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A comparative study to evaluate the effect of limited access dressing (LAD) on burn wound healing 下载免费PDF全文
Thittamaranahalli M Honnegowda Pramod Kumar Echalasara G Padmanabha Udupa Anurag Sharan Rekha Singh Hemanth K Prasad Pragna Rao 《International wound journal》2016,13(5):791-798
Biochemical and histopathological analyses are commonly used objective parameters in research and clinical fields to assess the healing status of burn wounds. In this study, the effect of newer intermittent negative‐pressure wound therapy in combination with moist environment [limited access dressing (LAD)] on burn wound healing is studied. Various biochemical parameters like hydroxyproline, hexosamine and total protein, and antioxidants like reduced glutathione (GSH), glutathione peroxidase (GPx) and oxidative biomarker malondialdhyde (MDA) were measured in the granulation tissue. Histopathologically, necrotic tissue, amount of inflammatory infiltrate, angiogenesis and extracellular matrix deposition (ECM) were studied to determine wound healing. A total of 55 patients were divided into two groups as follows: LAD group (n = 28) and conventional dressing group (n = 27). Patients treated with LAD have shown significant increase in the mean levels of (±SD) hydroxyproline (75·2 ± 26·30 versus 27·8 ± 15·5; P = 0·010), hexosamine (9·0 ± 1·99 versus 8·0 ± 1·18; P = 0·038), total protein (15·6 ± 8·23 versus 10·26 ± 4·94; P = 0·003), GSH (7·40 ± 1·91 versus 5·1 ± 1·28; P = 0·037), GPx (112·6 ± 46·4 versus 92 ± 32·4; P = 0·016), and decrease in MDA (6·5 ± 2·24 versus 1 0·6 ± 3·8; P = 0·002). Histopathologically, between LAD and conventional dressing groups, there was a significant difference after 10 days of treatment (mean±SE) in necrotic tissue of (LAD versus conventional dressing groups = 10 ± 1·8 versus 11·9 ± 2·6; P = 0·033), inflammatory cells (8·4 ± 1·9 versus 13 ± 3·46; P = 0·021), new blood vessels (12·5 ± 2·87 versus 9·4 ± 1·7; P = 0·047), ECM deposit (12·9 ± 2·41 versus 9·68 ± 1·3; P = 0·018) and showed comparatively fewer inflammatory cells, increased and well‐organised extracellular matrix deposit, more angiogenesis in LAD group as compared with that in conventional dressing group. To conclude, LAD exerts its beneficial effects on wound healing by reducing oxidative stress, decreasing necrotic tissue and amount of inflammatory infiltrate, and increasing ECM deposition and angiogenesis. 相似文献
104.
Sharan M Ahmed S Ghebrehiwet M Rogo K 《International journal of gynaecology and obstetrics》2011,115(3):244-250
Objective
To examine the quality of the maternal health system in Eritrea to understand system deficiencies and its relevance to maternal mortality within the context of Millennium Development Goal (MDG) 5.Methods
A sample of 118 health facilities was surveyed. Data were collected on 5 dimensions of health system quality: availability; accessibility; management; infrastructure; and process indicators. Data on the causes of hospital admissions for obstetric patients and maternal deaths were extracted from medical records.Results
Eritrea has only 11 comprehensive emergency obstetric care (CEmOC) facilities, all of which are grossly understaffed. There is considerable pressure on the infrastructure and health providers at hospitals. Compliance with clinical care standards and availability of supplies were optimal. As a result, the case fatality rate of 0.65% was low. In total, 45.6% of obstetric admissions and 19.5% of maternal deaths were attributed to abortion complications.Conclusion
In Eritrea, critical gaps in the health system—especially those related to human resources—will impede progress toward MDG 5, and it will not be possible to reduce maternal mortality without addressing the high burden of abortion. 相似文献105.
Pediatricians and family practitioners have the responsibility of providing the crucial primary care for the children. They
are considered to be in a unique position to contribute to the dental health of their young patients. In view of this a study
was conducted in Mangalore city (India) to assess pediatricians’ views about oral health care and their advice regarding oral
hygiene maintenance. Fifty pediatricians were personally interviewed with a questionnaire. All pediatricians acknowledged
their role in oral hygiene maintenance of their patients. This study showed that there is a need for more communication between
the two pediatric specialties of medicine and dentistry so as to deliver better child health care. 相似文献
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Kevin O’Halloran Andres Depalma Vilma Joseph Neil Cobelli Alok Sharan 《Current reviews in musculoskeletal medicine》2012,5(4):283-289
The goal of Accountable Care Organizations is to improve patient outcomes while maximizing the value of the services provided. This will be achieved through the use of performance and quality measures that facilitate efficient, cost-effective, evidence-based care. By creating a network connecting primary care physicians, specialists, rehabilitation facilities and hospitals, patient care should be maximized while at the same time delivering appropriate value for those services provided. The Medicare Shared Savings Program will financially reward ACOs that meet performance standards while at the same time lowering costs. The orthopaedic surgeon can only benefit by understanding how to participate in and negotiate the complexities of these organizations. 相似文献
108.
David L. Penn MS Benjamin M. Zussman BS Chengyuan Wu MD Ashwini D. Sharan MD 《Neuromodulation》2012,15(6):581-585
Objectives: To illustrate a new surgical revision strategy for malfunctioning spinal cord stimulation (SCS) paddle electrodes. Background: SCS is a treatment for chronic neuropathic pain that delivers therapeutic doses of electric current to the dorsal columns resulting in dermatomal paresthesia and pain reduction. Reasons for SCS failure include hardware malfunction or breakage and medical complications. Case Report: A 34‐year‐old woman presented with a two‐year history of intractable pain in the left upper extremity and thoracic region which was previously controlled by SCS. Imaging demonstrated breakage of the cervical electrode wire that had been advanced in the caudal direction from the C1 spinal level. Revision of the broken electrode was performed by hemilaminectomy of C3‐C4 and the replacement electrode was advanced in the cephalad direction. Results: Ideal and exact paresthesia pattern was confirmed intraoperatively and the patient maintained successful pain reduction at five‐year follow‐up. Conclusion: Advancing SCS electrodes into the upper cervical spine in the cephalad direction, using the previously formed scar capsule, offers an alternate strategy for revision of malfunctioning SCS paddle electrodes. 相似文献
109.
Objective: The use of cervical spinal cord stimulators for the treatment of refractory neck and upper extremity pain is widely accepted and growing in use as a treatment modality. This case highlights a previously unreported potential complication of spinal cord stimulators. Methods: Analysis of a patient with a cervical spinal cord stimulator presenting with a spinal cord injury. Patient was followed from presentation in the emergency room until 1‐year follow‐up in the office. Results: The patient in this case presented after a fall and sustained a cervical spinal cord injury induced by the electrodes of her spinal cord stimulator working as a space occupying mass. Conclusion: As more patients are undergoing implantation of spinal cord stimulators we must be aware of the long‐term risks that can be encountered. 相似文献
110.
Andrew?A.?Monte Diane?P.?Calello Roy?R.?Gerona Eike?Hamad Sharan?L.?Campleman Jeffery?Brent Paul?Wax Robert?G.?Carlson On behalf of the ACMT Toxicology Investigators Consortium 《Journal of medical toxicology》2017,13(2):146-152