. Alkaloid fractions of Adhatoda vasica, Cordia latifolia, and Origanum vulgare and flavonoid fraction of the Althaea officinalis, Origanum vulgare, Thymus Vulgaris, and Ziziphus jujuba exhibited antimicrobial activity. Effective plant extracts show 0.93–0.7% erythrocyte haemolysis. The results obtained from this study provide a scientific rationale for the traditional use of these herbs and laid the basis for future studies to explore novel antimicrobial compounds. PMID:27429983

Managing pressures ulcers in a resource constrained situation: A holistic approach

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Abhijit Dam

2011-01-01

Full Text Available Managing pressure ulcers remain a challenge and call for a multidisciplinary team approach to care. Even more daunting is the management of such patients in remote locations and in resource constrained situations. The management of pressure sores in a patient with progressive muscular atrophy has been discussed using resources that were locally available, accessible, and affordable. Community participation was encouraged. A holistic approach to care was adopted.

A Review on Pressure Ulcer: Aetiology, Cost, Detection and Prevention Systems

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Mishu, Mahbub C.; Dubey, Venketesh N.; Hickish, Tamas F.; Cole, Jonathan

2014-01-01

Pressure ulcer (also known as pressure sore, bedsore, ischemia, decubitus ulcer) is a global challenge for today’s healthcare society. Found in several locations in the human body such as the sacrum, heel, back of the head, shoulder, knee caps, it occurs when soft tissues are under continuous loading and a subject’s mobility is restricted (bedbound/chair bound). Blood flow in soft tissues becomes insufficient leading to tissue necrosis (cell death) and pressure ulcer. The subject’s physiologi...

The effects of a repeated bout of eccentric exercise on indices of muscle damage and delayed onset muscle soreness.

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Paddon-Jones, D; Muthalib, M; Jenkins, D

2000-03-01

This study examined markers of muscle damage following a repeated bout of maximal isokinetic eccentric exercise performed prior to full recovery from a previous bout. Twenty non-resistance trained volunteers were randomly assigned to a control (CON, n=10) or experimental (EXP, n=10) group. Both groups performed 36 maximal isokinetic eccentric contractions of the elbow flexors of the non-dominant arm (ECC1). The EXP group repeated the same eccentric exercise bout two days later (ECC2). Total work and peak eccentric torque were recorded during each set of ECC1 and ECC2. Isometric torque, delayed onset muscle soreness (DOMS), flexed elbow angle and plasma creatine kinase (CK) activity were measured prior to and immediately following ECC1 and ECC2. at 24h intervals for 7 days following ECC1 and finally on day 11. In both groups, all dependent variables changed significantly during the 2 days following ECC1. A further acute post-exercise impairment in isometric torque (30 +/- 5%) and flexed elbow angle (20 +/- 4%) was observed following ECC2 (p0.05). These findings suggest that when maximal isokinetic eccentric exercise is repeated two days after experiencing of contraction-induced muscle damage, the recovery time course is not significantly altered.

The analysis of metabolites in human sweat: analytical methods and potential application to investigation of pressure ischaemia of soft tissues.

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Taylor, R P; Polliack, A A; Bader, D L

1994-01-01

A straightforward technique was developed for sweat collection applicable to tissues subjected to external load without introducing distortion of underlying tissues, and for analysis of six metabolites in the collected sweat. Chloride was measured colorimetrically and lactate, urea and urate by enzymatic methods on a centrifugal analyser. Sodium and potassium were measured by flame photometry. The methods showed good precision, recovery and linearity. To assess the technique sweat was collected: (i) from the sacrum, ischium, forearm and calf in healthy individuals at 32 degrees C for 1 h; (ii) from the sacrum of healthy subjects at ambient temperature for 9 h; (iii) at ambient temperature from the sacrum of a patient with a history of pressure sores. Sweat rates were greater at the sacrum and ischium than the calf or forearm. There were differences in the concentrations of lactate and urea between sites but these were smaller when expressed as amount secreted. Sweat rates were significantly lower in groups (ii) and (iii), but sweat could be collected reliably. This technique has potential clinical application to the investigation of susceptibility to pressure sores.

Computerized tomography of pelvic osteomyelitis in patients with spinal cord injuries

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Firooznia, H.; Rafii, M.; Golimbu, C.; Sokolow, J.

1983-01-01

Computerized tomography (CT) was performed in 19 patients with spinal cord injury (SCI) who had large pressure sores and in whom other complications were suspected. CT detected the depth, extent, and degree of undermining of the edges of the pressure sores in 19 of 27 lesions. Conventional radiography detected four cases of pelvic osteomyelitis. CT detected eight additional cases of pelvic osteomyelitis, as well as eight clinically unsuspected peripelvic and intrapelvic abscesses. Technetium-99m bone scanning was not very helpful because of localization in chronic proliferative changes of bone and widespread foci of myositis ossificans, as well as in osteomyelitis. Gallium-67 scanning detected only one of six abscesses. It was not very helpful because of confusion of abscess and osteomyelitis with intense soft tissue swelling and cellulitis, which are often associated with pressure sores in patients with chronic SCI. CT was found to be, by far, the modality of choice for detection of pelvic osteomyelitis and abscess in patients with SCI

The Effect of Zinc Lozenge on Postoperative Sore Throat: A Prospective Randomized, Double-Blinded, Placebo-Controlled Study.

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Farhang, Borzoo; Grondin, Lydia

2018-01-01

Postoperative sore throat (POST) is commonly seen after endotracheal intubation, and oral zinc prevents oral mucositis associated with chemotherapy. This study is designed to evaluate the effects of administration of zinc lozenges on POST. Seventy-nine patients undergoing low- or moderate-risk surgery with endotracheal intubation were randomly assigned into 2 groups: Control group received placebo and zinc group received 40-mg zinc lozenges 30 minutes preoperatively. Patients were assessed for incidence and severity (4-point scale, 0-3) of POST at 0, 2, 4, and 24 hours postoperatively. The primary outcome was incidence of POST at 4 hours after surgery. The secondary outcomes were the incidence of POST at 0, 2, and 24 hours and the severity of POST. At 4 hours, there was a significantly lower incidence of POST in the zinc group, 7%, than the control group, 29% (P = .046). The incidence of POST at 0 hour was 0% in zinc group and 24% in control group (P = .004). The highest incidence of POST occurred at the second hour after surgery, with the rate of 10% in the zinc group and 34% in the control group (P = .0495). The incidence of POST at 24 hours was 13% in zinc group and 24% in control group (not significant). The severity of POST was significantly lower in the zinc group for mild (P = .003) and moderate (P = .004) POST. The administration of a single dose of 40-mg zinc lozenge 30 minutes preoperatively is effective to reduce both incidence of POST in the first 4 hours and severity of mild and moderate POST in the immediate postoperative period.

The evidence-based principles of negative pressure wound therapy in trauma & orthopedics.

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A, Novak; Khan, Wasim S; J, Palmer

2014-01-01

Negative pressure wound therapy is a popular treatment for the management of both acute and chronic wounds. Its use in trauma and orthopedics is diverse and includes the acute traumatic setting as well as chronic troublesome wounds associated with pressure sores and diabetic foot surgery. Efforts have been made to provide an evidence base to guide its use however this has been limited by a lack of good quality evidence. The following review article explores the available evidence and describes future developments for its use in trauma and orthopaedic practice.

Expanded Flaps in Surgical Treatment of Pressure Sores: Our Experience for 25 Years.

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Di Caprio, Giovanni; Serra-Mestre, José Maria; Ziccardi, Pasquale; Scioli, Michelina; Larocca, Fabio; Nunziata, Vincenzo; Grella, Roberto; D'Andrea, Francesco

2015-11-01

Because the ischial region is the main weight-bearing area in sitting, it is one of the areas most frequently affected by pressure ulcers in paraplegic patients resuming the sitting position during the subacute and chronic stages. The techniques described to date have not been able to reduce the high rates of recurrence and flap dehiscence. Other groups have described successful tissue expansion in the treatment of pressure ulcers, but to date, the long-term results of the procedure have not been reported. The long-term follow-up of 138 reconstructions of the ischial region in patients with pressure ulcers types III to IV treated with posterior thigh expanded rotation flaps is reported. All patients achieved complete resolution, with adequate coverage of deeper layers, although 15.94% presented minor complications. None of these complications impeded full repair of the lesion. The 28 lesions that recurred were all reconstructed with the re-expansion of the same flap. There were no cases of flap dehiscence. The use of tissue expanders to treat ischial pressure ulcers, especially in patients with long life expectancy, offers important advantages over other approaches. The procedure provides abundant, high-quality tissue and may be repeated many times without creating new scars. With the use of tissue expanders, other reconstructive options can be reserved for the future.

Additional effects of taurine on the benefits of BCAA intake for the delayed-onset muscle soreness and muscle damage induced by high-intensity eccentric exercise.

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Ra, Song-Gyu; Miyazaki, Teruo; Ishikura, Keisuke; Nagayama, Hisashi; Suzuki, Takafumi; Maeda, Seiji; Ito, Masaharu; Matsuzaki, Yasushi; Ohmori, Hajime

2013-01-01

Taurine (TAU) has a lot of the biological, physiological, and pharmocological functions including anti-inflammatory and anti-oxidative stress. Although previous studies have appreciated the effectiveness of branched-chain amino acids (BCAA) on the delayed-onset muscle soreness (DOMS), consistent finding has not still convinced. The aim of this study was to examine the additional effect of TAU with BCAA on the DOMS and muscle damages after eccentric exercise. Thirty-six untrained male volunteers were equally divided into four groups, and ingested a combination with 2.0 g TAU (or placebo) and 3.2 g BCAA (or placebo), thrice a day, 2 weeks prior to and 4 days after elbow flexion eccentric exercise. Following the period after eccentric exercise, the physiological and blood biochemical markers for DOMS and muscle damage showed improvement in the combination of TAU and BCAA supplementation rather than in the single or placebo supplementations. In conclusion, additional supplement of TAU with BCAA would be a useful way to attenuate DOMS and muscle damages induced by high-intensity exercise.

Effect of BCAA supplement timing on exercise-induced muscle soreness and damage: a pilot placebo-controlled double-blind study.

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Ra, Song-Gyu; Miyazaki, Teruo; Kojima, Ryo; Komine, Shoichi; Ishikura, Keisuke; Kawanaka, Kentaro; Honda, Akira; Matsuzaki, Yasushi; Ohmori, Hajime

2017-09-22

The aim of present study was to compare the effects of branched-chain amino acid (BCAA) supplementation taken before or after exercise on delayed onset muscle soreness (DOMS) and exercise-induced muscle damage (EIMD). Fifteen young men (aged 21.5 ± 0.4 years) were given either BCAA (9.6 g·day-1) or placebo before and after exercise (and for 3 days prior to and following the exercise day) in three independent groups: the Control group (placebo before and after exercise), the PRE group (BCAA before exercise and placebo after exercise), and the POST group (placebo before exercise and BCAA after exercise). Participants performed 30 repetitions of eccentric exercise with the non-dominant arm. DOMS, upper arm circumference (CIR), elbow range of motion (ROM), serum creatine kinase (CK), lactate dehydrogenase (LDH), and aldolase, BCAA, and Beta-hydroxy-Beta-methylbutyrate (3HMB) were measured immediately before and after the exercise and on the following 4 days. Serum BCAA and 3HMB concentrations increased significantly in the PRE group immediately after the exercise, recovering to baseline over the following days. In the days following the exercise day, DOMS, CIR, and ROM were significantly improved in the PRE group compared to the Control group, with weaker effects in the POST group. Serum activities of CK, LDH, and aldolase in the days following the exercise day were significantly suppressed in the PRE group compared to Control group. Present study confirmed that repeated BCAA supplementation before exercise had a more beneficial effect in attenuating DOMS and EIMD induced by eccentric exercise than repeated supplementation after exercise.

Myocellular enzyme leakage, polymorphonuclear neutrophil activation and delayed onset muscle soreness induced by isokinetic eccentric exercise.

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Croisier, J L; Camus, G; Deby-Dupont, G; Bertrand, F; Lhermerout, C; Crielaard, J M; Juchmès-Ferir, A; Deby, C; Albert, A; Lamy, M

1996-01-01

To address the question of whether delayed onset muscular soreness (DOMS) following intense eccentric muscle contraction could be due to increased production of the arachidonic acid derived product prostaglandin E2 (PGE2). 10 healthy male subjects were submitted to eccentric and concentric isokinetic exercises on a Kin Trex device at 60 degrees/s angular velocity. Exercise consisted of 8 stages of 5 maximal contractions of the knee extensor and flexor muscle groups of both legs separated by 1 min rest phases. There was an interval of at least 30 days between eccentric and concentric testing, and the order of the two exercise sessions was randomly assigned. The subjective presence and intensity of DOMS was evaluated using a visual analogue scale, immediately, following 24 h and 48 h after each test. Five blood samples were drawn from an antecubital vein: at rest before exercise, immediately after, after 30 min recovery, 24 h and 48 h after the tests. The magnitude of the acute inflammatory response to exercise was assessed by measuring plasma levels of polymorphonuclear elastase ([EL]), myeloperoxidase ([MPO]) and PGE2 ([PGE2]). Using two way analysis of variance, it appeared that only eccentric exercise significantly increased [EL] and DOMS, especially of the hamstring muscles. Furthermore, a significant decrease in eccentric peak torque of this muscle group only was observed on day 2 after eccentric work (- 21%; P < 0.002). Serum activity of creatine kinase and serum concentration of myoglobin increased significantly 24 and 48 h after both exercise tests. However, these variables reached significantly higher values following eccentric contractions 48 h after exercise. Mean [PGE2] in the two exercise modes remained unchanged over time and were practically equal at each time point. On the basis of these findings, we conclude that the magnitude of polymorphonuclear (PMN) activation, muscle damage, and DOMS are greater after eccentric than after concentric muscle

Perbandingan Penggunaan Topikal Spray Benzidamin HCl 0,15% dan Gel Lidokain 2% pada Pipa Endotrakeal terhadap Kejadian Nyeri Tenggorok Pascaintubasi Endotrakeal

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Maulana Muhammad

2015-08-01

Full Text Available Postoperative sore throat is common and unpleasant after endotracheal anesthesia. This study was conducted to determine whether the use of benzydamine hcl 0.15% can further reduce the incidence of sore throat compared to lidocaine gel 2% in patients under endotracheal anesthesia. This experimental study was a randomized control trial (RCT in 90 patients with ASA physical status I–II, aged 18–60 years who underwent elective surgery in the central surgical operating room of Dr. Hasan Sadikin General Hospital during the period of June to August 2014. Patients were divided in benzydamine group, lidocaine group, and NaCl group. The hemodynamic changes were noted during surgery. The endotracheal tube cuff pressure was maintained below 25 mmHg and a graded scale for sore throat was performed at 2 hours, 6 hours, and 24 hours (T2, T6, T24 after surgery. Statistical tests using t-test, Kruskal-Wallis, and chi-square test were conducted. From the results, the incidence of sore throat in the benzydamine HCL group was significantly lower than in the lidoccaine HCL group at 6 hours after surgery (T6; p<0.05. It is concluded that benzydamin HCL 0.15% spray is able to reduce the incidence of postoperative sore throat when compared to lidocaine 2% gel.

Skin care and incontinence

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... skin care; Incontinence - pressure sore; Incontinence - pressure ulcer Patient Instructions Preventing pressure ulcers Images Male urinary system References Holroyd S. Incontinence-associated dermatitis: identification, prevention and care. Br J Nurs . 2015;24( ...

Effect of an herbal/botanical supplement on recovery from delayed onset muscle soreness: a randomized placebo-controlled trial.

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Rynders, Corey A; Weltman, Judy Y; Rynders, Sara D; Patrie, James; McKnight, John; Katch, Frank I; Hertel, Jay; Weltman, Arthur

2014-01-01

We examined the effects of a proprietary herbal/botanical supplement (StemSport, Stemtech, San Clemente, CA.) suggested to increase circulating stem cells, decrease inflammation, and attenuate exercise induced muscle damage on recovery from delayed onset muscle soreness (DOMS). Sixteen subjects (male = 7, female = 9; age 23.8 ± 10 years; height 171.9 ± 10 cm, mass 72.2 ± 15 kg) were randomized in a crossover, double-blind, placebo controlled trial to receive a placebo or StemSport supplement (6150 mg/day) for 14 days. DOMS was induced on day 7 for both placebo and active conditions in the non-dominant elbow flexor group with repeated eccentric repetitions. Muscle swelling (biceps girth), elbow flexor isometric strength (hand held dynamometer), muscle pain/tenderness (visual analog scale), range of motion (active elbow flexion and extension), and inflammation (hsCRP, IL6, and TNF-α) were measured at baseline and at 24 h, 48 h, 72 h, and 168 h (1 week) post eccentric exercise. The crossover washout period was ≥14 days. No significant condition-by-time interactions between placebo and StemSport supplementation were observed with regard to measures of pain (p = 0.59), tenderness (p = 0.71), isometric strength (p = 0.32), elbow flexion (p = 0.45), muscle swelling (p = 0.90), or inflammation (p > 0.90). Decrements in elbow extension range of motion 48 h post-exercise were less after StemSport supplementation (Δ elbow extension 48 h post; StemSport, -2.0 deg; placebo, -10 deg; p = 0.003). These data suggest that compared to placebo, StemSport supplementation does not improve outcome measures related to muscle recovery after acute upper-arm induced DOMS.

Relationship between physical exercise, muscle damage and delayed-onset muscle soreness

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Denis Foschini

2007-03-01

Full Text Available The objective of the present study was to investigate the relationship between physical exercise involving muscle damage and delayed-onset muscle soreness (DOMS. A literature review of national and international periodicals was carried out. Muscle structures (membranes, Z-line, sarcomeres, T tubules and myofi brils can become damaged as a result of an imposed mechanical overload. Of greatest note are exercises requiring strength, particularly when muscular action is eccentric. Damage to skeletal musculature can be analyzed by direct methods (muscle biopsy or magnetic resonance or by indirect methods (maximum voluntary movement, subjective pain perception scales, analysis of enzyme and protein concentrations in blood. Creatine kinase (CK, lactate dehydrogenase (LDH, myosin heavy chain fragments, troponin-I and myoglobin can be used as indirect markers of muscle damage. Both DOMS and muscle damage can be infl uenced by the type of activity, with emphasis on eccentric muscle movements, type of exercise, velocity of the movement, interval period between series, the level of individual fi tness, this last primarily affecting beginners. When myotrauma occurs, muscle damage repair is initiated by leukocytes migrating to the injured area, although, the histamines, prostaglandins, kinins and K+ produced by neutrophils and macrophages stimulate free nerve endings in the muscle, causing the DOMS. Despite this apparent relationship between muscle damage and DOMS, it is not possible toestablish a linear relationship between these two variables, since published data are divergent. RESUMO O objetivo desse estudo foi investigar as relações do exercício físico com o dano muscular e dor muscular de início tardio (DMIT. Para tanto, foi realizada uma revisão de literatura de periódicos nacionais e internacionais. O dano muscular pode ocorrer em estruturas musculares (membranas, linha Z, sarcolema, túbulos T e miofi brilas em função da sobrecarga mec

Headache: an important factor associated with muscle soreness/pain at the two-year follow-up point among patients with major depressive disorder.

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Hung, Ching-I; Liu, Chia-Yih; Yang, Ching-Hui; Wang, Shuu-Jiun

2016-01-01

No study has compared the associations of headache, anxiety, and depression at baseline with muscle soreness or pain (MS/P) at baseline and at the two-year follow-up point among outpatients with major depressive disorder (MDD). This study aimed to investigate the above issue. This study enrolled 155 outpatients with MDD at baseline, and 131 attended a two-year follow-up appointment. At baseline, migraine was diagnosed based on the International Classification of Headache Disorders, 2(nd) edition. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale was used to evaluate the intensities of headache and MS/P in the neck, shoulder, back, upper limbs, and lower limbs. Depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale. Multiple linear regressions were used to compare the associations of these factors with MS/P. Compared with anxiety disorders, migraine was more strongly associated with MS/P in all areas at baseline and in the upper and lower limbs at follow-up. Headache intensity at baseline was the factor most strongly associated with MS/P in all areas at baseline and follow-up after controlling for depression and anxiety. Headache intensity at baseline predicted MS/P at baseline and follow-up. Migraine and headache intensity are important factors related to MS/P at baseline and follow-up among patients with MDD. Integrating depression and headache treatment might be indicated to improve MS/P.

Mouth ulcers

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... Gingivostomatitis Herpes simplex ( fever blister ) Leukoplakia Oral cancer Oral lichen planus Oral thrush A skin sore caused by histoplasmosis may ... mouth Images Oral thrush Canker sore (aphthous ulcer) Lichen planus on the oral mucosa Mouth sores References Daniels TE, Jordan RC. ...

Sexually Transmitted Infection

Science.gov (United States)

... infected person’s herpes sore or fluid from a herpes sore. Having genital herpes during pregnancy can cause serious health problems for ... pass herpes to your baby if you have genital herpes sores and blisters (called an outbreak) for the ...

Sore Throats

Science.gov (United States)

... since drainage from nose or sinus infections can cause throat infections as well. If you live or work in close quarters such as a child care center, classroom, office, prison, or military installation, ...

Canker Sore

Science.gov (United States)

... base of your gums, or on your soft palate. You might notice a tingling or burning sensation ... border) Pain that you can't control with self-care measures Extreme difficulty eating or drinking High ...

Sore Throats

Science.gov (United States)

... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

Mouth Sores

Science.gov (United States)

... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

Sore Society

DEFF Research Database (Denmark)

Fausing, Bent

2014-01-01

This is not brand new; in fact, I do not even mention the word selfie. However, it was very rewarding for me in terms of the intellectual and emotional richness and challenge, I got in return from working with this article and the questions and the answers it deals with. Maybe it will be good...

Cold Sores

Science.gov (United States)

... Men? The History of Dental Advances Pacifiers Have Negative and Positive Effects What is Dental Amalgam (Silver Filling)? What is a Composite Resin (White Filling)? Learn what those dental words mean. Check out how your teeth and mouth change in every stage of life. More RSS ...

Neurodynamic mobilization and foam rolling improved delayed-onset muscle soreness in a healthy adult population: a randomized controlled clinical trial

Directory of Open Access Journals (Sweden)

Blanca Romero-Moraleda

2017-10-01

Full Text Available Objectives Compare the immediate effects of a Neurodynamic Mobilization (NM treatment or foam roller (FR treatment after DOMS. Design Double blind randomised clinical trial. Setting The participants performed 100 drop jumps (5 sets of 20 repetitions, separated by 2 min rests from a 0.5-m high box in a University biomechanics laboratory to induce muscle soreness. The participants were randomly assigned in a counter-balanced fashion to either a FR or NM treatment group. Participants Thirty-two healthy subjects (21 males and 11 females, mean age 22.6 ± 2.2 years were randomly assigned into the NM group (n = 16 or the FR group (n = 16. Main Outcome Measures The numeric pain rating scale (NPRS; 0–10, isometric leg strength with dynamometry, surface electromyography at maximum voluntary isometric contraction (MVIC and muscle peak activation (MPA upon landing after a test jump were measured at baseline, 48 h after baseline before treatment, and immediately after treatment. Results Both groups showed significant reduction in NPRS scores after treatment (NM: 59%, p  .05. The percentage change improvement in the MVIC for the rectus femoris was the only significant difference between the groups (p < 0.05 at post-treatment. After treatment, only the FR group had a statistically significant improvement (p < 0.01 in strength compared to pre-treatment. Conclusion Our results illustrate that both treatments are effective in reducing pain perception after DOMS whereas only FR application showed differences for the MVIC in the rectus femoris and strength.

VAC Therapy in Large Infected Sacral Pressure Ulcer Grade IV—Can Be an Alternative to Flap Reconstruction?

OpenAIRE

Batra, R. K.; Aseeja, Veena

2012-01-01

Vacuum-assisted closure (VAC) therapy is a new entrant in wound care after growth factors and alginate or hydrocolloid dressing, in the treatment of pressure ulcers. We have been using this technique for diabetic foot ulcers. A young nondiabetic man presented with a large sacral bed sore after high doses of ionotropes in an intensive care unit for treating severe hypotension. His wound was debrided, and instead of flap surgery in such infected wound, he was treated with VAC therapy. The compl...

Maintaining Healthy Skin -- Part 2

Science.gov (United States)

... and SCI • Depression and SCI • Taking Care of Pressure Sores • Maintaining Healthy Skin (Part I) • Maintaining Healthy Skin ( ... For information on establishing skin tolerance, see our “Pressure Sores” pamphlet.) Pressure releases in a wheelchair can be ...

Multiple sclerosis

Science.gov (United States)

... indwelling catheter Osteoporosis or thinning of the bones Pressure sores Side effects of medicines used to treat the ... Daily bowel care program Multiple sclerosis - discharge Preventing pressure ulcers Swallowing problems Images Multiple sclerosis MRI of the ...

Caring for muscle spasticity or spasms

Science.gov (United States)

... provider tells you to. Be careful about getting pressure sores from exercise or being in the same position ... Instructions Brain surgery - discharge Multiple sclerosis - discharge Preventing pressure ulcers Stroke - discharge Review Date 5/21/2016 Updated ...

Neurogenic bladder

Science.gov (United States)

... cause skin to break down and lead to pressure sores Kidney damage if the bladder becomes too full, ... dysfunction; NBSD Patient Instructions Multiple sclerosis - discharge Preventing pressure ulcers Images Voiding cystourethrogram References Chapple CR, Osman NI. ...

Recovering after stroke

Science.gov (United States)

... urine from their body. To prevent skin or pressure sores: Clean up after incontinence Change position often and ... artery surgery - discharge Daily bowel care program Preventing pressure ulcers Stroke - discharge References Dobkin BH. Neurological rehabilitation In: ...

Investigating the reliability and validity of the waterlow risk assessment scale: a literature review.

LENUS (Irish Health Repository)

Walsh, Breda

2012-02-01

The aim of this review was to examine health literature on the reliability and validity of the Waterlow pressure sore assessment scale. A systematic review of published studies relating to the topic was conducted and literature was examined for its relevancy to the topic under investigation. Findings suggest that despite the availability of over 40 assessment tools, the Waterlow assessment scale is the most frequently used by health care staff. Research suggests that the Waterlow Scale is an unreliable method of assessing individuals at risk of pressure sore development with all studies indicating a poor interrater reliability status. Its validity has also been criticized because of its high-sensitivity but low-specificity levels.

Investigating the reliability and validity of the waterlow risk assessment scale: a literature review.

LENUS (Irish Health Repository)

Walsh, Breda

2011-05-01

The aim of this review was to examine health literature on the reliability and validity of the Waterlow pressure sore assessment scale. A systematic review of published studies relating to the topic was conducted and literature was examined for its relevancy to the topic under investigation. Findings suggest that despite the availability of over 40 assessment tools, the Waterlow assessment scale is the most frequently used by health care staff. Research suggests that the Waterlow Scale is an unreliable method of assessing individuals at risk of pressure sore development with all studies indicating a poor interrater reliability status. Its validity has also been criticized because of its high-sensitivity but low-specificity levels.

Effects of acute postexercise chocolate milk consumption during intensive judo training on the recovery of salivary hormones, salivary SIgA, mood state, muscle soreness, and judo-related performance.

Science.gov (United States)

Papacosta, Elena; Nassis, George P; Gleeson, Michael

2015-11-01

This study examined the effects of postexercise chocolate milk (CM) or water (W) consumption during 5 days of intensive judo training with concomitant weight loss on salivary cortisol and testosterone, salivary secretory immunoglobulin A (SIgA), delayed-onset muscle soreness (DOMS), and judo-related performance. Twelve trained male judo athletes engaged in 5 days of intensive judo training followed by a simulated judo competition, on 2 separate training weeks 14 days apart. The athletes consumed 1000 mL of W (week 1) or CM (week 2) immediately post-training. During both weeks, athletes were instructed to "make weight" for the upcoming competition. Performance in timed push-ups and the Special Judo Fitness Test improved by 14.6% and 6.8%, respectively, at the end of the training week with CM consumption (both p mood disturbance (p 0.05). Body mass decreased by 1.9% in the W condition and by 1.1% in the CM condition, with no significant difference between treatments. This study indicates that postexercise CM consumption during short-term intensive judo training enhances aspects of recovery without affecting intentional weight loss.

[Pressure sores secondary to immobilization with cervical collar: a complication of acute cervical injury].

Science.gov (United States)

Molano Alvarez, Esteban; Murillo Pérez, María del Ara; Salobral Villegas, María Teresa; Domínguez Caballero, Mireia; Cuenca Solanas, Manuela; García Fuentes, Carlos

2004-01-01

Cervical collars are essential in the treatment of patients with suspicion or verification of acute cervical spine injury (ACSI). One of the complications of these devices is the development of pressure scores (PS). This study aims to determine its incidence in our unit, the characteristics of patients with ACSI who suffer PS due to the collar and to describe aspects related with these injuries. We include 92 patients with ACSI hospitalized more than 24 hours from January 2002 to December 2003. We analyze demographic variables, incidence, risk factors and characteristics of the PS that develop. The incidence of these lesions was 23.9%. Patients with PS presented: a higher injury severity score (ISS) (37.5 9.8 vs. 31.3 14.9), a greater percentage of catheter carriers of intracraneal pressure (ICP) (55.6% vs. 16.2%), longer time of mechanical ventilation (15.4 8.2 vs. 6.1 9) and longer stays (24.6 10.9 vs. 10 10.3), all statistically significant (pACSI, elevated ISS, monitoring of ICP, mechanical ventilation and prolonged stays is required. The occipital zone requires special attention due to the seriousness of the injuries recorded. We suggest a specific multidisciplinary protocol for this problem.

Wound care centers

Science.gov (United States)

Pressure ulcer - wound care center; Decubitus ulcer - wound care center; Diabetic ulcer - wound care center; Surgical wound - wound ... Common types of non-healing wounds include: Pressure sores Surgical ... flow, or swollen legs Certain wounds may not heal well due to: ...

Sex and Fertility After SCI

Medline Plus

Full Text Available ... Living with SCI Personal Experiences by Topic Resources Peer ... Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

Basics of SCI Rehabilitation

Medline Plus

Full Text Available ... Living with SCI Personal Experiences by Topic Resources Peer ... Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

African Journal of Neurological Sciences - 2009 Vol. 28 No 1

African Journals Online (AJOL)

Department of Medicine, Makerere University College of Health Sciences, Kampala, ... and emergency unit, and general neurology unit by a neurologist, internal medicine physicians, nurses and ... deep vein thrombosis and pressure sores.

Spinal Cord Injury 101

Medline Plus

Full Text Available ... Living with SCI Personal Experiences by Topic Resources Peer ... Adult Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

Bone setter's gangrene | Nwadiaro | Nigerian Journal of Medicine

African Journals Online (AJOL)

Abstract. Background: Gangrene usually supervenes following prolonged pressure of tight splintage by traditional bone setters (TBS) in the process of treating fractures. However, various complications such as blisters, pressure sores, Volkmann's ischaemia/ contracture, Crush syndrome and pregangrene occur by the same ...

Marjolin’s ulcer in chronic wounds – review of available literature

Directory of Open Access Journals (Sweden)

Dariusz Bazaliński

2017-09-01

Full Text Available Marjolin’s ulcer is a rare, aggressive skin cancer developing in scar tissue, chronic ulcers and areas affected by inflammations. Its incidence is estimated to range from 1% to 2% of all burn scars. It most frequently takes the form of squamous cell carcinoma which sometimes is diagnosed during examination of lesions developing in scars and hard-to-heal chronic wounds (pressure sores, leg ulcers. Therapeutic management of Marjolin’s ulcer requires well-designed treatment plan to ensure optimal medical care and good quality of life for the patient. The high risk of metastases and damage to the structure of vitally important organs determines the need for early diagnosis and prompt surgical intervention with supplementary therapy. The purpose of the study was to examine etiopathogenesis of Marjolin’s ulcer and principles of its treatment. The authors focused on the aspect of malignant degeneration in chronic wounds (leg ulcers, pressure sores as a very rare, aggressive form of Marjolin’s ulcer. A review of the available literature on the issue of Marjolin ulcers was conducted using the key words; Marjolin ulcers, pressure sore, chronic wound. Malignant degeneration in chronic wounds is a very rare aggressive form of Marjolin ulcer. Increased oncological alertness should be displayed by nursing and medical personnel taking care of patients with chronic wounds.

Factors affecting length of hospital stay for people with spinal cord injuries at Kanombe military hospital, Rwanda

Directory of Open Access Journals (Sweden)

PB Bwanjugu

2012-12-01

Full Text Available In patients with spinal cord injuries increased length ofhospital stay is often as a result of secondary complications such as pressuresores, urinary tract infection and respiratory infection. An increased lengthof hospital stay was observed at Kanombe Military Hospital in Rwanda.The aim of this study was to determine specific factors affecting length ofhospital stay for individuals with spinal cord injuries at Kanombe MilitaryHospital in Rwanda. The records of 124 individuals with spinal cordinjuries who were discharged from the hospital between 1st January1996and 31st December 2007 were reviewed to collect data. Information collected and captured on a data gathering sheetincluded demographic data, information relating to the injury, occurrence of medical complications and length ofhospital stay. Linear regression analysis was computed in SPSS to determine factors affecting the length of stay.The necessary ethical considerations were adhered to during the implementation of the study. Current employmentstatus and the occurrence of pressure sores were significantly associated with the length of hospital stay (p=0.021 andp=0.000 respectively. A strong relationship was noted between pressure sores and length of stay (R= 0.703. There is aneed for all members of the rehabilitation team to devise and implement effective measures to prevent the developmentof pressure sores, in patients with spinal cord injuries in the study setting.

Spinal Cord Injury 101

Medline Plus

Full Text Available ... Medical Experts People Living with SCI Personal Experiences by Topic Resources Peer ... Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

Basics of SCI Rehabilitation

Medline Plus

Full Text Available ... Medical Experts People Living with SCI Personal Experiences by Topic Resources Peer ... Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

Sex and Fertility After SCI

Medline Plus

Full Text Available ... Medical Experts People Living with SCI Personal Experiences by Topic Resources Peer ... Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

Departmental of Clinical Investigation: Annual Research Progress Report for Fiscal Year 1992. Volume 1

Science.gov (United States)

1993-01-01

effect of cisapride on the symptoms of unexplained upper abdominal pain, nausea, vomiting, anorexia, early satiety, bloating/ distension in patients with...for 30 minutes following eccentric exercise will less the 3 indices of delayed-onset muscle soreness (DOMS): perceived muscular soreness, reduced...post-exercise and the Talag Pain Rating Scale will be used to assess muscular soreness. Progress: No progress report was furnished by the principal

Subungual Hematoma

Science.gov (United States)

... of the nail and intense pressure. Initially the injury may only hurt. The nail may feel sore or tender to the touch. As the blood pools under the nail the pressure from the blood can cause severe pain. The pressure caused by blood underneath the nail may result in the ...

Walking (Gait), Balance, and Coordination Problems

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Secondary-Progressive MS (SPMS)

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Diagnosing MS

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Staying Well

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Health and Wellness

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

T Cells

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Primary-Progressive MS (PPMS)

Science.gov (United States)

... FES) d Complementary & Alternative Medicines Chiropractic Therapy Marijuana Massage and Bodywork Acupuncture d For Clinicians d Resources & ... Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d Resources for ...

Relapsing-Remitting MS (RRMS)

Medline Plus

Full Text Available ... at MSconnection.org Join a Local Support Group Peer Connections: One-on-One Edward M. Dowd Personal Advocate Program d Advanced Care Needs Pressure Sores Osteoporosis Seeking Services: Questions to Ask d ...

Overview of Spinal Cord Disorders

Science.gov (United States)

... care to prevent complications, which include the following: Pressure sores : Nurses inspect the person's skin daily, keep the skin dry and clean, and turn the person frequently. When necessary, a special ... It can be turned to shift pressure on the body from front to back and ...

Decubitus prophylaxis

DEFF Research Database (Denmark)

Andersen, Klaus Ejner; Jensen, O; Kvorning, S A

1983-01-01

Six hundred patients at risk for pressure sores were randomized in either a control group or one of two experimental groups placed on alternating-pressure air-mattresses and water-mattresses. The groups remained comparable throughout the 10-day study period. Twenty-one patients from the control...

A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds

Directory of Open Access Journals (Sweden)

Tauro Leo

2007-01-01

Full Text Available Aim: To assess the efficacy of topical negative pressure moist wound dressing as compared to conventional moist wound dressings in improving the healing process in chronic wounds and to prove that negative pressure dressings can be used as a much better treatment option in the management of chronic wounds. Materials and Methods: This is a prospective comparative study of data from 112 patients with chronic wounds, of which 56 patients underwent topical negative pressure dressings (17 diabetic, 10 pressure sores, nine ischemic, two varicose, 10 post-infective raw areas and eight traumatic - six had bone exposed, two orthopaedic prosthesis exposed. The remaining 56 patients underwent conventional moist dressings (20 diabetic, two ischemic, 15 pressure sores, three varicose, eight post-infective raw areas and eight traumatic - five had bone exposed, three orthopaedic prosthesis exposed. The results were compared after 10 days. The variables compared were, rate of granulation tissue formation as a percentage of ulcer area covered, skin graft take up as the percentage of ulcer surface area and duration of hospital stay. The variables were compared using Unpaired Student′s t test. A " P" value < 0.05 was considered significant. Results: Out of 56 patients who underwent topical negative pressure dressings, six (10.71% were failures, due to failure in maintaining topical negative pressure due to defective sealing technique; these were included into the study group. After 10 days, the mean rate of granulation tissue formation was 71.43% of ulcer surface area. All these 56 cases underwent split-thickness skin grafting. The mean graft take-up was 79.29%. The mean hospital stay was 32.64 days. In the remaining 56 patients, the mean rate of granulation tissue formation was 52.85% of ulcer surface area. The mean graft take-up was only 60.45% of the total ulcer surface area. The mean hospital stay was 60.45 days. Conclusion: To conclude, topical negative

The sore throat

African Journals Online (AJOL)

remains the major treatable organism and needs a specific work-up. It also remains the most common bacterial cause of pharyngitis in children and adolescents. The differences in evaluating children and adults need to be understood.

Download this PDF file

African Journals Online (AJOL)

loss of sitting balance and necessitates the use of the patient's arms for support, thereby reducing function. Asymmetrical buttock pressure distribution and the absence of sensation may result in ischial pressure sores. Surgical scoliosis correction is reserved for curves exceeding 50° and involves instrumented fusion from T2.

Spinal Cord Injury 101

Medline Plus

Full Text Available ... Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ... a spinal cord injury? play_arrow Why are high-dose steroids often used right after an injury? ...

Pressure-induced referred pain areas are more expansive in individuals with a recovered fracture

DEFF Research Database (Denmark)

Doménech-García, Víctor; Skuli Palsson, Thorvaldur; Boudreau, Shellie Ann

2018-01-01

the shoulder region was induced by a 60-s pressure stimulation (PPT+20%) at the infraspinatus muscle and recorded on an electronic body chart. Following Day-0 assessments, delayed onset muscle soreness (DOMS) was induced to challenge the pain systems by exercising the external rotators of the recovered...... a shoulder fracture and 20 age/gender matched controls participated in two experimental sessions (Day-0, Day-1) separated by 24 hours. On both days, pressure pain thresholds (PPTs) were measured bilaterally at infraspinatus, supraspinatus, trapezius, and gastrocnemius muscles. Referred pain towards....../dominant shoulder. The size of pressure-induced pain referral on Day-0 did not differ between groups although there was a tendency for a smaller referred pain area in recovered group. PPTs at the infraspinatus muscle on the DOMS side was reduced on Day-1 in both groups (P=0.03). An expansion of pressure...

Sex and Fertility After SCI

Medline Plus

Full Text Available ... Adult Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from ... Rosenberg, PsyD Understanding SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa ...

Basics of SCI Rehabilitation

Medline Plus

Full Text Available ... Adult Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from ... Rosenberg, PsyD Understanding SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa ...

A quality control circle process to improve implementation effect of prevention measures for high-risk patients.

Science.gov (United States)

Feng, Haixia; Li, Guohong; Xu, Cuirong; Ju, Changping; Suo, Peiheng

2017-12-01

The aim of the study was to analyse the influence of prevention measures on pressure injuries for high-risk patients and to establish the most appropriate methods of implementation. Nurses assessed patients using a checklist and factors influencing the prevention of a pressure injury determined by brain storming. A specific series of measures was drawn up and an estimate of risk of pressure injury determined using the Braden Scale, analysis of nursing documents, implementation of prevention measures for pressure sores and awareness of the system both before and after carrying out a quality control circle (QCC) process. The overall scores of implementation of prevention measures ranged from 74.86 ± 14.24 to 87.06 ± 17.04, a result that was statistically significant (P prevention measure scores ranged from 11.48 ± 4.18 to 13.96 ± 3.92. Differences in all of the above results are statistically significant (P prevention measures for patients who are vulnerable to pressure sores and is of practical importance to their prevention and control. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Comparison of complications of spinal and general anesthasia in ...

African Journals Online (AJOL)

Patient's blood pressure was measured and recorded at various times and in recovery as well as in the ... Intra-operative bleeding, pain in the surgery area, nausea and vomiting, shortness of breath and sore throat were recorded for the two ...

Diabetes, Gum Disease, and Other Dental Problems

Science.gov (United States)

... Diabetes, Sexual, & Bladder Problems Diabetes, Gum Disease, & Other Dental Problems How can diabetes affect my mouth? Too ... What if my mouth is sore after my dental work? A sore mouth is common after dental ...

Neurological Consequences of Cytomegalovirus Infection

Science.gov (United States)

... that causes cold sores (herpes simplex virus), infectious mononucleosis (Epstein-Barr virus), and chickenpox/shingles (varicella zoster ... that causes cold sores (herpes simplex virus), infectious mononucleosis (Epstein-Barr virus), and chickenpox/shingles (varicella zoster ...

Impetigo

Science.gov (United States)

Impetigo is a skin infection caused by bacteria. It is usually caused by staphylococcal (staph) bacteria, but ... itchy, but scratching them can spread the sores. Impetigo can spread by contact with sores or nasal ...

Riboflavin

Science.gov (United States)

... Organ meats, such as liver and kidneys Legumes Milk Nuts Breads and cereals are often fortified with ... lip sores Skin disorders Sore throat Swelling of mucus membranes Growth failure Because riboflavin is a water- ...

Diabetic Complications and Amputation Prevention

Science.gov (United States)

... become exposed. They can be caused by excess pressure due to ill... Ulcers Ulcers, which are open sores in the skin, occur when the outer layers of the skin are injured and the deeper tissues become exposed. They can be caused by excess pressure due to ill... Tingly Feet Tingly feet can ...

Reishi Mushroom

Science.gov (United States)

... may be used for viruses, such as the human papilloma virus (HPV), genital herpes, and cold sores. ... time needed for cold sores to heal. HPV (Human papilloma virus). Early research shows that taking a combination ...

Tissue expansion in the treatment of pressure ulcers.

Science.gov (United States)

Esposito, G; Di Caprio, G; Ziccardi, P; Scuderi, N

1991-03-01

The authors report their experience using skin expanders in 11 patients with severe bed sores. The expanders, with different volumes, from 250 to 1000 cc, were generally overfilled using the cutaneous tonometer. In fact, with the information revealed by this apparatus on the skin in expansion, the authors were able to reduce the filling intervals without risking ulceration. In their experience, the results obtained were satisfactory: All patients treated achieved surgical recovery. The authors see a wide future for skin-expander use in pressure-ulcer treatment. They have a working hypothesis about using expanders to progressively advance sensitive skin in areas subject to ulceration. This hypothesis is based on the possibility of reexpanding the same flap several times, as has been seen in the treatment of other types of pathology.

Chondroitin Sulfate

Science.gov (United States)

... caused by drugs used to treat breast cancer, acid reflux, high cholesterol, muscle soreness after exercise, a bladder ... not reduce muscle soreness after exercise in men. Acid reflux. When taken along with conventional treatments such as ...

Acyclovir Topical

Science.gov (United States)

... ointment is used to treat first outbreaks of genital herpes (a herpes virus infection that causes sores to ... body. Acyclovir does not cure cold sores or genital herpes, does not prevent outbreaks of these conditions, and ...

[Contribution of the scrotal flap for the coverage of ischial and perineal pressure ulcers].

Science.gov (United States)

Vantomme, M; Viard, R; Aimard, R; Vincent, P-L; Comparin, J-P; Voulliaume, D

2018-04-11

The ischiatric pressure sore is a common pathology in rehabilitated spinal cord injured people, despite careful prevention. Medical treatment by discharge and directed healing is not always sufficient and surgery using local musculocutaneous flaps is often essential. Unfortunately, recidivism is frequent and the availability of local flaps is limited. The scrotal flap is an excellent complement to classic flaps, gluteal flaps or hamstrings. It can be used alone or in addition to another musculocutaneous flap, in first or second intention. The scrotal flap is a musculocutaneous flap, using the Dartos, the platys muscle of the scrotum. It is richly vascularized, extensible and resistant. Its great plasticity makes it adaptable to any form of loss of substance, with an arc of rotation that can reach the anal margin. It can also be desepidermized and buried to fill a deep defect. Ten cases of scrotal flaps and their different indications are reviewed: some are used in first intention, others in addition to musculocutaneous flaps. The removal of a scrotal flap is fast and extremely easy. The simple closure of the donor site allows the sampling of half of the scrotum due to the great local laxity. The scrotal flaps achieved quickly healed, as well as the donor sites. Only one recurrence was observed after an inappropriate treatment of underlying osteitis. No complications have occurred. The scrotal musculocutaneous flap, reliable, resistant, quick and easy to remove is an excellent means of coverage of the perineal region. It can be used for the treatment of any loss of perineal substance in humans, but remains particularly useful for the treatment of ischial or perineal pressure sores. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

VAC Therapy in Large Infected Sacral Pressure Ulcer Grade IV-Can Be an Alternative to Flap Reconstruction?

Science.gov (United States)

Batra, R K; Aseeja, Veena

2014-04-01

Vacuum-assisted closure (VAC) therapy is a new entrant in wound care after growth factors and alginate or hydrocolloid dressing, in the treatment of pressure ulcers. We have been using this technique for diabetic foot ulcers. A young nondiabetic man presented with a large sacral bed sore after high doses of ionotropes in an intensive care unit for treating severe hypotension. His wound was debrided, and instead of flap surgery in such infected wound, he was treated with VAC therapy. The complete wound healing was achieved in 6 weeks and at half the cost of flap surgery. Moreover, the chances of flap failure and its related complications were eliminated.

Genital Herpes

Science.gov (United States)

Genital herpes is a sexually transmitted disease (STD) caused by a herpes simplex virus (HSV). It can cause sores on ... also infect their babies during childbirth. Symptoms of herpes are called outbreaks. You usually get sores near ...

Home Health Care: What It Is and What to Expect

Science.gov (United States)

... of care + Share widget - Select to show What’s home health care? What's home health care? Home health care is a wide ... or skilled nursing facility (SNF). Examples of skilled home health services include: Wound care for pressure sores ...

Influence of laser beam shape on in-vitro cellular and molecular transformations in human skin fibroblasts

CSIR Research Space (South Africa)

Mthunzi, P

2006-07-01

Full Text Available A variety of strategies have been utilised for prevention and treatment of chronic wounds such as leg ulcers, diabetic foot ulcers and pressure sores. Low Level Laser Therapy (LLLT) has been reported to be an invaluable tool in the enhancement...

Old age, malnutrition, and pressure sores: an ill-fated alliance

NARCIS (Netherlands)

Mathus-Vliegen, Elisabeth M. H.

2004-01-01

Wound healing is a complex, tightly regulated process, consisting of three distinct phases. In each phase of wound healing, energy and macronutrients are required. Moreover, animal studies have established a specific role for certain nutrients such as the amino acid arginine, the vitamins A, B, and

Varicose and other vein problems - self-care

Science.gov (United States)

... neomycin Drying lotions, such as calamine Lanolin, a natural moisturizer Benzocaine or other creams that numb the skin Watch for skin sores on your leg, mainly around your ankle. Take care of sores right away to prevent infection. When ...

Hormone Therapy

Science.gov (United States)

... it also can be a sign of endometrial cancer. All bleeding after menopause should be evaluated. Other side effects reported by women who take hormone therapy include fluid retention and breast soreness. This soreness usually lasts for a short ...

Effects of Light-Emitting Diode Therapy on Muscle Hypertrophy, Gene Expression, Performance, Damage, and Delayed-Onset Muscle Soreness: Case-control Study with a Pair of Identical Twins.

Science.gov (United States)

Ferraresi, Cleber; Bertucci, Danilo; Schiavinato, Josiane; Reiff, Rodrigo; Araújo, Amélia; Panepucci, Rodrigo; Matheucci, Euclides; Cunha, Anderson Ferreira; Arakelian, Vivian Maria; Hamblin, Michael R; Parizotto, Nivaldo; Bagnato, Vanderlei

2016-10-01

The aim of this study was to verify how a pair of monozygotic twins would respond to light-emitting diode therapy (LEDT) or placebo combined with a strength-training program during 12 weeks. This case-control study enrolled a pair of male monozygotic twins, allocated randomly to LEDT or placebo therapies. Light-emitting diode therapy or placebo was applied from a flexible light-emitting diode array (λ = 850 nm, total energy = 75 J, t = 15 seconds) to both quadriceps femoris muscles of each twin immediately after each strength training session (3 times/wk for 12 weeks) consisting of leg press and leg extension exercises with load of 80% and 50% of the 1-repetition maximum test, respectively. Muscle biopsies, magnetic resonance imaging, maximal load, and fatigue resistance tests were conducted before and after the training program to assess gene expression, muscle hypertrophy and performance, respectively. Creatine kinase levels in blood and visual analog scale assessed muscle damage and delayed-onset muscle soreness, respectively, during the training program. Compared with placebo, LEDT increased the maximal load in exercise and reduced fatigue, creatine kinase, and visual analog scale. Gene expression analyses showed decreases in markers of inflammation (interleukin 1β) and muscle atrophy (myostatin) with LEDT. Protein synthesis (mammalian target of rapamycin) and oxidative stress defense (SOD2 [mitochondrial superoxide dismutase]) were up-regulated with LEDT, together with increases in thigh muscle hypertrophy. Light-emitting diode therapy can be useful to reduce muscle damage, pain, and atrophy, as well as to increase muscle mass, recovery, and athletic performance in rehabilitation programs and sports medicine.

Bell palsy

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... in the face Other symptoms that may occur: Dry eye, which may lead to eye sores or infections ... Complications may include: Eye surface becoming dry, leading to eye sores, infections, and vision loss Swelling in the muscles due to loss of nerve function

15 (No. 2)

African Journals Online (AJOL)

mwakagugu

immobilization e.g. parietal-submental bandage, interdental wiring and second; permanent method ... otherwise compression ulcer will occur on the gum. Splint should be firmly fixed to each tooth using stainless wire ... forming sores from rubber band pressure. When preparing stainless wire splint with hooks, through ...

Implications of bisphosphonate calcium ion depletion interfering with desmosome epithelial seal in osseointegrated implants and pressure ulcers.

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Touyz, Louis Z G; Afrashtehfar, Kelvin I

2017-09-01

Osteoporosis (OP) is a global bone disease prevalent in aging in humans, especially in older women. Bisphosphonates (BPs) are commonly used as therapy for OP as it influences hard and soft tissues calcium metabolism. Mucosal and dermal ulceration with exposure of underlying bone arises from incomplete epithelial recovery due to reduced desmosome formation deriving from lack of available calcium. Pathological situations such as bisphosphonate-related osteonecrosis of the jaw have been described. This hypothesis states other situations which demand intact functional desmosomes such as healing skin over chronic pressure points leading to pressure ulcers (as well-known as bedsores, pressure sores, pressure injuries, decubitus ulcers), and hemidesmosomes such as epithelial seals in contact with titanium surfaces will have a higher prevalence of breakdown among patients being treated with BPs. This may be proven through the diminished modulation of calcium ions due to BPs, and its effect on the formation of intercellular gap junctions. Copyright © 2017. Published by Elsevier Ltd.

The use of hemoglobin saturation ratio as a means of measuring tissue perfusion in the development of heel pressure sores.

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Aliano, Kristen A; Stavrides, Steve; Davenport, Thomas

2013-09-01

The heel is a common site of pressure ulcers. The amount of pressure and time needed to develop these wounds is dependent on various factors including pressure surface, the patient's anatomy, and co-morbidities. We studied the use of the hemoglobin saturation ratio as a means of assessing heel perfusion in various pressure settings. The mixed perfusion ratio in the heels of 5 volunteers was assessed on 3 pressure surfaces and at the time of off-load. The surfaces studied included: stretcher pad, plastic backboard without padding, and pressure reduction gel. Each surface was measured for 5 minutes with a real-time reading. On the stretcher, the average StO2% decrease for each pressure surface was 26.2 ± 10 (range 18-43). The average StO2% decrease on the backboard was 22.8 ± 12.3 (range 8-37), and 24.0 ± 4.8 (range 19-30) on the gel pad. The StO2% drop plateaued with the stretcher and gel pad, but with the backboard there was a continued slow drop at 5 minutes. This study demonstrates that hemoglobin oxygenation ratio may be effective in assessing a tissue's direct perfusion in the setting of tissue pressure and may also be beneficial to better assess the effects of pressure-reduction surfaces. Further studies will be needed to determine time to skin breakdown as it pertains to pressure and tissue oxygenation.

Adding Fish Oil to Whey Protein, Leucine, and Carbohydrate Over a Six-Week Supplementation Period Attenuates Muscle Soreness Following Eccentric Exercise in Competitive Soccer Players.

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Philpott, Jordan D; Donnelly, Chris; Walshe, Ian H; MacKinley, Elizabeth E; Dick, James; Galloway, Stuart D R; Tipton, Kevin D; Witard, Oliver C

2018-01-01

Soccer players often experience eccentric exercise-induced muscle damage given the physical demands of soccer match-play. Since long chain n-3 polyunsaturated fatty acids (n-3PUFA) enhance muscle sensitivity to protein supplementation, dietary supplementation with a combination of fish oil-derived n-3PUFA, protein, and carbohydrate may promote exercise recovery. This study examined the influence of adding n-3PUFA to a whey protein, leucine, and carbohydrate containing beverage over a six-week supplementation period on physiological markers of recovery measured over three days following eccentric exercise. Competitive soccer players were assigned to one of three conditions (2 × 200 mL): a fish oil supplement beverage (FO; n = 10) that contained n-3PUFA (1100 mg DHA/EPA-approximately 550 mg DHA, 550 mg EPA), whey protein (15 g), leucine (1.8 g), and carbohydrate (20 g); a protein supplement beverage (PRO; n = 10) that contained whey protein (15 g), leucine (1.8 g), and carbohydrate (20 g); and a carbohydrate supplement beverage (CHO; n = 10) that contained carbohydrate (24 g). Eccentric exercise consisted of unilateral knee extension/flexion contractions on both legs separately. Maximal force production was impaired by 22% during the 72-hour recovery period following eccentric exercise (p recovery, was less in FO (1948 ± 1091 mm × 72 h) than PRO (4640 ± 2654 mm × 72 h, p soccer performance, or blood c-reactive protein concentrations were observed between groups. In conclusion, the addition of n-3PUFA to a beverage containing whey protein, leucine, and carbohydrate ameliorates the increase in muscle soreness and blood concentrations of creatine kinase following eccentric exercise in competitive soccer players.

Antimicrobial activities of medicinal plants used in folklore remedies ...

African Journals Online (AJOL)

In south-western part of Nigeria Psidium guajava and Mangifera indica are commonly used for herbal preparations in the treatment of toothache, gastrointestinal disorders, dynsentery, diarrhoea, sore gums and sore throats. This has, therefore, led to the investigation of the antimicrobial activities of methanolic extracts of P.

TropJrnal Vol 28 No1&2 4Intnet publicatn

African Journals Online (AJOL)

Administrator

umbilicus, umbilical pressure sore, anaemia and sepsis was made. She was admitted to the antenatal ward for resuscitation, fetal monitoring and investigations. Blood sample was also taken for blood profile, chemical and serological analysis. A wound swab was sent for microscopy, culture and sensitivity. Her packed cell ...

Re‑Evaluation of the First Phenytoin Paste Healing Effects on Oral ...

African Journals Online (AJOL)

Until now, several studies have demonstrated the healing effects of phenytoin on various kinds of wound such as leprosy, burns, diabetic foot, war wounds, excisional biopsies, and pressure sores.[1,6-9] Topical phenytoin has been documented to promote wound healing and improve the quality and vascularity of ...

Ošetřovatelská péče u pacientů s dekubity na JIP, ARO

OpenAIRE

Banková, Simona

2011-01-01

The dissertation theme "Nursing care for patients with pressure ulcers in the JIP, ARO". Thesis entitled "Nursing care of patients with pressure ulcers in JIP, ARO, deals with the prevention and treatment of pressure ulcers at selected sites. The thesis is divided into theoretical and practical. In the theoretical part of the work focuses on basic knowledge of anatomy, physiology, skin and subcutaneous tissue, the definition of pressure sore formation mechanism, formation factors, risk assess...

Method for the measurement of susceptibility to decubitus ulcer formation.

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Meijer, J H; Schut, G L; Ribbe, M W; Goovaerts, H G; Nieuwenhuys, R; Reulen, J P; Schneider, H

1989-09-01

A method for measuring the susceptibility of a patient to develop decubitus ulcers is described and initially evaluated. It is based on an indirect, noninvasive measurement of the transient regional blood flow response after a test pressure load which simulates the external stimulus for pressure-sore formation. This method was developed to determine the individual risk of a patient and to study the subfactors which contribute to the susceptibility. This would also offer the possibility of evaluating the effect of preventive treatment aimed at reducing the susceptibility. The method was found to discriminate between preselected elderly patients at risk on the one hand, and non-risk patients and healthy young adults on the other hand. No differences in blood flow responses were found between the non-risk elderly patients and the healthy young adults. This suggests that age per se is not a factor in the formation of pressure sores. In the risk group the recovery time after pressure relief was found to be three times as long as the duration of the pressure exercise. This indicates that the recovery time after pressure exercise may be as important as the period of pressure exercise in deducing the risk of developing decubitus ulcers.

Sore Throat (For Parents)

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... another illness, like a cold , the flu , or mononucleosis . They also can be caused by a strep ... topic for: Parents Kids Teens Strep Throat Coughing Mononucleosis Strep Test: Rapid Strep Test: Throat Culture Flu ...

Soothing a Sore Throat

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... hard candies or lozenges, try cold liquids and popsicles. Throat pain might also be soothed by throat ... water or use ice chips. Cold liquids or popsicles can numb the pain. Throat sprays and over- ...

Cold Sores (HSV-1)

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... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... or HIV/AIDS ) as well as those with eczema . For people with any of these conditions, an ...

No effect of short-term amino acid supplementation on variables related to skeletal muscle damage in 100 km ultra-runners - a randomized controlled trial

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Rosemann Thomas

2011-04-01

Full Text Available Abstract Background The purpose of this study was to investigate the effect of short-term supplementation of amino acids before and during a 100 km ultra-marathon on variables of skeletal muscle damage and muscle soreness. We hypothesized that the supplementation of amino acids before and during an ultra-marathon would lead to a reduction in the variables of skeletal muscle damage, a decrease in muscle soreness and an improved performance. Methods Twenty-eight experienced male ultra-runners were divided into two groups, one with amino acid supplementation and the other as a control group. The amino acid group was supplemented a total of 52.5 g of an amino acid concentrate before and during the 100 km ultra-marathon. Pre- and post-race, creatine kinase, urea and myoglobin were determined. At the same time, the athletes were asked for subjective feelings of muscle soreness. Results Race time was not different between the groups when controlled for personal best time in a 100 km ultra-marathon. The increases in creatine kinase, urea and myoglobin were not different in both groups. Subjective feelings of skeletal muscle soreness were not different between the groups. Conclusions We concluded that short-term supplementation of amino acids before and during a 100 km ultra-marathon had no effect on variables of skeletal muscle damage and muscle soreness.

Design and Evaluation of a Pressure and Temperature Monitoring System for Pressure Ulcer Prevention

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Farve Daneshvar Fard

2014-08-01

Full Text Available Introduction Pressure ulcers are tissue damages resulting from blood flow restriction, which occurs when the tissue is exposed to high pressure for a long period of time. These painful sores are common in patients and elderly, who spend extended periods of time in bed or wheelchair. In this study, a continuous pressure and temperature monitoring system was developed for pressure ulcer prevention. Materials and Methods The monitoring system consists of 64 pressure and 64 temperature sensors on a 40×50 cm2 sheet. Pressure and temperature data and the corresponding maps were displayed on a computer in real-time. Risk assessment could be performed by monitoring and recording absolute pressure and temperature values, as well as deviations over time. Furthermore, a posture detection procedure was proposed for sitting posture identification. Information about the patient’s movement history may help caregivers make informed decisions about the patient’s repositioning and ulcer prevention strategies. Results Steady temporal behaviour of the designed system and repeatability of the measurements were evaluated using several particular tests. The results illustrated that the system could be utilized for continuous monitoring of interface pressure and temperature for pressure ulcer prevention. Furthermore, the proposed method for detecting sitting posture was verified using a statistical analysis. Conclusion A continuous time pressure and temperature monitoring system was presented in this study. This system may be suited for pressure ulcer prevention given its feasibility for simultaneous monitoring of pressure and temperature and alarming options. Furthermore, a method for detecting different sitting postures was proposed and verified. Pressure ulcers in wheelchair-bound patients may be prevented using this sitting posture detection method.

Primary gas- and particle-phase emissions and secondary organic aerosol production from gasoline and diesel off-road engines.

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Gordon, Timothy D; Tkacik, Daniel S; Presto, Albert A; Zhang, Mang; Jathar, Shantanu H; Nguyen, Ngoc T; Massetti, John; Truong, Tin; Cicero-Fernandez, Pablo; Maddox, Christine; Rieger, Paul; Chattopadhyay, Sulekha; Maldonado, Hector; Maricq, M Matti; Robinson, Allen L

2013-12-17

Dilution and smog chamber experiments were performed to characterize the primary emissions and secondary organic aerosol (SOA) formation from gasoline and diesel small off-road engines (SOREs). These engines are high emitters of primary gas- and particle-phase pollutants relative to their fuel consumption. Two- and 4-stroke gasoline SOREs emit much more (up to 3 orders of magnitude more) nonmethane organic gases (NMOGs), primary PM and organic carbon than newer on-road gasoline vehicles (per kg of fuel burned). The primary emissions from a diesel transportation refrigeration unit were similar to those of older, uncontrolled diesel engines used in on-road vehicles (e.g., premodel year 2007 heavy-duty diesel trucks). Two-strokes emitted the largest fractional (and absolute) amount of SOA precursors compared to diesel and 4-stroke gasoline SOREs; however, 35-80% of the NMOG emissions from the engines could not be speciated using traditional gas chromatography or high-performance liquid chromatography. After 3 h of photo-oxidation in a smog chamber, dilute emissions from both 2- and 4-stroke gasoline SOREs produced large amounts of semivolatile SOA. The effective SOA yield (defined as the ratio of SOA mass to estimated mass of reacted precursors) was 2-4% for 2- and 4-stroke SOREs, which is comparable to yields from dilute exhaust from older passenger cars and unburned gasoline. This suggests that much of the SOA production was due to unburned fuel and/or lubrication oil. The total PM contribution of different mobile source categories to the ambient PM burden was calculated by combining primary emission, SOA production and fuel consumption data. Relative to their fuel consumption, SOREs are disproportionately high total PM sources; however, the vastly greater fuel consumption of on-road vehicles renders them (on-road vehicles) the dominant mobile source of ambient PM in the Los Angeles area.

Psychosocial responses to spinal cord injury as predictors of pressure sores

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Erin Martz

2010-01-01

Full Text Available La úlcera por presión es una complicación secundaria común, aunque prevesible, de la lesión de la médula espinal (LME. La investigación sobre la influencia de los factores psicológicos en el desarrollo de las úlceras por presión es limitada. El objetivo de nuestro estudio ex post facto fue examinar el rol de las respuestas emocionales y estrategias de afrontamiento en la moderación de la relación entre las variables médicas demográficas y relacionadas con la LME y la frecuencia y severidad de las úlceras por presión. Noventa y cinco individuos con LME de aparición súbita completaron un cuestionario autoinformado enviado a la población de pacientes que han recibido un servicio de rehabilitación después de la lesión en un centro de rehabilitación en el sur de los Estados Unidos. Análisis de regresión múltiple indicaron que la depresión predijo de forma significativa la severidad de la úlcera por presión, mientras que el afrontamiento por abandono predijo su ocurrencia (aunque en la dirección opuesta a la esperada. La interacción del tiempo desde la lesión y la depresión influyeron tanto en la ocurrencia como en la severidad de las úlceras por presión. Estos resultados tienen importantes implicaciones para los profesionales de la rehabilitación, evaluación clínica y tratamiento de las personas con LME.

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

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El-Seify Zeinab

2010-01-01

Full Text Available Background: Low flow anesthesia can lead to reduction of anesthetic gas and vapor consumption. Laryngeal mask airway (LMA has proved to be an effective and safe airway device. The aim of this study is to assess the feasibility of laryngeal mask airway during controlled ventilation using low fresh gas flow (1.0 L/min as compared to endotracheal tube (ETT. Patients and Methods : Fifty nine non-smoking adult patients; ASA I or II, being scheduled for elective surgical procedures, with an expected duration of anesthesia 60 minutes or more, were randomly allocated into two groups - Group I (29 patients had been ventilated using LMA size 4 for females and 5 for males respectively; and Group II (30 patients were intubated using ETT. After 10 minutes of high fresh gas flow, the flow was reduced to 1 L/min. Patients were monitored for airway leakage, end-tidal CO 2 (ETCO 2 , inspiratory and expiratory isoflurane and nitrous oxide fraction concentrations, and postoperative airway-related complications Results : Two patients in the LMA-group developed initial airway leakage (6.9% versus no patient in ETT-group. Cough and sore throat were significantly higher in ETT patients. There were no evidences of differences between both groups regarding ETCO 2 , uptake of gases, nor difficulty in swallowing. Conclusion : The laryngeal mask airway proved to be effective and safe in establishing an airtight seal during controlled ventilation under low fresh gas flow of 1 L/min, inducing less coughing and sore throat during the immediate postoperative period than did the ETT, with continuous measurement and readjustment of the tube cuff pressure.

Failure of Urological Implants in Spinal Cord Injury Patients due to Infection, Malfunction, and Implants Becoming Obsolete due to Medical Progress and Age-Related Changes in Human Body Making Implant Futile: Report of Three Cases

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Subramanian Vaidyanathan

2013-01-01

Full Text Available Any new clinical data, whether positive or negative, generated about a medical device should be published because health professionals should know which devices do not work, as well as those which do. We report three spinal cord injury patients in whom urological implants failed to work. In the first, paraplegic, patient, a sacral anterior root stimulator failed to produce erection, and a drug delivery system for intracavernosal administration of vasoactive drugs was therefore implanted; however, this implant never functioned (and, furthermore, such penile drug delivery systems to produce erection had effectively become obsolete following the advent of phosphodiesterase type 5 inhibitors. Subsequently, the sacral anterior root stimulator developed a malfunction and the patient therefore learned to perform self-catheterisation. In the second patient, also paraplegic, an artificial urinary sphincter was implanted but the patient developed a postoperative sacral pressure sore. Eight months later, a suprapubic cystostomy was performed as urethral catheterisation was very difficult. The pressure sore had not healed completely even after five years. In the third case, a sacral anterior root stimulator was implanted in a tetraplegic patient in whom, after five years, a penile sheath could not be fitted because of penile retraction. This patient was therefore established on urethral catheter drainage. Later, infection with Staphylococcus aureus around the receiver block necessitated its removal. In conclusion, spinal cord injury patients are at risk of developing pressure sores, wound infections, malfunction of implants, and the inability to use implants because of age-related changes, as well as running the risk of their implants becoming obsolete due to advances in medicine. Some surgical procedures such as dorsal rhizotomy are irreversible. Alternative treatments such as intermittent catheterisations may be less damaging than bladder stimulator in

A quantitative analysis of microcirculation in sore-prone pressure areas on conventional and pressure relief hospital mattresses using laser Doppler flowmetry and tissue spectrophotometry.

Science.gov (United States)

Rothenberger, Jens; Krauss, Sabrina; Held, Manuel; Bender, Dominik; Schaller, Hans-Eberhard; Rahmanian-Schwarz, Afshin; Constantinescu, Mihai Adrian; Jaminet, Patrick

2014-11-01

Pressure ulcers are associated with severe impairment for the patients and high economic load. With this study we wanted to gain more insight to the skin perfusion dynamics due to external loading. Furthermore, we evaluated the effect of different types of pressure relief mattresses. A total of 25 healthy volunteers were enrolled in the study. Perfusion dynamics of the sacral and the heel area were assessed using the O2C-device, which combines a laser light, to determine blood flow, and white light to determine the relative amount of hemoglobin. Three mattresses were evaluated compared to a hard surface: a standard hospital foam mattress bed, a visco-elastic foam mattress, and an air-fluidized bed. In the heel area, only the air-fluidized bed was able to maintain the blood circulation (mean blood flow of 13.6 ± 6 versus 3.9 ± 3 AU and mean relative amount of hemoglobin of 44.0 ± 14 versus 32.7 ± 12 AU.) In the sacral area, all used mattresses revealed an improvement of blood circulation compared to the hard surface. The results of this study form a more precise pattern of perfusion changes due to external loading on various pressure relief mattresses. This knowledge may reduce the incidence of pressure ulcers and may be an influencing factor in pressure relief mattress selection. Copyright © 2014 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Current nursing practice by hospital-based stoma specialist nurses.

Science.gov (United States)

Burch, Jennie

Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.

Rehabilitation of traumatic brain injury in Italy: a multi-centred study.

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Zampolini, M; Zaccaria, B; Tolli, V; Frustaci, A; Franceschini, M

2012-01-01

The aims of this study were to analyse TBI rehabilitation in Italy, identifying the main factors conditioning motor and functional recovery and destination upon discharge of traumatic severe acquired brain injury (sABI) patients who had undergone intensive rehabilitative treatment. An observational prospective study of 863 consecutive patients admitted to 52 Rehabilitation Centres from January 2001 to December 2003. The main cause of trauma was road accidents (79.8%), the mean length of stay was 87.31 ± 77.26 days and 40.4% access to rehabilitation facilities after a month. Pressure sore rates fell from 26.1% to 6.6% during the rehabilitation programme. After discharge 615 patients returned home, whilst 212 were admitted to other health facilities. This study highlights some major criticisms of rehabilitation of TBI. The delay of admission and evitable complications such as pressure sores are correlated to a worse outcome. While LOS causes a problem of cost-effectiveness, the rate of home discharge is prevalent and very high compared with other studies.

Pressure ulcers: Back to the basics.

Science.gov (United States)

Agrawal, Karoon; Chauhan, Neha

2012-05-01

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most.

Pressure ulcers: Back to the basics

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Karoon Agrawal

2012-01-01

Full Text Available Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most.

Pressure ulcers: Back to the basics

Science.gov (United States)

Agrawal, Karoon; Chauhan, Neha

2012-01-01

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of “prevention is better than cure” suits this condition the most. PMID:23162223

Potential therapeutic effects of branched-chain amino acids supplementation on resistance exercise-based muscle damage in humans

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da Luz Claudia R

2011-12-01

Full Text Available Abstract Branched-chain amino acids (BCAA supplementation has been considered an interesting nutritional strategy to improve skeletal muscle protein turnover in several conditions. In this context, there is evidence that resistance exercise (RE-derived biochemical markers of muscle soreness (creatine kinase (CK, aldolase, myoglobin, soreness, and functional strength may be modulated by BCAA supplementation in order to favor of muscle adaptation. However, few studies have investigated such effects in well-controlled conditions in humans. Therefore, the aim of this short report is to describe the potential therapeutic effects of BCAA supplementation on RE-based muscle damage in humans. The main point is that BCAA supplementation may decrease some biochemical markers related with muscle soreness but this does not necessarily reflect on muscle functionality.

Effects of Short-Term Docosahexaenoic Acid Supplementation on Markers of Inflammation after Eccentric Strength Exercise in Women

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Katherine E. Corder, Katherine R. Newsham, Jennifer L. McDaniel, Uthayashanker R. Ezekiel, Edward P. Weiss

2016-03-01

Full Text Available The omega-3 fatty acid docosahexaenoic acid (DHA has anti-inflammatory and anti-nociceptive (pain inhibiting effects. Because strenuous exercise often results in local inflammation and pain, we hypothesized that DHA supplementation attenuates the rise in markers of local muscle inflammation and delayed onset muscle soreness (DOMS that occur after eccentric strength exercise. Twenty-seven, healthy women (33 ± 2 y, BMI 23.1±1.0 kg·m-2 were randomized to receive 9d of 3000 mg/d DHA or placebo in a double-blind fashion. On day 7 of the supplementation period, the participants performed 4 sets of maximal-effort eccentric biceps curl exercise. Before and 48h after the eccentric exercise, markers of inflammation were measured including measures of muscle soreness (10-point visual analog pain scale, VAS, swelling (arm circumference, muscle stiffness (active and passive elbow extension, skin temperature, and salivary C-reactive protein (CRP concentrations. As expected, muscle soreness and arm circumference increased while active and passive elbow extension decreased. The increase in soreness was 23% less in the DHA group (48h increase in VAS soreness ratings: 4.380.4 vs. 5.600.5, p=0.02. Furthermore, the number of subjects who were able to achieve full active elbow extension 48h after eccentric exercise was greater in the DHA group (71% vs. 15%, p = 0.006, indicating significantly less muscle stiffness. No between-group differences were observed for passive elbow extension (p = 0.78 or arm swelling (p = 0.75. Skin temperature and salivary CRP concentrations did not change from baseline to 48h after exercise in either group. These findings indicate that short-term DHA supplementation reduces exercise-induced muscle soreness and stiffness. Therefore, in addition to other health benefits that n-3 fatty acids have been associated with, DHA supplementation could be beneficial for improving tolerance to new and/or strenuous exercise programs and thereby

The effects of a multi-ingredient supplement on markers of muscle damage and inflammation following downhill running in females.

Science.gov (United States)

Köhne, Jessica L; Ormsbee, Michael J; McKune, Andrew J

2016-01-01

The effects of a multi-ingredient performance supplement (MIPS) on markers of inflammation and muscle damage, perceived soreness and lower limb performance are unknown in endurance-trained female athletes. The purpose of this study was to determine the impact of MIPS (NO-Shotgun®) pre-loaded 4 weeks prior to a single-bout of downhill running (DHR) on hsC-Reactive Protein (hsCRP), interleukin (IL)-6, creatine kinase (CK), muscle soreness, lower limb circumferences and performance. Trained female runners ( n  = 8; 29 ± 5.9 years) (VO 2max : ≥ 50 ml -1 .kg -1 .min -1 , midfollicular phase (7-11 days post-menses) were randomly assigned in a double-blind manner into two groups: MIPS ( n  = 4) ingested one serving of NO Shotgun daily for 28 days prior to DHR and 30 min prior to all post-testing visits; Control (CON) ( n  = 4) consumed an isocaloric maltodextrin placebo in an identical manner to MIPS. hsCRP, IL-6, CK, perceived soreness, limb circumferences, and performance measures (flexibility, squat jump peak power) were tested on 5 occasions; immediately before (PRE), immediately post-DHR, 24, 48 and 72 h post-DHR. There were main effects of time for CK ( p  = 0.05), pain pressure threshold (right tibialis anterior ( p  = 0.010), right biceps femoris ( p  = 0.01), and left iliotibial band (ITB) ( p  = 0.05) across all time points), and maximum squat jump power ( p  = 0.04). Compared with 24 h post-DHR, maximum squat jump power was significantly lower at 48 h post-DHR ( p  = 0.05). Lower body perceived soreness was significantly increased at 24 h ( p  = 0.02) and baseline to 48 h ( p  = 0.02) post DHR. IL-6 peaked immediately post-DHR ( p  = 0.03) and hsCRP peaked at 24 h post-DHR ( p  = 0.06). Calculation of effect sizes indicated a moderate attenuation of hsCRP in MIPS at 72 h post-DHR. Consumption of MIPS for 4 weeks prior to a single bout of DHR attenuated inflammation three days post, but did

Evaluation of negative pressure vacuum-assisted system in acute and chronic wounds closure: our experience.

Science.gov (United States)

Chiummariello, S; Guarro, G; Pica, A; Alfano, C

2012-10-01

Negative-pressure therapy or vacuum-assisted closure (VAC) has been used in clinical applications since the 1940's and has increased in popularity over the past decade. This dressing technique consists of an open cell foam dressing put into the wound cavity, a vacuum pump produces a negative pressure and an adhesive drape. A controlled sub atmospheric pressure from 75 to 150 mmHg is applied. The vacuum-assisted closure has been applied by many clinicians to chronic wounds in humans; however it cannot be used as a replacement for surgical debridement. The initial treatment for every contaminated wound should be the necrosectomy. The VAC therapy has a complementary function and the range of its indications includes pressure sores, stasis ulcers, chronic wounds such as diabetic foot ulcers, post traumatic and post operative wounds, infected wounds such as necrotizing fasciitis or sternal wounds, soft-tissue injuries, bone exposed injuries, abdominal open wounds and for securing a skin graft. We describe our experience with the VAC dressing used to manage acute and chronic wounds in a series of 135 patients, with excellent results together with satisfaction of the patients.

Complex muscular adaptation to perturbations after induction of experimental low back pain in healthy participants

DEFF Research Database (Denmark)

Larsen, Lars Henrik; Hirata, Rogerio Pessoto; Graven-Nielsen, Thomas

2014-01-01

Background and aims Spine stability is affected in low back (LB) pain and potentially by muscle fatigue and soreness. This study assessed motor control responses to unexpected surface perturbations during stance during experimental LB muscle pain combined with fatigue and muscle soreness. Methods...... Nineteen healthy participants were examined day 1-3 before and after bilateral injections of hypertonic saline into m. longissimus. Pain intensity was scored on a visual analogue scale (VAS). Day 2 included injections during post-exercise LB muscle fatigue and day 3 during delayed onset back muscle...... soreness (DOMS). Twenty perturbations were conducted randomly with tilts in sagittal and frontal plane or displacements in the frontal plane. Bilateral electromyography (EMG) was recorded from 12 trunk muscles. The root-mean-square (RMS-EMG) was extracted. Changes (DeltaRMS) and absolute changes (Delta...

Browse Title Index

African Journals Online (AJOL)

Items 151 - 200 of 242 ... Vol 12, No 1 (2013), Pattern of Pressure Sores in Spinal Injured Patients with in the First Six Months of Injury, Abstract. CU Nwadinigwe, K Amaefule, AO Uduezue. Vol 6, No 1 (2007), Pattern of requests for major limb amputations as seen in a Nigerian Teaching Hospital, Abstract. AA Musa. Vol 4, No 1 ...

Comparison of three types of full‐body compression garments on throwing and repeat‐sprint performance in cricket players

Science.gov (United States)

Duffield, Rob; Portus, Marc

2007-01-01

Objective To compare the effects of three types of full‐body compression garments (Skins, Adidas and Under Armour) on repeat‐sprint and throwing performance in cricket players. Methods Following familiarisation, 10 male cricket players performed four randomised exercise sessions (3 garments and a control). Each session involved a 30 min repeat‐sprint exercise protocol comprising 20 m sprints every minute, separated by submaximal exercise. Throwing tests included a pre‐exercise and a postexercise maximal distance test and accuracy throwing tests. During each session, measures of heart rate, skin temperature, change in body mass, rate of perceived exertion and perceived muscle soreness were recorded. Capillary blood samples were analysed before and after exercise for lactate, pH, O2 saturation and O2 partial pressure, and 24 h after exercise for creatine kinase (CK). Ratings of perceived muscle soreness were also obtained 24 h after exercise. Results No significant differences (p>0.05) were evident in repeat‐sprint performance (10 m, 20 m time or total submaximal distance covered) or throwing performance (maximum distance or accuracy). No significant differences (p>0.05) were observed in heart rate, body mass change or blood measures during exercise. Significant differences (p0.05). Conclusions No benefit was noted when wearing compression garments for repeat‐sprint or throwing performance; however, the use of the garments as a recovery tool, when worn after exercise, may be beneficial to reduce postexercise trauma and perceived muscle soreness. PMID:17341589

Comparison of three types of full-body compression garments on throwing and repeat-sprint performance in cricket players.

Science.gov (United States)

Duffield, Rob; Portus, Marc

2007-07-01

To compare the effects of three types of full-body compression garments (Skins, Adidas and Under Armour) on repeat-sprint and throwing performance in cricket players. Following familiarisation, 10 male cricket players performed four randomised exercise sessions (3 garments and a control). Each session involved a 30 min repeat-sprint exercise protocol comprising 20 m sprints every minute, separated by submaximal exercise. Throwing tests included a pre-exercise and a postexercise maximal distance test and accuracy throwing tests. During each session, measures of heart rate, skin temperature, change in body mass, rate of perceived exertion and perceived muscle soreness were recorded. Capillary blood samples were analysed before and after exercise for lactate, pH, O(2) saturation and O(2) partial pressure, and 24 h after exercise for creatine kinase (CK). Ratings of perceived muscle soreness were also obtained 24 h after exercise. No significant differences (p>0.05) were evident in repeat-sprint performance (10 m, 20 m time or total submaximal distance covered) or throwing performance (maximum distance or accuracy). No significant differences (p>0.05) were observed in heart rate, body mass change or blood measures during exercise. Significant differences (p0.05). No benefit was noted when wearing compression garments for repeat-sprint or throwing performance; however, the use of the garments as a recovery tool, when worn after exercise, may be beneficial to reduce postexercise trauma and perceived muscle soreness.

Development of the computer code for transient analysis in experimental fast reactor

International Nuclear Information System (INIS)

Moreira, M.L.; Sato, E.F.

1989-01-01

A calculational model of heat transfer and fluid coolant dynamics, for thermal-hydraulic simulation of the primary system components of a pool type experimental fast breeder reactor, has developed. Programmed in FORTRAN, the SORES code was used to simulate transients as loss of pumping and loss of secondary sodium flow in the EBRII. The SORES results compared with measured data and NATDEMO code results was found to be good. (author) [pt

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.

Sore Throat: Symptoms and Causes

Science.gov (United States)

... of the mouth, throat and voice box. Allergies. Seasonal allergies or ongoing allergic reactions to dust, molds ... HIV, diabetes, treatment with steroids or chemotherapy drugs, stress, fatigue, and ... when soap and water aren't available. Avoid touching public phones or ...

Fever, sore throat and myalgia

African Journals Online (AJOL)

Occult bacterial abscess. Renal carcinoma. Variants of rheumatoid arthritis. Kikuchi-Fujimoto disease. Endocarditis. Atrial myxoma. Systemic lupus erythematosus. Melioidosis. Brucellosis. Temporal arteritis. Polymyalgia rheumatica. Pyrexia of unknown origin defined as temperature >38.3oC for >3 weeks, with >2 outpatient ...

Protein Supplementation During or Following a Marathon Run Influences Post-Exercise Recovery

Directory of Open Access Journals (Sweden)

Michael J. Saunders

2018-03-01

Full Text Available The effects of protein supplementation on the ratings of energy/fatigue, muscle soreness [ascending (A and descending (D stairs], and serum creatine kinase levels following a marathon run were examined. Variables were compared between recreational male and female runners ingesting carbohydrate + protein (CP during the run (CPDuring, n = 8 versus those that were consuming carbohydrate (CHODuring, n = 8. In a second study, outcomes were compared between subjects who consumed CP or CHO immediately following exercise [CPPost (n = 4 versus CHOPost (n = 4]. Magnitude-based inferences revealed no meaningful differences between treatments 24 h post-marathon. At 72 h, recovery [Δ(72 hr-Pre] was likely improved with CPDuring versus CHODuring, respectively, for Physical Energy (+14 ± 64 vs −74 ± 70 mm, Mental Fatigue (−52 ± 59 vs +1 ± 11 mm, and Soreness-D (+15 ± 9 vs +21 ± 70 mm. In addition, recovery at 72 h was likely-very likely improved with CPPost versus CHOPost for Physical Fatigue, Mental Energy, and Soreness-A. Thus, protein supplementation did not meaningfully alter recovery during the initial 24 h following a marathon. However, ratings of energy/fatigue and muscle soreness were improved over 72 h when CP was consumed during exercise, or immediately following the marathon.

The aetiology of pressure sores: combining animal experiments and finite element modelling

NARCIS (Netherlands)