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1.
Natsuko Noguchi Tomonori Hirose Tomoko Suzuki Masami Kagaya Kazuhiro Chida Shigeo Ohno Motomu Manabe Shin-Ichi Osada 《Journal of dermatological science》2019,93(2):101-108
Background
The epidermis possesses regenerative properties that become apparent only after wounding. Atypical protein kinase C (aPKC) isoforms aPKCζ and aPKCλ form a ternary complex with Par3 and Par6, and play crucial roles in establishing and maintaining epithelial cell polarity. The epidermal loss of aPKCλ?results in progressive depletion of hair follicle stem cells. However, it is unclear whether aPKCs have equivalent activities in epidermal regeneration.Objectives
To clarify functional differences between aPKCζ and aPKCλ in cutaneous wound healing.Methods
We compared cutaneous wound healing processes in vivo using mutant mice with genetic deletion of each aPKC isoform. We also analyzed functional differences between aPKCζ and aPKCλ in cell proliferation, directional cell migration, and formation of microtubules in vitro using primary keratinocytes established from each mutant mouse.Results
Wound healing was significantly retarded in epidermis-specific aPKCλ knockout mice. In aPKCλ-deleted keratinocytes, the correct orientation of cell protrusions toward the wound was disrupted through the destabilization of Par6β. The elongation of stabilized β-tubulin was also deteriorated in aPKCλ-deleted keratinocytes, leading to defects in cell spreading. Conversely, wound healing and directional cell migration in aPKCζ-deleted mice were comparable to those in their control littermates.Conclusions
aPKCs are not functionally equivalent; aPKCλ, but not aPKCζ, plays a primary role in cutaneous wound healing. 相似文献2.
Chanat Kumtornrut Takeshi Yamauchi Saaya Koike Setsuya Aiba Kenshi Yamasaki 《Journal of dermatological science》2019,93(3):150-158
Background
The main pathogenesis of acne vulgaris is increase in sebum production and abnormal keratinization of the hair infundibulum. The androgens are involved in acne pathogenesis by modulating sebaceous glands to enhance sebum production. However, the molecular mechanisms of abnormal keratinization of the hair infundibulum are not fully elucidated.Objective
We hypothesized that the androgens affect the dermal fibroblasts, another androgen receptor-positive cells in the skin, resulting in abnormal keratinization through keratinocyte-fibroblast interaction.Methods
We investigated effects of androgens and estrogens on growth factors expressions by RT-PCR and western blot analysis in human fibroblast (hFB), human keratinocyte (hKC), and fibroblast-keratinocyte co-culture. In vivo, we examined the growth factor expression in acne lesions compared to normal hair follicles by laser-assisted confocal microscope.Results
In vitro, androgens but not estrogens significantly increased amphiregulin (AREG), epiregulin (EREG), fibroblast growth factor (FGF) 10, and insulin-like growth factor binding protein (IGFBP) 5 mRNA and protein expressions in human fibroblasts but not in keratinocytes. In vivo, AREG, EREG, FGF10, and IGFBP5 were more abundant in acne lesion compared to normal facial skin. FGF10 suppressed cytokeratin 1 and cytokeratin 10 expression in hKC, which was along with the decreased ratio of cytokeratin 10 against cytokeratin 14 in acne lesions compared to normal facial skin. Also, DHT suppressed cytokeratin 1 and cytokeratin 10, in fibroblast-keratinocyte co-culture similarly to the effect of FGF10 to hKC.Conclusion
These observations suggested that androgens enhance growth factors production from dermal fibroblasts, and growth factors from fibroblasts alter keratinocyte differentiation in acne lesion. 相似文献3.
Hsiao-Chi Lai Chang-Shen Lin Ching-Shuang Wu Cheng-Che E. Lan 《Journal of dermatological science》2019,93(2):116-122
Background
Ultraviolet B (UVB) is commonly used for treating dermatologic conditions. Recently, high irradiance UVB (HIUVB) has been suggested to be more effective for treating skin conditions as compared to its low irradiance (LI) counterpart. The biological impact of UVB radiation emitted at different irradiance on cutaneous immunity remains obscure.Objective
This study aimed to explore the impacts of UVB radiation administered at equivalent fluence (mJ/cm2) but different irradiance (mW/cm2) on cutaneous immune response.Methods
Cultured bone marrow derived dendritic cell (BMDC) were treated with equivalent fluence of UVB radiation with HIUVB or LIUVB. The phenotypic and functional alterations of BMDCs were documented. Animal models were used to validate the in vitro results in vivo and explore the mechanisms involved.Results
After equivalent fluence of UVB radiation, the HIUVB treated BMDC showed significantly lower MHCII and CD86 expressions, reduced capacity to stimulate T cell proliferation, and enhanced activation of aryl hydrocarbon receptor (AhR)-activated genes as compared to control while their LIUVB treated counterpart showed no significant change. Using animal model, the HIUVB induced significantly higher immune suppressive effect in mice as compared to their LIUVB counterpart after equivalent fluence of UVB treatment. The superior immune suppressive effect of HIUVB over LIUVB radiation was not observed when similar experiments were performed using AhR-deficient mice.Conclusion
We propose irradiance played an important role modulating UVB-induced cutaneous immune suppression. Future works on UVB phototherapy, both clinical and research, should incorporate this important parameter into consideration. 相似文献4.
Saki Maeda-Otsuka Ikko Kajihara Yukino Tasaki Saori Yamada-Kanazawa Ryoko Sakamoto Soichiro Sawamura Mamiko Masuzawa Mikio Masuzawa Yasuyuki Amoh Daichi Hoshina Riichiro Abe Yoshihiro Komohara Hironobu Ihn 《Journal of dermatological science》2019,93(2):123-132
Background
Angiosarcoma is a rare malignant tumor with a poor prognosis. It is known that hypoxic condition activates tumor progression in several cancers. Additionally, hypoxic tumor microenvironment accelerates immune escape. However, the presence and significance of hypoxia in angiosarcoma has not been adequately investigated.Objective
To study the role of hypoxia in the progression of angiosarcoma.Methods
The protein level of hypoxia inducible factor-1α (HIF-1α) in angiosarcoma was examined using immunohistochemistry and immunoblotting. To study the effect of hypoxia on tumor progression, cell proliferation, migration, invasion, and tube formation assays were performed in angiosarcoma cells. The influence of tumor cell supernatant in hypoxia from angiosarcoma cells on immune escape and angiogenesis was analysed to investigate the modulatory effect of hypoxia on tumor microenvironment of angiosarcoma. The molecular mechanism related to these results was investigated using immunoblotting and real time RT-PCR.Results
HIF-1α protein was over-expressed in angiosarcoma tissues and cell lines under hypoxic conditions, and there was heterogeneity of oxygen supply in angiosarcoma. Hypoxia enhanced the proliferation, migration, and invasion abilities and inhibited tube formation in angiosarcoma cells. Tumor cell supernatant in hypoxia from angiosarcoma cells activated the monocyte invasion ability, facilitated its differentiation into M2-like macrophages, and suppressed cell-adhesion. These in vitro results were compatible to the pathological findings of angiosarcoma patients.Conclusion
Hypoxia plays a major role in progression of angiosarcoma cells by enhancing cell proliferation, migration, and invasion and by modulating the tumor microenvironment. 相似文献5.
6.
Arturo César Argote Ruiz Óscar Mora Hernández Lilian Torres-Tobar Marcela Gómez Garzón Carlos Reverend Catherine Alba Ayala Joanna Cajamarca Rueda Alejandra Toquica Díaz 《Piel》2019,34(4):204-211
Background
Acne is one of the most common reasons for consultation in dermatology. It affects the most adolescents and brings psychosocial consequences that alter their quality of life. Among the pathophysiological aspects is the colonization by Cutibacterium acnes (C. acnes) of which currently have been described 6 phylotypes (IA1, IA2, IB, IC, II, and III) related to their inflammatory potential.Objective
To identify the phylotypes of C. acnes in the lesions of patients with acne who consulted the Dermatology Department at Hospital San José, Bogotá, Colombia.Methods and materials
A 90 samples of acne patients pustules were collected. The bacterium was identified in culture by anaerobic conditions. The isolates where subjected to antibiotic sensitivity tests and subsequently processed and analysed using Microflex? LT MALDI-TOF.Result
57.78% of the isolates corresponded to the genera Propionibacterium and Cutibacterium; of these, 65.38% were C. acnes, typified by mass spectrometry. The phylotypes found were of type IA1, IA2, IB, and II in 5.88%, 85.29%, 2.94%, and 5.88%, respectively.Conclusions
The phylotype IA2 was the most frequently identified, a result that differs from data reported in non-Latin American studies in which the IA1 is the predominant, this relevant finding opens new questions about the behavior of C. acne in different populations. It also reports the global antibiotic resistance to the phylotypes to the four antibiotics most commonly used in clinical practice, finding greater resistance to erythromycin, followed by clindamycin, and in a lesser proportion to doxycycline and tetracycline. 相似文献7.
Li Zhang Yuli Kang Shujun Chen Li Wang Min Jiang Leihong Xiang 《Journal of dermatological science》2019,93(2):92-100
Background
Vitiligo is an autoimmune disease with varying pathological features. Activation of the CCL20-CCR6 axis plays an important role in chronic inflammatory diseases. However, whether CCL20-CCR6 and Th1/17 cells are indicative of active vitiligo is unclear.Objective
To investigate the potential role of CCL20 and the involvement of Th1/17 and Tc1/17 cells in the mechanism in vitiligo.Methods
One hundred patients with vitiligo, and 20 healthy controls were included. The serum and blister fluid IL-17, IFN-γ, CCL20, and CXCL10 were studied using enzyme-linked immunosorbent assays. The numbers of Th1/17 cells and Tc1/17 cells in circulation were quantified using flow cytometry. CCR6 mRNA in peripheral blood mononuclear cells (PBMCs) was analyzed by real-time polymerase chain reaction and the protein level was confirmed by western blotting. CCR6 and CCL20 expression in lesions was analyzed by immunohistochemistry.Results
The serum CCL20 level was significantly elevated in patients with vitiligo. The level of serum CCL20 was higher in active than in the stable stage, which correlated positively with the Vitiligo European Task Force spreading score and the Vitiligo Area Scoring Index score. Patients with active vitiligo had elevated numbers of circulating Th1/17 cells and Tc1/17 cells, and upregulated expression of CCR6 in PBMCs and lesions. After effective treatment, the level of CCL20 in sera and blister fluid was significantly decreased, as were the numbers of circulating Th1/17 cells and Tc1/17 cells.Conclusion
CCL20 might be a vital biomarker of active vitiligo, and circulating Th1/17 and Tc1/17 cells are involved in the pathogenesis of vitiligo. 相似文献8.
Chihiro Imura Azumi Ueyama Yoshikazu Sasaki Masaya Shimizu Yoko Furue Nobuyuki Tai Kenichiro Tsujii Kazufumi Katayama Takayuki Okuno Michitaka Shichijo Kiyoshi Yasui Mina Yamamoto 《Journal of dermatological science》2019,93(3):176-185
Background
Retinoic acid receptor-related orphan receptor gamma t (RORγt) has critical roles in the development, maintenance and function of interleukin (IL)-17-producing cells and is a highly attractive target for the treatment of IL-17-mediated autoimmune disease, particularly psoriasis. On the other hand, RORγt is also critical for controlling apoptosis during thymopoiesis, and genetic RORγt ablation or systematic RORγt inhibition cause progressive thymic aberrations leading to T cell lymphomas.Objective
We investigated whether topical administration of our novel RORγt inhibitor, S18-000003 has therapeutic potential for psoriasis with low risk of thymic aberrations.Methods
We evaluated the effect of topical S18-000003 on psoriasis-like skin inflammation and influence on the thymus in a 12-O-tetradecanoylphorbol-13-acetate-induced K14.Stat3C mouse psoriasis model.Results
S18-000003 markedly inhibited the development of psoriatic skin inflammation via suppression of the IL-17 pathway. In the skin, S18-000003 suppressed all subsets of IL-17-producing cells that we previously identified in this psoriasis model: Th17 cells, Tc17 cells, dermal γδ T cells, TCR? cells that probably included innate lymphoid cells, and CD4?CD8? double-negative αβ T cells. Notably, neither reduction of CD4+CD8+ double-positive thymocytes nor dysregulation of cell cycling was observed in S18-000003-treated mice, even at a high dose.Conclusion
Our topically administered RORγt inhibitor is a potential therapeutic agent for psoriasis with low risk of thymic lymphoma. 相似文献9.
Kimiko Nakajima Sayo Kataoka Kenji Sato Mikiro Takaishi Mayuko Yamamoto Hideki Nakajima Shigetoshi Sano 《Journal of dermatological science》2019,93(2):82-91
Background
Psoriasis is an inflammatory disease associated with aberrant crosstalk between the epidermis and immune system. However, the role of Langerhans cells (LCs) in psoriasis remains controversial.Objectives
To elucidate whether LCs are functionally involved in the development of psoriasis using a mouse model.Methods
Two lines of transgenic mice were used and crossed. They included K5.Stat3C, the psoriasis-model mouse and langerin DTR knock-in (KI) mouse. We performed immunofluorescence staining for LCs in psoriatic lesion of human and model mice. Flow cytometric analyses were performed to compare between dendritic cells (DCs) and LCs in the epidermis and skin-draining lymph nodes (sDLNs). To assess cytokine/chemokine expression in the skin lesion or primary cultured keratinocytes, we performed RT-PCR, microarray analysis or intracellular staining on the flow cytometer.Results
LCs were activated in psoriatic lesion of patients with psoriasis and K5.Stat3C mice. Compared with non-transgenic mice, K5.Stat3C mice constitutively showed an increased number of LCs in the sDLNs before psoriasis-like lesion developed. Stat3C transgenic keratinocytes expressed an elevated level of IL-1α. Psoriasis-like lesion in K5.Stat3C mice were attenuated in the absence of LCs, indicating that LCs were essential to the development of psoriasis-like lesion. Furthermore, we also recognized that epidermal LCs in psoriatic lesion of not only K5.Stat3C mice but also psoriasis patients produced IL-23.Conclusions
Our study suggests that Stat3 activation in keratinocytes may impact on LC activation in situ via IL-1α stimulation, at least in part, and that their presence may be essential for the pathogenesis of psoriasis through producing IL-23. 相似文献10.
M. Ribera S. Ros B. Madrid R. Ruiz-Villaverde F. Rebollo S. Gómez E. Loza G. Carretero 《Actas dermo-sifiliográficas》2019,110(2):102-114
Objective
To establish recommendations to determine, identify, and manage the psychological and emotional needs of patients with chronic inflammatory skin diseases in clinical practice.Methods
A guided discussion was held at meeting of a nominal group of expert dermatologists and psychologists on the psychological and emotional needs of patients with chronic inflammatory skin diseases, how to manage these cases, and which referral criteria to employ. Based on the results of the discussion, and with the aid of a patient focus group and a review of the literature, a master document was drawn up with recommendations for discussion. A Delphi survey was circulated among a larger group of dermatologists and psychologists to assess the level of agreement with the recommendations.Results
Ten recommendations were established and can be summarized as follows: explore the psychological sphere of the patients with open questions at the time of diagnosis and during the course of the disease; provide patients with clear explanations that address their concerns and inform them of the existence of patient associations; investigate symptoms of anxiety and depression and, if confirmed by means of a Hospital Anxiety and Depression score (HADS) of 11 or greater, consider referral to a mental-health specialist; and, during visits, create a climate of trust, empathize with patients, agree goals and treatment options with them, and motivate them to adhere to those treatments.Conclusions
These recommendations may help health care professionals address psychological and emotional aspects of their patients in daily clinical practice. 相似文献11.
Lula María Nieto Benito Ángel Manuel Rosell Díaz Ana Mateos Mayo Carmen Rodríguez Sáinz Ricardo María Suárez Fernández Ofelia Baniandrés Rodríguez 《Piel》2019,34(5):266-271
Introduction
Palmoplantar pustulosis (PPP) is characterised by the presence of sterile association with other diseases differ among published studies. IL36RN gene mutation has recently been identified in patients with mainly generalised pustular forms, but also in some patients with PPP. The objective of this study is to describe clinical and epidemiological characteristics, the incidence of inflammatory diseases in PPP, and to study the frequency of IL36RN gene mutations.Methods
An observational, retrospective, longitudinal study is presented, which includes all patients attended in our centre between 2009 and 2017 with a PPP diagnosis if only they were controlled by photography.Results
41 patients were included (90% women; average age of 55, 8). 94% were smokers or ex-smokers, 24% had a history of plaque psoriasis, 39% ungueal psoriasis and 27% a positive familiar background. On analysing IMIDs (immune mediated inflammatory disorders) incidence in PPP patients, 7% had inflammatory bowel disease, 10% psoriatic arthritis, and 22% other types of arthritis. No IL36RN gene mutations were found in any of the 11 patients in whom a genetic study was performed.Conclusions
Patients with PPP are mostly women who smoke, in the fifth decade of life, with an incidence of IMIDs higher than expected, as well as with a high prevalence of personal and family history of psoriasis. 相似文献12.
Ying Liu Linli Xue Hang Gao Lucheng Chang Xiuju Yu Zhiwei Zhu Xiaoyan He Jianjun Geng Yanjun Dong Hongquan Li Liping Zhang Haidong Wang 《Journal of dermatological science》2019,93(3):159-167
Background
Pigmentation is controlled by complex mechanisms. Evidence suggests that miRNAs can regulate pigmentation. However, the mechanism has not been fully elucidated. Objective In this study, we revealed a novel mechanism that regulates pigmentation involving exosomes, miRNAs and the crosstalk between keratinocytes and melanocytes.Methods
The expression and localization of exosome specific marker TSG101 in keratinocytes and melanocytes; Changes of melanin content in melanocytes after co-culture of exosome and melanocytes; Expression changes of target gene TYR and its related genes and inhibitory effect of miR-330-5p on pigmentation were studied by using various molecular biological techniques.Results
In this experiment, we used miR-330-5p in keratinocytes to verify the effect of keratinocyte derived exosome on melanocyte pigmentation. First, we found that keratinocytes secrete exosomes carrying miR-330-5p; moreover, greater miR-330-5p expression was found in exosomes derived from keratinocytes that overexpressed miR-330-5p. Second, we found that exosomes derived from keratinocytes with overexpression of miR-330-5p caused a significant increase in miR-330-5p in melanocytes. Finally, exosomes derived from keratinocytes that overexpressed miR-330-5p induced a significant decrease in the production of melanin and expression of TYR in melanocytes. Meanwhile, we overexpressed miR-330-5p in melanocytes, which also proved the inhibitory effect of miR-330-5p on pigmentation.Conclusion
These findings suggest that keratinocytes crosstalk with melanocytes in the epidermal melanin unit via exosomal miRNAs. These studies reveal an important role of exosomes in melanocyte pigmentation, which opens a new pathway of melanogenesis. 相似文献13.
Yu-Jing Zhang Yang Han Yu-Zhe Sun Hang-Hang Jiang Min Liu Rui-Qun Qi Xing-Hua Gao 《Journal of dermatological science》2019,93(3):168-175
Background
Malassezia is one of the commensal microorganisms colonized on human skin and has been shown to be related to several inflammatory cutaneous disorders. Previous studies indicated that Malassezia. sympodialis (M. sympodialis) can produce extracellular vesicles, however, the immunoregulatory function of Malassezia extracellular vesicles on keratinocytes has not been studied.Objective
To investigate the extracellular vesicular production capability of Malassezia. furfur (M. furfur) and examine their immunoregulatory effects both in vitro and in vivo.Methods
Extracellular vesicles derived from M. furfur were isolated by sequential ultracentrifugation procedure. Their structure and diameter were determined by negative stain TEM and NTA, respectively. Confocal microscopy was used to visualize the internalization of these nanoparticles into HaCaT cells and mice epidermal keratinocytes. The expressions of inflammatory cytokines were screened using PCR Array assay and validated in vitro by qPCR and ELISA assays. In vivo cytokine production was measured by the IHC method. The role of NF-κB in such process was evaluated in HaCaT cells by western blot assay.Results
Our results showed that M. furfur produced ovoid-shaped nanoparticles, which could be then internalized into HaCaT cells, as well as mice epidermal keratinocytes. IL-6 expression was significantly enhanced in response to extracellular vesicular stimulation both in vitro and in vivo, in which process the activation of NF-κB was involved.Conclusion
M. furfur has the ability to release extracellular vesicles, which can be internalized into keratinocytes and promote the production of IL-6 with the involvement of NF-κB dependent pathway. Such findings reveal some important new insights into Malassezia pathogenesis and therapy. 相似文献14.
Introduction
Medical photography is a noninvasive technique used for diagnostic, monitoring, and educational purposes. It is important to understand the patient's attitude to all or part of their body being photographed. The objective of this study was to analyze the attitudes of patients towards medical photography at a district hospital in Tarragona, Spain.Methodology
This exploratory study used a questionnaire to evaluate attitudes to medical photography among outpatients at Pius Hospital de Valls. The questionnaire explored the patients’ beliefs about the usefulness of medical photography, the circumstances in which they would agree to be photographed and by whom, as well as their prior experience of medical photography. They were also asked whether they would authorize the use of photography and, if not, to explain their motives.Results
The questionnaire was completed by 134 patients. The results showed that patients had a clearly positive attitude to being photographed for medical purposes (94.8%), treatment follow-up (88.1%), and consultation of their case with other physicians (86.6%). Acceptance was 88.8% if the lesion was malignant and 85.1% if it was extensive. For facial lesions, only 78.4% were willing to be photographed and in the case of genitals the percentage fell to 70.2%. Most patients (95.5%) would agree to being photographed by their doctor. The rate of acceptance was 66.4% in the case of a nurse, 64.9% for another doctor, and 21.6% for a professional photographer.Conclusions
Our study revealed that patients have a positive attitude to being photographed for medical purposes, particularly when they have a malignant lesion, when the photograph is taken by their specialist, and when they cannot be identified. 相似文献15.
Derivación de pacientes en consulta de dermatología y de teledermatología en España. Estudio DIADERM
G. González-López M.Á. Descalzo-Gallego S. Arias-Santiago A. Molina-Leyva Y. Gilaberte P. Fernández-Crehuet H. Husein-El Ahmed A. Viera-Ramírez P. Fernández-Peñas R. Taberner I. García-Doval A. Buendía-Eisman 《Actas dermo-sifiliográficas》2019,110(2):146-152
16.
Dorien De Meyer Sofie Verhaeghe Ann Van Hecke Dimitri Beeckman 《Journal of tissue viability》2019,28(2):59-69
Background
Pressure ulcers have a high impact on patients and their families. Profound and up-to-date knowledge among nurses is important given the effect on attitudes and preventative behaviour. To gain insight into educational needs and priorities, regular knowledge assessments are needed.Objective
To gain insight into the knowledge of nurses and nursing assistants about pressure ulcer prevention.Design
Cross-sectional multicentre study.Methods
474 nurses and nursing assistants recruited at 29 wards in 16 hospitals completed individually the PUKAT 2.0, a valid and reliable questionnaire to measure nurses knowledge about pressure ulcer prevention. Data were collected between February 2016 and December 2017. Independent sample t-tests, one-way analyses of variance and Kruskal-wallis tests were performed to analyse the results.Results
The mean total score was 50.7%. The lowest scores were found in the themes knowledge about prevention (42.7%), aetiology (45.6%) and prevention for specific patient groups (46.6%). Higher educational level (H?=?40.43, p?<?0.001) and attending additional training about pressure ulcers or wound care in general (t?=?2.93, p?=?0.004) resulted in significant higher total knowledge scores.Conclusion
The results of this study highlight an important knowledge deficit about pressure ulcer prevention. The PUKAT 2.0 knowledge assessment tool made it possible to differentiate between a variety of cognitive process levels. This allowed to identify knowledge gaps and focus areas for continuing professional education. Education curricula for nurses and associated healthcare professionals are to be screened thoroughly and the identified knowledge gaps should be covered. Besides, multifaceted strategies are needed to improve clinical practice. 相似文献17.
Ehsan Zarei Elmira Madarshahian Adeleh Nikkhah Soheila Khodakarim 《Journal of tissue viability》2019,28(2):70-74
Background and objective
Pressure ulcer (PU) is one of the important and frequent complications of hospitalization, associated with high treatment costs. The present study was conducted to determine the incidence of PU and its direct treatment costs for patients in intensive care unit (ICU) in Iran.Material and methods
In this retrospective study, medical records of 643 discharged patients from ICU of two selected hospitals were examined. The demographic and clinical data of all patients and data of resources and services usage for patients with PU were extracted through their records. Data analysis was done using logistic regression tests in SPSS 22 software. The cost of PU treatment was calculated for each grade of ulcer.Results
The findings showed that 8.9% of patients developed PU during their stay in ICU. Muscular paralysis (OR?=?5.1), length of stay in ICU (OR?=?4.0), diabetes (OR?=?3.5) age (OR?=?2.9), smoking (OR?=?2.1) and trauma (OR?=?1.4) were the most important risk factors of PU. The average cost of PU treatment varied from USD 12 for grade I PU to USD 66?834 for grade IV PUs. The total treatment costs for all studied patients with PU was estimated at USD 519?991.Conclusion
The cost of PU treatment is significant. Since the preventive measures are more cost-effective than therapeutic measures, therefore, effective preventive interventions are recommended. 相似文献18.
Chitra Mehta MdTariq Ali Yatin Mehta Joby V. George Manish Kumar Singh 《Journal of tissue viability》2019,28(1):35-39
Background
Pressure ulcers (PU) usually occur over bony prominences in hospitalized patients. But they may occur due to medical devices referred also as Medical device related pressure ulcers (MDRPU). The United States National advisory panel (NPUAP) recognizes it as an important entity. MDRPU is one of the key quality indicators of hospital care, so far no data is available on MDRPU from the Indian Sub-continent.Aim
The primary objective of the study was to examine prevalence and Risk factors of MDRPU in critically sick patients.Design
A Cross-sectional point prevalence study.Methods
All patients above 18 years of age admitted in Intensive care units (ICU) on the date of the survey were included in the study. It was conducted in medical, cardiothoracic and neurosurgical ICUs. Demographic and MDRPU data were recorded. MDRPU was staged as per National Pressure ulcer advisory panel staging system. Ethics Committee approval was obtained prior to the start of the study.Results
One hundred and forty-six patients were included. The prevalence of PU was 26.0%. The prevalence of MDRPU was found to be 19.2%. MDRPUs most commonly occurred with non-invasive ventilation mask (NIV) and nasogastric tube (NGT) (20% and 12.3% respectively). MDRPUs were associated with a longer ICU Stay.Conclusions
MDRPUs pose a significant burden on healthcare. Our study showed significant prevalence rate of MDRPU which is comparable to those seen internationally. There is a compelling need to have continuous audits and structured training programs among healthcare professionals to prevent MDRPUs in critically sick patients. 相似文献19.
Hanne Van Tiggelen Nele Van Damme Sofie Theys Eline Vanheyste Sofie Verhaeghe Kimberly LeBlanc Karen Campbell Kevin Woo Ann Van Hecke Dimitri Beeckman 《Journal of tissue viability》2019,28(2):100-106
Background
Although skin tears are among the most prevalent acute wounds in nursing homes, their recognition as a unique condition remains in its infancy. Elderly patients are at risk of developing skin tears due to increased skin fragility and other contributing risk factors. In order to provide (cost-) effective prevention, patients at risk should be identified in a timely manner.Objectives
(1) To determine the point prevalence of skin tears and (2) to identify factors independently associated with skin tear presence in nursing home residents.Methods
A cross-sectional observational study was set up, including 1153 residents in 10 Belgian nursing homes. Data were collected by trained researchers and study nurses using patient records and skin observations. A multiple binary logistic regression model was designed to explore independent associated factors (significance level α?<?0.05).Results
The final sample consisted of 795 nursing home residents, of which 24 presented with skin tears, resulting in a point prevalence of 3.0%. Most skin tears were classified as category 3 (defined as complete flap loss) according to the International Skin Tear Advisory Panel (ISTAP) Classification System and 75.0% were located on the lower arms/legs. Five independent associated factors were identified: age, history of skin tears, chronic use of corticosteroids, dependency for transfers, and use of adhesives/dressings.Conclusions
This study revealed a skin tear prevalence of 3.0% in nursing home residents. Age, history of skin tears, chronic use of corticosteroids, dependency for transfers, and use of adhesives/dressings were independently associated with skin tear presence. 相似文献20.