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1.
Ana Belén Moya-Suárez José Miguel Morales-Asencio Marta Aranda-Gallardo Margarita Enríquez de Luna-Rodríguez José Carlos Canca-Sánchez 《Journal of tissue viability》2017,26(4):260-270
Aim of the study
The main objective of this work is the development and psychometric validation of an instrument to evaluate nurses' adherence to the main recommendations issued for preventing pressure ulcers.Material and methods
An instrument was designed based on the main recommendations for the prevention of pressure ulcers published in various clinical practice guides. Subsequently, it was proceeded to evaluate the face and content validity of the instrument by an expert group. It has been applied to 249 Spanish nurses took part in a cross-sectional study to obtain a psychometric evaluation (reliability and construct validity) of the instrument. The study data were compiled from June 2015 to July 2016.Results
From the results of the psychometric analysis, a final 18-item, 4-factor questionnaire was derived, which explained 60.5% of the variance and presented the following optimal indices of fit (CMIN/DF: 1.40 p < 0.001; GFI: 0.93; NFI: 0.92; CFI: 0.98; TLI: 0.97; RMSEA: 0.04 (90% CI 0.025–0.054).Conclusions
The results obtained show that the instrument presents suitable psychometric properties for evaluating nurses' adherence to recommendations for the prevention of pressure ulcers. 相似文献2.
Manuel Escamilla Cardeñosa Gabriel Domínguez-Maldonado Antonio Córdoba-Fernández 《Journal of tissue viability》2017,26(2):138-143
Objectives
The aim of this study was to analyse the efficacy and safety of using platelet rich in growth factor (PRGF) as a local treatment for venous ulcers.Methods
In a clinical trial 102 venous ulcers (58 patients) were randomly assigned to the study group (application of PRGF) or the control group (standard cure with saline). For both groups the healed area was calculated before and after the follow up period (twenty-four weeks). The Kundin method was used to calculate the healed area (Area = Length × Width × 0.785). Pain was measured at the start and end of treatment as a secondary variable for each group by record obtained by means of self-evaluation visual analogue scale.Results
The average percentage healed area in the platelet rich plasma group was 67.7 ± 41.54 compared to 11.17 ± 24.4 in the control group (P = 0.001). Similarly, in the experimental group a significant reduction in pain occurred on the scale (P = 0.001). No adverse effects were observed in either of the two treatment groups.Conclusions
The study results reveal that application of plasma rich in platelets is an effective and safe method to speed up healing and reduce pain in venous ulcers. 相似文献3.
J. Hosking 《Journal of tissue viability》2017,26(3):189-195
Purpose
Custom contouring techniques are effective for reducing pressure ulcer risk in wheelchair seating. These techniques may assist the management of pressure ulcer risk during sleep for night time postural management.Objectives
To investigate the effectiveness of custom contoured night time postural management components against planar support surfaces for pressure ulcer risk measures over the heels.Method
Supine posture was captured from five healthy participants using vacuum consolidation and 3-dimensional laser scanning. Custom contoured abduction wedges were carved from polyurethane and chipped foams. Pressure mapping and the visual analog scale were used to evaluate the effectiveness of the contoured foams in reducing pressure and discomfort under the posterior heel against standard planar support surfaces.Results
Custom contoured shapes significantly reduced interface pressures (p < 0.05) and discomfort scores (p < 0.05) when compared to planar support surfaces. Polyurethane foam was the most effective material but it did not differ significantly from chipped foam. Linear regression revealed a significant relationship between the Peak Pressure Index and discomfort scores (r = 0.997, p = 0.003).Conclusions
The findings of this pilot study suggested that custom contoured shapes were more effective than planar surfaces at reducing pressure ulcer risk surrogate measures over the posterior heels with polyurethane foam being the most effective material investigated. It is recommended that Evazote foam should not be used as a support surface material for night time postural management. 相似文献4.
M. Turkmen B. Gerceker Turk I. Kilinc Karaarslan B. Yaman F. Ozdemir 《Dermatologica Sinica》2018,36(3):136-139
Background
Basal cell carcinoma (BCC) is the most frequent of all skin cancers in the white population. The typical dermoscopic features of pigmented BCCs have been well known. In the literature a new dermoscopic pattern of BCC has been reported as “blue-white variant”.Objective
In this study, we aimed to evaluate the blue-white variant of BCC's seen in our cases at our Dermato-oncology Unit.Methods
Patient files between the years 2003–2011 were searched for the cases with the histopathologic diagnosis of BCC. Among them, the cases that were compatible with the diagnosis of blue-white variant of BCC were determined. The morphological and clinical features of the lesions, dermoscopic images together with the histopathological slides were all evaluated.Results
Among 350 histopathologically proven BCCs, 3.1% of them showed diffuse blue-white areas, namely “the blue-white variant”. On histopathological examination, typical aggregates of basaloid cells with nuclear atypia connected focally to the epidermis were observed. To our knowledge, this is the first research about the blue-white variant of pigmented BCC.Conclusion
The blue-white variant of pigmented BCC seems to be the most challenging type of BCC in the diagnosis for the clinician. 相似文献5.
Background/Objective
Vitiligo is a common pigmentary disorder. Significant psychological effects and social discrimination was noticed among vitiligo patients. The severity of the negative impact is related to the society's attitude and knowledge. Therefore, this study aims to investigate knowledge and attitudes among general population towards vitiligo.Methods
A cross-sectional study design was created using a survey based on the simulation video of the real situation. The participants were recruited from healthcare and non-healthcare workers attending Thammasat Hospital and Thammasat University. Demographic data, knowledge and attitudes towards the person in the video were recorded.Results
Total 101 subjects completed the questionnaires. Less than one-fourth of the participants recognized this condition as vitiligo and realized that it was a hereditary disease. Around two-third known that it did not transmit via direct contact. In attitude perceptions, the lowest attitude score was in starting to date a vitiligo victim while the highest attitude score was found when individuals already married with vitiligo patients. Moreover, sufficient knowledge tended to have more positive attitudes towards the disease significantly (p < 0.004).Conclusions
Misconceptions about vitiligo in this study seems to be higher than previous reports. This may be due to the visualized based questionnaires instead of asking from the word ‘vitiligo’ directly. Therefore, educational knowledge about disease recognition, causes and mode of transmission should be encouraged for public. 相似文献6.
Christopher Heard Wendy Chaboyer Vinah Anderson Brigid M. Gillespie Jennifer A. Whitty 《Journal of tissue viability》2017,26(1):79-84
Background
Negative pressure wound therapy (NPWT) is increasingly used prophylactically following surgery despite limited evidence of clinical or cost-effectiveness.Objective
To evaluate whether NPWT is cost-effective compared to standard care, for the prevention of surgical site infection (SSI) in obese women undergoing elective caesarean section, and inform development of a larger trial.Methods
An economic evaluation was conducted alongside a pilot randomised controlled trial at one Australian hospital, in which women were randomised to NPWT (n = 44) or standard care (n = 43). A public health care provider perspective and time horizon to four weeks post-discharge was adopted. Cost-effectiveness assessment was based on incremental cost per SSI prevented and per quality-adjusted life year (QALY) gained.Results
Patients receiving NPWT each received health care costing AU$5887 (±1038) and reported 0.069 (±0.010) QALYs compared to AU$5754 (±1484) and 0.066 (±0.010) QALYs for patients receiving standard care. NPWT may be slightly more costly and more effective than standard care, with estimated incremental cost-effectiveness ratios (ICERs) of AU$1347 (95%CI dominant- $41,873) per SSI prevented and AU$42,340 (95%CI dominant- $884,019) per QALY gained. However, there was considerable uncertainty around these estimates.Conclusions
NPWT may be cost-effective in the prophylactic treatment of surgical wounds following elective caesarean section in obese women. Larger trials could clarify the cost-effectiveness of NPWT as a prophylactic treatment for SSI. Sensitive capture of QALYs and cost offsets will be important given the high level of uncertainty around the point estimate cost-effectiveness ratio which was close to conventional thresholds.Australian and New Zealand trial registration number
ACTRN12612000171819. 相似文献7.
M. Schario T. Tomova-Simitchieva A. Lichterfeld H. Herfert G. Dobos N. Lahmann U. Blume-Peytavi J. Kottner 《Journal of tissue viability》2017,26(2):150-155
Background
Pressure Ulcers (PUs) are a severe form of skin and soft tissue lesions, caused by sustained deformation. PU development is complex and depends on different factors. Skin structure and function change during prolonged loading on PU predilection sites and surfaces being in direct contact with skin are likely to have an impact as well. Little is known about the influence of fabrics on skin function under pressure conditions.Objectives
To investigate skin responses to sustained loading in a sitting position and possible differences between two fabrics.Methods
Under controlled conditions 6 healthy females (median age 65.0 (61.0–67.8) years) followed a standardized immobilization protocol of a sitting position for 45 min on a spacer and on a cotton fabric. Before and after the loading period skin surface temperature, stratum corneum hydration, transepidermal water loss (TEWL), erythema, skin elasticity and ’relative elastic recovery‘ were measured at the gluteal areas.Results
A 45 min sitting period caused increases of skin surface temperature and erythema independent of the fabric. Loading on spacer fabric showed a two times higher increase of TEWL compared to cotton. Stratum corneum hydration showed slight changes after loading, skin elasticity and ’relative elastic recovery’ remained stable.Conclusions
Sitting on a hard surface causes skin barrier changes at the gluteal skin in terms of stratum corneum hydration and TEWL. These changes are influenced by the fabric which is in direct contact to the skin. There seems to be a dynamic interaction between skin and fabric properties especially in terms of temperature and humidity accumulation and transport. 相似文献8.
Shereen Farouk Gheida Yomna Mazid El-Hamd Neinaa Dareen Abd El-Aziz Mohammed 《Dermatologica Sinica》2018,36(4):179-184
Background
Caveolin-1 (CAV-1) is a key structural and functional membrane protein that is thought to play a role in controlling cellular proliferation and differentiation.Objective
To study the immunohistochemical expression of caveolin-1 in psoriasis and the two common types of non-melanoma skin cancers (NMSCs); basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in comparison to normal control skin and to correlate their expression with disease severity and progression.Patients and methods
This study included 90 patients and paraffin blocks (30 psoriasis, 30 BCC and 30 SCC) and 30 normal control skin specimens. Skin biopsy specimens were taken from all and examined for immunohistochemical expression of caveolin-1.Results
Significant reduction of caveolin-1 expression was detected in all studied patients groups in comparison to control group. Caveolin-1 expression in psoriasis showed significant downregulation with progression of Psoriasis Area and Severity Index (PASI) score. In addition, caveolin-1 expression was significantly decreased in aggressive types of BCC compared to non-aggressive types. Furthermore, poorly differentiated SCC showed significantly reduced caveolin-1 expression compared to moderately and well differentiated SCC.Conclusion
Caveolin-1 downregulation may increase the susceptibility to both benign and malignant hyperproliferative skin disorders. It could be useful as predictive biomarker of disease severity and progression. 相似文献9.
Anke Scheel-Sailer Angela Frotzler Gabi Mueller Simon Annaheim René Michel Rossi Siegfried Derler 《Journal of tissue viability》2017,26(2):89-94
Aim of the study
To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.Study design
An experimental controlled study with a convenience sample.Setting
A Swiss acute care and rehabilitation clinic specializing in SCIs.Materials and methods
We determined hydration, redness, elasticity and perfusion of the unloaded skin in the sacral region of 6 SCI/PU patients (affected and healthy skin), 20 SCI/PA patients and 10 able-bodied controls. These measures were made by two trained examiners after the patients were lying in the supine position.Results
The affected skin of SCI/PU patients showed elevated redness: median 595.5 arbitrary units (AU) (quartiles 440.4; 631.6) and perfusion: 263.0 AU (104.1; 659.4), both significantly increased compared to the healthy skin in SCI/PA patients and CON (p < 0.001). Similarly, healthy skin of SCI/PA patients showed elevated redness (p = 0.016) and perfusion (p < 0.001) compared to CON. On the other hand, differences in redness and perfusion between the affected and unaffected skin in SCI/PU patients were not significant. The results for skin hydration and skin elasticity were similar in all groups.Conclusions
Skin perfusion and redness were significantly increased in grade 1 PUs and for healthy skin in both SCI/PA patients and CON participants; thus, these are important in understanding the pathophysiology of PUs and skin in SCI. 相似文献10.
11.
Bilge Fettahlıoğlu Karaman Suhan Gunasti Topal Aydin Yucel Varol Lutfu Aksungur 《Dermatologica Sinica》2018,36(2):65-69
Background/Objective
Dermatologists use the word lilac to describe a shade of erythema; especially in lichen planus, morphea, and dermatomyositis. The aim of this study to determine whether or not there is a color really consistent with a lilac color, when they perceive it.Methods
Four illustrations were prepared for each of these three diseases. Only one illustration of each of the diseases had a color really consistent with a lilac color. Seventy-two physicians working in dermatology (16 residents, 20 teaching staffs, and 36 non-academician specialists) were included in this study. They were asked to choose the most representative illustration for each of the diseases.Results
Only a few physicians chose illustrations having a color really consistent with a lilac color. In most commonly chosen illustrations, there was a rose or even a salmon color in the area perceived as having a lilac color by the physicians.Conclusion
Our results might be explained by the color contrast phenomenon. In other words, a human may discern a verging towards lilac from an object not colored such by comparing its color to that of its background, so he may perceive this color. 相似文献12.
13.
Tak-Wah Wong En-Chi Wu Wen-Chien Ko Ching-Chi Lee Lien-I Hor I-Hsiu Huang 《Dermatologica Sinica》2018,36(1):8-15
Background
Antimicrobial photodynamic therapy (APDT) has become a potential regimen to treat multidrug-resistant bacterial infections. Limited data showed indocyanine green (ICG), a safe and inexpensive contrast medium for eye angiography and hepatic function examination, is an effective photosensitizer in APDT to kill methicillin-resistant Staphylococcus aureus (MRSA) after excitation with laser.Objective
We investigated the potentials of ICG-APDT with an inexpensive, non-coherent commercial near infrared (NIR) lamp against MRSA.Methods
The inhibition of MRSA was studied after exposing bacteria to NIR with different light doses and concentrations of ICG. The selectivity on MRSA was examined on human fibroblasts. Bacterial virulence including the activities of coagulase and enterotoxin was investigated. The effects of singlet oxygen scavengers (tryptophan and ascorbic acid) and H2O2 on cell survival were evaluated. The morphology of bacteria after PDT was observed by transmission electron microscopy.Results
ICG-PDT inhibited the growth of bacteria by 5 log (99.999% inhibition) with 200 J/cm2 at 65.5 mW/cm2 in the presence of 100 μg/mL ICG. Adding 0.1% H2O2 at a lower PDT dose (25 μg/mL ICG and 100 J/cm2) increased its efficacy by 5 log. This PDT dose was not toxic to human fibroblasts. PDT significantly reduced the level of bacterial virulence factors. The inhibition effects were decreased by tryptophan and ascorbic acid suggested singlet oxygen involved in the process. TEM showed severe non-selective cell destruction immediately after irradiation.Conclusion
The study reveals ICG-PDT has the potential to treat MRSA by using a clinical accessible NIR lamp and photosensitizer. 相似文献14.
Background
The variation in the management of venous leg ulceration in the UK is partly attributable to an uncertain clinical environment but the quality of judgements is influenced by the how well nurses' confidence and accuracy are aligned.Objectives
To assess UK community nurses' confidence in the accuracy of their diagnostic judgements and treatment choices when managing venous leg ulceration.Design
Judgement Analysis.Setting
UK community and primary care nursing services.Participants
18 community non-specialist nurses working in district (home) nursing teams and general practitioner services and 18 community tissue viability specialist nurses.Methods
Using judgement analysis methods, 18 community non-specialist nurses and 18 community tissue viability specialist nurses made diagnoses and treatment judgements about compression therapy for 110 clinical scenarios and indicated their confidence for each judgement. An expert panel made consensus judgements for the same scenarios and these judgements were used as a standard against which to compare the participants. Confidence analysis was used to assess the nurses' confidence about their diagnostic judgements and treatment choices.Results
Despite being very experienced, both non-specialist nurses' and specialist tissue viability nurses' levels of confidence were not well calibrated with their levels of accuracy.Conclusion
The results of this study are important as errors resulting from both over and under-confidence at the diagnostic phase of management may influence treatment choices, and thus increase the chances of treatment error. 相似文献15.
16.
H.E.W. de Laat A.C. de Munter M.J. van der Burg D.J.O. Ulrich O. Kloeters 《Journal of tissue viability》2017,26(1):69-74
Introduction
Little is known about health activation and self-management behavior in preventing pressure ulcers (PU) in paraplegic patients. Therefore this study aimed to describe the extent of health activation and self-management behavior in paraplegics to prevent PU's and associations between this behavior and patient characteristics.Furthermore, we aimed to find differences in health activation in paraplegics who never had a PU compared to paraplegics with a previous history of PU's or a new-onset PU's.Methods
A cross-sectional survey on health activation and self-management behavior was conducted among adult paraplegics recruited from two rehabilitation centers in the Netherlands. The Patient Activation Measure (PAM-score) was used to measure the extent of health activation. Patient statements on their level of self management behavior to prevent PU were evaluated.Results
The mean PAM-score (0–100) was 54 (±8.1; n = 162) indicating a low level of health activation. Two indicators turned out to be statistically significant associated with health activation: level of education (OR = 2.2, p = 0.017) and degree of paraplegia (OR = 2.8, p = 0.036). Evaluation of health activation levels amongst paraplegics with or without a PU- history showed no significant difference. Analysis of patients statements demonstrated a large discrepancy between intended and actual behavior to prevent pressure ulcers.Conclusion
Level of education and level of paraplegia are significantly associated with health activation. A positive PU-history is not associated with future responsible behavior nor for compliant behavior in terms of health management. 相似文献17.
18.
Bulent Cetin Bilge Aktas Oznur Bal Efnan Algin Tulay Akman Lokman Koral Mehmet Ali Kaplan Umut Demirci Dogan Uncu Ahmet Ozet 《Dermatologica Sinica》2018,36(4):185-189
Background
Kaposi's sarcoma (KS) is a reactive, multifocal, multicentric, angiogenic neoplastic proliferation that is thought to originate from endothelial cells that are infected with human herpesvirus-8 (HHV-8). This report examines a cohort of patients with classic Kaposi's sarcoma (KS) evaluated at the national institute of oncology over the 13-year period.Methods
A retrospective analysis of 156 patients with classic KS, between January 2000 and November 2013, was performed. This study focused on the clinical presentation, staging, diagnosis, and treatment of classic KS.Results
One hundred fifty-six patients (median age 69 and 115 male) were enrolled into the study. Median age at diagnosis was 69 (range: 32–95 years). Male/female ratio was 2.80. The most common location was the lower limbs. There were 75 stage I patients (48.1%), 8 stage II patients (22.4%), 31 stage III patients (19.9%) and 15 stage IV patients (9.6%). Surgery was the most common local treatment method (43%). 44 patients (28.2%) received radiotherapy (RT) at diagnosis. Cytotoxic treatment with chemotherapy or interferon-α was administered in 57 patients. Visceral involvement was observed in 10 patients (lung: nine patients, liver: one patient) and bone metastasis occurred in two patients at relapse.Conclusion
This study is one of the largest reported series. Further studies are required and it will be important to standardize the assessment of disease activity and clinical response. 相似文献19.
Susanne Coleman E. Andrea Nelson Peter Vowden Kathryn Vowden Una Adderley Lesley Sunderland Judy Harker Tracy Conroy Sarah Fiori Nicola Bezer Emma Holding Leanne Atkin Emma Stables Jo Dumville Sue Gavelle Heidi Sandoz Keith Moore Tina Chambers Jane Nixon 《Journal of tissue viability》2017,26(4):226-240
Background
At present there is no established national minimum data set (MDS) for generic wound assessment in England, which has led to a lack of standardisation and variable assessment criteria being used across the country. This hampers the quality and monitoring of wound healing progress and treatment.Aim
To establish a generic wound assessment MDS to underpin clinical practice.Method
The project comprised 1) a literature review to provide an overview of wound assessment best practice and identify potential assessment criteria for inclusion in the MDS and 2) a structured consensus study using an adapted Research and Development/University of California at Los Angeles Appropriateness method. This incorporated experts in the wound care field considering the evidence of a literature review and their experience to agree the assessment criteria to be included in the MDS.Results
The literature review identified 24 papers that contained criteria which might be considered as part of generic wound assessment. From these papers 68 potential assessment items were identified and the expert group agreed that 37 (relating to general health information, baseline wound information, wound assessment parameters, wound symptoms and specialists) should be included in the MDS.Discussion
Using a structured approach we have developed a generic wound assessment MDS to underpin wound assessment documentation and practice. It is anticipated that the MDS will facilitate a more consistent approach to generic wound assessment practice and support providers and commissioners of care to develop and re-focus services that promote improvements in wound care. 相似文献20.
Regis Ernest Mendame Ehya Yong Zhao Xun Zheng Wanrong Yi Guy-Armel Bounda Zonghuan Li Weidong Xiao Aixi Yu 《Journal of tissue viability》2017,26(4):282-288