Tissue oxygen perfusion and pressure ulcer healing.

Diabetes mellitus is known to retard wound healing. This study of 35 subjects with pressure ulcers found that carbon dioxide levels were negatively correlated to healing rates. Transcutaneous oxygen levels of peri ulcer was not statistically significantly related to healing rates.     

Improving outcomes in the elderly after pressure ulcer repair.

Pressure ulcer repair with skin or muscle flaps may appear to close the wound, but elderly patients need extra precautions before and after surgery to improve the outcome. Nursing care of these patients include monitoring nutrition, removing devitalized tissue from the wound bed, providing proper pressure relief, administering proper patient positioning, and monitoring the flap.     

A proteomic investigation of Streptococcus agalactiae grown under conditions associated with neonatal exposure reveals the upregulation of the putative virulence factor C protein β antigen

Streptococcus agalactiae is a major neonatal pathogen that is able to adapt to a variety of host environments, including both rectal and vaginal maternal carriage, growth in amniotic fluid and at various neonatal body sites. As such it is important to elucidate the patterns of protein expression that are associated with S. agalactiae growth under these different in vivo conditions. To this end, we have grown S. agalactiae strain A909 under in vitro conditions reflecting those associated with maternal vaginal carriage (low pH, low oxygen, nutrient stress) and those associated with exposure to body fluids during invasive disease (neutral pH, aeration, nutrient sufficient). The protein profiles of bacterial cells grown under each of these conditions were compared using a proteome approach. A total of 76 proteins were reproducibly identified 16 of which were shown to be differentially expressed. The putative virulence factor C protein β and several proteins linked to resistance to oxidative stress were found to be upregulated under the conditions hypothesised to reflect those associated with foetal exposure to S. agalactiae. Thus, these data add to the currently limited understanding of the molecular basis of S. agalactiae GBS adaptation to different environmental conditions.     

Genetic variation within the Tupi linguistic group: new data on three Amazonian tribes

A total of 505 individuals belonging to four populations of three Brazilian Indian tribes were variously studied in relation to 34 genetic systems, and the results were compared with South American Indian averages and five other Tupi populations. Rare variants (CdE of the Rh system, PGM₂ 11-1, CpA-CAY1, serum cholinesterase₂ C5 + and some Gm combinations) were observed with varying prevalences, and the three tribes showed different degrees of departure (28%–40% of differences of 10% or more in gene frequencies) from South American Indian averages. People from two communities who speak the same language and are labelled as belonging to the same tribe (Asurini) showed a large degree of genetic differentiation. Another of the tribes studied (Urubu-Kaapor) link through genetic distance analyses with two other tribes from the north of the continent, forming a distinct microevolutionary unit. These features emphasize the peculiarities of the genetic variation in populations with a hunter-gatherer, rudimentary agriculture type of economy.     

Development of PCR Assays for Detection of Trichomonas vaginalis in Urine Specimens

Trichomonas vaginalis infections are usually asymptomatic or can result in nonspecific clinical symptoms, which makes laboratory-based detection of this protozoan parasite essential for diagnosis and treatment. We report the development of a battery of highly sensitive and specific PCR assays for detection of T. vaginalis in urine, a noninvasive specimen, and development of a protocol for differentiating among Trichomonas species that commonly infect humans.     

Disability in Older Adults 1: Prevalence,Causes, and Consequences

The effects of disability on an aging population's health and welfare are an important issue in gerontological research. The rapid growth of the elderly population and increases in longevity have led to an ongoing debate about whether longer lives can be matched by longer active lives that are free from disability. After a detailed review of current disability literature, the authors discuss the impact of disability in the elderly, defining disability and reviewing three classes of disability—physical, mental, and social. Both subjective and objective disability measures are described, and disability trends and prevalence rates are reviewed and compared cross culturally, by gender, by age, and over time. The path from chronic disease to disability is described and the consequences of living with disability are discussed in terms of family burdens and the increased need for medical care.     

Retained Shotgun Pellets in the Vulva: Case Report

BackgroundVulvar trauma is relatively uncommon and typically occurs in accidental or sports-related injuries. There is limited literature for management of penetrating trauma to the vulva.CaseA 38-year-old G9, P9 woman presented to the gynaecology service for assessment of vulvar injury after a gunshot wound to the right lateral thigh. She underwent initial stabilization and operative management by the Trauma and Plastic Surgery services for predominantly soft-tissue injuries. Multiple gunshot pellets were found embedded in the right labia majora and medial thigh. On assessment, surgical removal was deemed necessary on the basis of symptoms and potential for functional impairment.ConclusionWe present the first reported case on the management of vulvar injury secondary to penetrating trauma. The principles of non-obstetrical vulvar trauma management are discussed.