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1
Obogo, E., and E. Bassey. "Perforated duodenal ulcers associated with other complications of peptic ulcer disease." Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/27515.
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Adriaans, Beverley. "The aetiology and pathogenesis of tropical ulcer." Master's thesis, University of Cape Town, 1988. http://hdl.handle.net/11427/25758.
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Tropical ulcer is a very specific form of cutaneous ulceration. It occurs worldwide in most tropical and a number of subtropical areas. The disease occurs mainly in older children and young adults with children under the age of 5 and adults over 45 years rarely being affected. Ulcers occur most commonly on the lower leg but may occur on the upper limb. Although most ulcers normally heal slowly over many weeks or months, some ulcers may recur. Recognised complications include squamous cell carcinoma, gangrene and osteitis, although these are rare. A number of authors have reported on the disease and suggested diet, trauma and infection as aetiological factors for this condition. This survey was thus conducted to assess as many of these factors as possible. The study took place in 5 tropical areas, namely Zambia, Gambia, southern India, Fiji and Papua New Guinea. Consultations took place at hospitals, rural clinics, health centres and villages. Although many authors have suggested that the disease is related to malnutrition, few have objectively assessed the nutritional status of the patients and compared it with controls. Those studies which included objective assessments were limited to small areas and only investigated specific parameters. In order to investigate the immune response of the host to an anaerobic infection, the antibody levels to the organisms isolated from the ulcers were measured by an ELISA test. The local host response to an infection with a Fusobacterium species was assessed by the number of antibody secreting B-lymphocytes at the site of the ulcers. These parameters may play a role in the localisation of the ulcers and account for recurrent infections.
3
Loots, Miriam Alfonsa Maria. "Wound healing in diabetic ulcers." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2002. http://dare.uva.nl/document/66897.
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Sahin, Birnur. "DEVA : Treating Chroinic Leg Ulcers." Thesis, Umeå universitet, Designhögskolan vid Umeå universitet, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-172613.
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An ulcer is an open wound that remains unhealed even after weeks of treatment. These types of wounds require a long process of treatment due to other underlying health problems. Having an unhealing, painful and often infected wound decreases patients’ life quality significantly. The treatment includes using wound dressing applied by nurses, to protect the wound from infections, collect exudate and provide a closed and sterile environment. During a treatment, which could last for months, patients experience a lot of emotional and physical challenges. Deva is a design concept proposing the use of smart sensors in wound care treatment in a way that it will improve the communication between patients and nurses, by providing information and guidance. The ecosystem consists of a smart wound patch that will turn any wound dressing today into a “smart” one, an electrostimulation therapy sock and digital platforms where the information will be available. This way information on the wound status will be available for the patient, their family members or caregivers and the nurses.This project has been developed by interviewing nurses and wound care professionals from Turkey, Sweden and Denmark. The insights reflect the situation and the healthcare system in these countries and a wound care treatment journey might differ in other settings.
5
Angelis, Célio Damacena de [UNESP]. "Avaliação da proteção gástrica e duodenal do monoterpeno nerol em roedores." Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/91622.
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Este projeto se propôs a avaliar a ação farmacológica do nerol na prevenção de úlcera péptica. Nerol na dose de 60 mg/Kg por via oral exerceu proteção contra lesão gástrica induzida por etanol e por droga anti-inflamatória não esteróide (DAINE) em ratos, mas não protegeu contra úlcera duodenal induzida por cisteamina. Experimentos foram realizados para a elucidação dos mecanismos ação e verificou-se que a proteção exercida pelo Nerol não é por bloqueio dos radicais livres, por redução da secreção gástrica ou por aumento de muco, sua ação também não ocorre por formação de barreira mecânica. Verificou-se, contudo, que houve redução da motilidade gastrointestinal, o que pode ser um indicativo de redução do esvaziamento gástrico, o que contribui para o efeito gastroprotetor. A redução da motilidade gastrointestinal assim como a redução do acúmulo intestinal exercido pelo nerol foi revertida pela administração de naloxona (antagonista de receptores opióides), indicando, portanto, o envolvimento destes receptores. Através do bloqueio de fatores protetores da mucosa gástrica, verificou-se que a gastroproteção exercida pelo nerol é independente da via do óxido nítrico, de prostaglandinas e dos receptores mu opióides, porém, é dependente de compostos sulfidrílicos. Mostrou-se através da quantificação dos níveis de glutationa (GSH) e da atividade da enzima mieloperoxidase (MPO) que o tratamento com nerol mantém os níveis de compostos sulfidrílicos não-protéicos e reduz a infiltração de neutrófilos na mucosa gástrica em animais com lesão gástrica induzida por etanol. A administração aguda de nerol (doses de 60, 300, 600, 1250, 2500 ou 5000 mg/Kg) não provocou mortes nem alterações significantes nos parâmetros comportamentais até a dose de 600 mg/Kg. Neste trabalho portanto, ficou...
The present project proposed to evaluate the pharmacologic action of nerol in the prevection of peptic ulcer. It was seen that 60 mg/kg (p.o.) of nerol prevented gastric lesions induced by ethanol and no steroidal anti-inflammatory drugs (NSAID) in rats, however nerol did not have protected duodenal mucosa against cysteamine. Assays were performed to elucidation of the mechanisms of action and it was found that protection exerted by Nerol does not by block of free radicals, nor decrease gastric acid secretion nor increase mucus, its action is not by create a mechanical barrier. However It was found that nerol reduced gastrointestinal motility, this might be an indicative of slower gastric emptying that contribute to the gastric protective effect. Reduction of gastrointestinal motility, as well as the reduction of intestinal accumulation exerted by nerol was reverted by naloxone administration (antagonist of opioid receptors), therefore indicating involvement of the cited receptors. By blocking protective factors of gastric mucosa, it was verified that nerol’s gastroprotective effect does not involve nitric oxide, prostaglandin nor mu opioid receptors, but is dependent of sulfhydryl compounds. It was shown by quantifying glutathione levels (GSH) and myeloperoxidase (MPO) action that treatment with nerol keeps the levels of non proteic sulfhydryl compounds and decreases the neutrophil infiltration into the gastric mucosa in animals with ethanol-induced gastric damage. Acute administration of nerol (60, 300, 600, 1250, 2500 and 5000 mg/Kg) presented no deaths, neither significant behavior changes to doses of 60, 300 and 600 mg/kg. In this work, nerol showed a gastroprotective effect against ethanol- and indomethacin-induced lesions, and the depence of sulfhydryl compounds. The involvement of opioid receptors and the gastrointestinal... (Complete abstract click electronic access below)
6
Silva, Laísa Pinheiro da [UNESP]. "Avaliação dos mecanismos de ação envolvidos nas atividades antiulcerogênica e cicatrizante do extrato etanólico obtido a partir das folhas de Terminalia catappa L. (COMBRETACEAE)." Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/91639.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Terminalia catappa Linn é uma espécie comumente utilizada para arborização nas regiões tropical e subtropical. Essa espécie é também utilizada, em países da Ásia, como Taiwan, Índia, Flipinas e Indonésia, para tratamento de distúrbios hepáticos e do trato gastrointestinal. A literatura aponta que seus constituintes encontrados nos extratos polares das folhas são principalmente compostos polifenólicos, em especial os taninos. A partir desses dados e da ausência de registros na literatura sobre a ação antiulcerogênica desta espécie foram realizados estudos para avaliação dessa atividade das frações e caracterização da fração mais ativa, assim como a determinação do mecanismo de ação gastroprotetor e cicatrizante da fração ativa. A partir do extrato etanólico bruto das folhas, que em estudo anterior realizado pelo grupo demonstrou atividade gastroprotetora, antisecretória e cicatrizante, foi feita a partição com três solventes de diferentes polaridades (hexano, acetato de etila e metanol/água). As três frações oriundas destas extrações apresentaram ação gastroprotetora em úlcera induzida por etanol absoluto, porém a fração mais efetiva foi a aquosa na dose de 25 mg/Kg, selecionada para caracterizar os mecanismos de ação envolvidos na ação antiulcerogênica como: óxido nítrico (NO), prostaglandinas (PG), aumento de muco e atividade antioxidante por meio da manutenção dos níveis de glutationa e redução da atividade da enzima mieloperoxidase (MPO). Não foram observadas a participação dos grupamentos sulfidrila e ação antisecretória. Foi constatada atividade cicatrizante tanto com 7 como com 14 dias de tratamento, consecutivos, da fração aquosa. Durante o tratamento com a partição aquosa ocorreu uma...
Terminalia catappa Linn is a specie commonly used for afforestation in tropical and subtropical regions. It is used, in Asian countries, as Taiwan, India, Filipines and Indonesia, for treatment of hepatic and gastrointestinal disorders. Studies point to poliphenols as main components of polar leaves extract, specially the tannins. Based on this and in the lack of information about a possible gastroprotective action of this specie, studies for avaliation of this activity were done with fractions of the ethanolic extract, and gastroprotective action mechanisms were characterized in the most active fraction. A previous study done by our group showed the ethanolic extract as gastroprotective, antisecretory and healing. The ethanol extract were partitioned with three different solvents, hexane, etil acetate and methanol/water. The three fractions showed gastroprotective action in the model of ulcer induced by ethanol, but the most effective was aquous fraction in a dose of 25 mg/Kg, which was the one selected to the characterization of the mechanisms involved in the antiulcerogenic activity as: nitric oxide (NO), prostaglandins (PG), mucus and antioxidant activity by maintenance of glutathione levels and reduction in mieloperoxidase (MPO) enzyme activity. No participation of sulphidryls compounds and antisecretory activity were detected. The aquous fraction also showed healing action in the treatment for 7 and 14 days, in both of them was detected a down-regulation in metalloproteinase-2 (MPP-2). In a subchronic toxicity avaliation, the aquous fraction in 25 mg/Kg doesn´t presented a toxic potential. In the model of gastric ulcer induced by indomethacin, the aquous fraction in a dose of 50 mg/Kg, aggravated the lesions, which showed an evidence for antiinflamatory activity, it was confirmed in Formalin test and ear edema induced by... (Complete abstract click electronic access below)
7
Silva, Laísa Pinheiro da. "Avaliação dos mecanismos de ação envolvidos nas atividades antiulcerogênica e cicatrizante do extrato etanólico obtido a partir das folhas de Terminalia catappa L. (COMBRETACEAE) /." Botucatu : [s.n.], 2012. http://hdl.handle.net/11449/91639.
Full textAbstract:
Orientador: Clélia Akiko Hiruma-LimaBanca: Wagner Villegas
Banca: Walter Toma
Resumo: Terminalia catappa Linn é uma espécie comumente utilizada para arborização nas regiões tropical e subtropical. Essa espécie é também utilizada, em países da Ásia, como Taiwan, Índia, Flipinas e Indonésia, para tratamento de distúrbios hepáticos e do trato gastrointestinal. A literatura aponta que seus constituintes encontrados nos extratos polares das folhas são principalmente compostos polifenólicos, em especial os taninos. A partir desses dados e da ausência de registros na literatura sobre a ação antiulcerogênica desta espécie foram realizados estudos para avaliação dessa atividade das frações e caracterização da fração mais ativa, assim como a determinação do mecanismo de ação gastroprotetor e cicatrizante da fração ativa. A partir do extrato etanólico bruto das folhas, que em estudo anterior realizado pelo grupo demonstrou atividade gastroprotetora, antisecretória e cicatrizante, foi feita a partição com três solventes de diferentes polaridades (hexano, acetato de etila e metanol/água). As três frações oriundas destas extrações apresentaram ação gastroprotetora em úlcera induzida por etanol absoluto, porém a fração mais efetiva foi a aquosa na dose de 25 mg/Kg, selecionada para caracterizar os mecanismos de ação envolvidos na ação antiulcerogênica como: óxido nítrico (NO), prostaglandinas (PG), aumento de muco e atividade antioxidante por meio da manutenção dos níveis de glutationa e redução da atividade da enzima mieloperoxidase (MPO). Não foram observadas a participação dos grupamentos sulfidrila e ação antisecretória. Foi constatada atividade cicatrizante tanto com 7 como com 14 dias de tratamento, consecutivos, da fração aquosa. Durante o tratamento com a partição aquosa ocorreu uma... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Terminalia catappa Linn is a specie commonly used for afforestation in tropical and subtropical regions. It is used, in Asian countries, as Taiwan, India, Filipines and Indonesia, for treatment of hepatic and gastrointestinal disorders. Studies point to poliphenols as main components of polar leaves extract, specially the tannins. Based on this and in the lack of information about a possible gastroprotective action of this specie, studies for avaliation of this activity were done with fractions of the ethanolic extract, and gastroprotective action mechanisms were characterized in the most active fraction. A previous study done by our group showed the ethanolic extract as gastroprotective, antisecretory and healing. The ethanol extract were partitioned with three different solvents, hexane, etil acetate and methanol/water. The three fractions showed gastroprotective action in the model of ulcer induced by ethanol, but the most effective was aquous fraction in a dose of 25 mg/Kg, which was the one selected to the characterization of the mechanisms involved in the antiulcerogenic activity as: nitric oxide (NO), prostaglandins (PG), mucus and antioxidant activity by maintenance of glutathione levels and reduction in mieloperoxidase (MPO) enzyme activity. No participation of sulphidryls compounds and antisecretory activity were detected. The aquous fraction also showed healing action in the treatment for 7 and 14 days, in both of them was detected a down-regulation in metalloproteinase-2 (MPP-2). In a subchronic toxicity avaliation, the aquous fraction in 25 mg/Kg doesn't presented a toxic potential. In the model of gastric ulcer induced by indomethacin, the aquous fraction in a dose of 50 mg/Kg, aggravated the lesions, which showed an evidence for antiinflamatory activity, it was confirmed in Formalin test and ear edema induced by... (Complete abstract click electronic access below)
Mestre
8
Angelis, Célio Damacena de. "Avaliação da proteção gástrica e duodenal do monoterpeno nerol em roedores /." Botucatu, 2012. http://hdl.handle.net/11449/91622.
Full textAbstract:
Orientador: Clélia Akiko Hiruma-LimaBanca: Elfriede Marianne Bacchi
Banca: Luiz Claudio Di Stasi
Resumo: Este projeto se propôs a avaliar a ação farmacológica do nerol na prevenção de úlcera péptica. Nerol na dose de 60 mg/Kg por via oral exerceu proteção contra lesão gástrica induzida por etanol e por droga anti-inflamatória não esteróide (DAINE) em ratos, mas não protegeu contra úlcera duodenal induzida por cisteamina. Experimentos foram realizados para a elucidação dos mecanismos ação e verificou-se que a proteção exercida pelo Nerol não é por bloqueio dos radicais livres, por redução da secreção gástrica ou por aumento de muco, sua ação também não ocorre por formação de barreira mecânica. Verificou-se, contudo, que houve redução da motilidade gastrointestinal, o que pode ser um indicativo de redução do esvaziamento gástrico, o que contribui para o efeito gastroprotetor. A redução da motilidade gastrointestinal assim como a redução do acúmulo intestinal exercido pelo nerol foi revertida pela administração de naloxona (antagonista de receptores opióides), indicando, portanto, o envolvimento destes receptores. Através do bloqueio de fatores protetores da mucosa gástrica, verificou-se que a gastroproteção exercida pelo nerol é independente da via do óxido nítrico, de prostaglandinas e dos receptores mu opióides, porém, é dependente de compostos sulfidrílicos. Mostrou-se através da quantificação dos níveis de glutationa (GSH) e da atividade da enzima mieloperoxidase (MPO) que o tratamento com nerol mantém os níveis de compostos sulfidrílicos não-protéicos e reduz a infiltração de neutrófilos na mucosa gástrica em animais com lesão gástrica induzida por etanol. A administração aguda de nerol (doses de 60, 300, 600, 1250, 2500 ou 5000 mg/Kg) não provocou mortes nem alterações significantes nos parâmetros comportamentais até a dose de 600 mg/Kg. Neste trabalho portanto, ficou... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The present project proposed to evaluate the pharmacologic action of nerol in the prevection of peptic ulcer. It was seen that 60 mg/kg (p.o.) of nerol prevented gastric lesions induced by ethanol and no steroidal anti-inflammatory drugs (NSAID) in rats, however nerol did not have protected duodenal mucosa against cysteamine. Assays were performed to elucidation of the mechanisms of action and it was found that protection exerted by Nerol does not by block of free radicals, nor decrease gastric acid secretion nor increase mucus, its action is not by create a mechanical barrier. However It was found that nerol reduced gastrointestinal motility, this might be an indicative of slower gastric emptying that contribute to the gastric protective effect. Reduction of gastrointestinal motility, as well as the reduction of intestinal accumulation exerted by nerol was reverted by naloxone administration (antagonist of opioid receptors), therefore indicating involvement of the cited receptors. By blocking protective factors of gastric mucosa, it was verified that nerol's gastroprotective effect does not involve nitric oxide, prostaglandin nor mu opioid receptors, but is dependent of sulfhydryl compounds. It was shown by quantifying glutathione levels (GSH) and myeloperoxidase (MPO) action that treatment with nerol keeps the levels of non proteic sulfhydryl compounds and decreases the neutrophil infiltration into the gastric mucosa in animals with ethanol-induced gastric damage. Acute administration of nerol (60, 300, 600, 1250, 2500 and 5000 mg/Kg) presented no deaths, neither significant behavior changes to doses of 60, 300 and 600 mg/kg. In this work, nerol showed a gastroprotective effect against ethanol- and indomethacin-induced lesions, and the depence of sulfhydryl compounds. The involvement of opioid receptors and the gastrointestinal... (Complete abstract click electronic access below)
Mestre
9
Debacker, Martine M. J. "L'ulcère de Buruli dans un centre de santé rural au Bénin." Doctoral thesis, Universite Libre de Bruxelles, 2005. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/211042.
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Notre travail porte sur tous les cas UB enregistrés entre 1997 et 2003 au Centre Sanitaire Nutritionnel Gbemoten (CSNG) de Zagnanado dans la région du Zou au Bénin. Une base de données a été créée et a permis d’analyser divers aspects de l’UB. Ces analyses ont donné lieu à diverses publications dont les résultats essentiels sont repris ci-dessous.Une première publication porte sur 1700 cas consécutifs admis au CSNG entre 1997 et 2001. Ces données nous ont permis d’illustrer l’évolution du nombre des cas d’UB au cours des années, par département et par sous-préfecture. Le nombre de patients UB qui se présentent au centre est fonction de différents facteurs comme par exemple l’ouverture d’autres centres de traitement, l’organisation de campagnes d’information sur l’UB mais aussi de changements dans l’environnement. Au niveau des formes de la maladie, nous avons montré que les formes non ulcérées sont aussi fréquentes que les formes ulcérées. La forme de la maladie est liée au délai à consulter le CSNG. Les atteintes osseuses sont fréquentes et sont présentes chez plus de 13% des cas. Au fil des années, le délai à consulter le CSNG ainsi que la durée de l’hospitalisation ont été fortement réduits, passant de 4 mois à 1 mois dans le premier cas et de 9 mois à 1 mois en ce qui concerne l’hospitalisation. Les personnes ressources à cibler lors des campagnes de sensibilisation sur la maladie ont été identifiées. Il s’agit des anciens malades, qui dans 68% des cas, réfèrent les nouveaux malades au CSNG.
Une deuxième publication, portant sur la même période, nous a permis de mettre en évidence pour la première fois des taux d’UB élevés chez les sujets de 60 ans et plus, probablement du fait d’une diminution de leur immunité. Chez les 60 ans et plus, les hommes sont plus à risque de développer un UB que les femmes. Par contre aucune différence dans le risque d’UB en fonction du sexe n’est trouvée chez les moins de 60 ans. Les lésions d’UB prédominent au niveau des membres inférieurs pour tous les groupes d’âge. Du fait de leur petite stature, les enfants ont une répartition des lésions qui touchent tout le corps. Chez les adultes, les femmes présentent plus de lésions que les hommes au niveau de la tête, du cou et du tronc. Les sujets de moins de 15 ans développent souvent des lésions multifocales, associées à des atteintes osseuses. Ces atteintes osseuses constituent les formes graves de la maladie.
Notre troisième publication porte sur le suivi des malades au niveau des villages, entre mars 2000 et février 2001, afin de déterminer les taux de récurrences de l’UB. Le taux de récurrence de la maladie est faible (6.1%) pour un temps de suivi des malades allant jusqu’à 7 ans. La majorité des malades soignés au CSNG étaient en bonne santé. Nous n’avons néanmoins pu retrouver qu’un nombre limité de malades.
Dans notre quatrième publication, nous avons pu mettre en évidence le développement d’un UB sur le site d’une morsure humaine. La surface de la peau du malade a pu être contaminée par M. ulcerans et la morsure (= traumatisme) a occasionné l’entrée de M. ulcerans dans le derme. Une autre explication plausible est que la morsure ait réactivé un foyer latent de M. ulcerans au niveau du site de la morsure.
Notre base de données nous a également permis de contribuer à d’autres études, notamment celles sur l’influence du BCG et de la schistosomiase sur l’UB. Dans les deux cas, nous trouvons une association significative avec les formes graves de l’UB, l’absence de vaccination BCG et la schistosomiase favorisant le développement de formes osseuses. Aucun lien n’a pu être établi entre la présence ou l’absence de l’infection à Schistosoma haematobium et l’UB.
Dans la dernière partie de notre travail, nous nous sommes attachés à l’étude de quelques facteurs de risque de l’UB. Nous avons montré que l’UB est essentiellement associé à l’âge, le lieu de résidence et le type d’eau utilisé. Pour les sujets de 5 ans et plus, le risque d’UB est plus élevé chez les sujets vaccinés à la naissance avec le BCG. L’analyse par strate d’âge des sujets âgés de 5 ans et plus, nous a permis de voir que dans le groupe des 50 ans et plus l’influence du type d’eau utilisé est moindre que dans les autres groupes d’âge, laissant envisager qu’un autre facteur entre en jeu :une réactivation de la maladie à la faveur d’une baisse d’immunité.
Notre étude démontre que la prise en charge de l’UB doit être pluridisciplinaire et doit pouvoir englober diverses interventions telles que :
- les campagnes d’information à la population,
- la formation du personnel sanitaire ainsi qu’une implication de l’état,
- une bonne prise en charge des malades au niveau des centres de traitement de l’UB en collaboration avec les laboratoires régionaux et internationaux,
- la confirmation microbiologique des cas,
- la mise en place d’un suivi des malades en s’appuyant sur les structures déjà mises en place pour d’autres maladies,
- la mise à disposition des populations de sources d’eau potable (puits, pompes) qui par la même occasion permettront de limiter/diminuer d’autres affections liées à la consommation d’eau non potable,
- la poursuite des activités de recherche sur un éventuel vaccin ou une médication appropriée, ainsi que sur le réservoir de M. ulcerans afin de pouvoir mettre en place des stratégies de prévention de la maladie.
Doctorat en Sciences de la santé publique
info:eu-repo/semantics/nonPublished
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Tuttle, Marie S. "Microbial Bioburden in Venous Leg Ulcers." Case Western Reserve University School of Graduate Studies / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=case1409912389.
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Oliveira, Mariele Gobo de [UNESP]. "Estudo comparativo de gel de palquetas home made versus hidrocolóide no processo de cicatrização de úlcera crônicas de etiologia venosa." Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/93594.
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As úlceras venosas são impactantes e representam um grande desafio médico devido ao entrelaçamento de comorbidades e causas multifatoriais, sendo de suma importância o surgimento de inovações tecnológicas na abordagem terapêutica que sejam acessíveis aos seus portadores. Diante dessa realidade, este trabalho se propôs a abordar as úlceras venosas comparando um produto existente no mercado, Hidrocolóide (HC), com uma proposta in house, o Gel de Plaquetas (GP), através da diminuição da área, avaliação descritiva da vascularização e queixas referidas. Participaram do estudo 17 pacientes, perfazendo um total de 22 úlceras venosas que foram acompanhados durante 90 dias, utilizando um dos produtos citados, de acordo com o randomização, em associação com o uso de faixas elásticas. A distribuição do grupo, segundo a randomização foi de 13 lesões no grupo de hidrocolóide e 9 no grupo de gel de plaquetas. A média percentual de redução das áreas das feridas foi de 57,78% para hidrocolóide e de 53,45% para gel de plaquetas, não apresentando diferenças estatisticamente significativas. O desempenho dos produtos estudados apresentaram grande similaridade no percentual de redução de área, o que indica que é preciso um estudo amostral maior para evidenciar superioridade de um produto sobre o outro. Porém quando comparados, quanto ao menor tempo de acompanhamento (D15), o gel de plaquetas apresentou melhor desempenho, com redução maior do que o hidrocolóide em tempo reduzido semelhante. A análise histológica no momento pré e pós tratamento sugere que o GP atua de forma a estimular a regeneração dos tecidos (estroma coeso) e de forma mais definitiva (distribuição dos vasos difusa na derme reticular). O aspecto do fechamento da lesão é mais consistente quando comparado com os pacientes que usaram HC onde se observou a formação de uma fina epiderme frágil...
Venous ulcers are striking and represent a major challenge due to the commingling of medical comorbidities and multifactorial causes, with the emergence of great importance to technological innovations in therapeutic approaches that are accessible to their patients. Given this reality, this study proposes to address venous ulcers comparing a product on the market, hydrocolloid (HC) with a proposed in-house, the Platelet Gel (GP), by decreasing the area and descriptive evaluation of vascularization complaints referred. The study included 17 patients, a total of 22 venous ulcers who were followed for 90 days, using one of the products listed, according to the randomization, in association with the use of compression elastic. The distribution of the group, according to randomization was 13 injuries in the hydrocolloid group and 9 in the group of platelet gel. The average percentage reduction of wound areas was 57.78% for hydrocolloid and 53.45% for platelet gel, showing no statistically significant differences. The performance of the products studied showed great similarity in the percentage of area reduction, which indicates that it is necessary to study a larger sample to demonstrate the superiority of one product over another. But when compared, for the shortest time of follow-up (D15), the platelet gel performed better, with greater reductions than the hydrocolloid in a short time like that. Histological analysis in the D0 and D90 of the treatment suggests that the GP acts to stimulate the regeneration of tissues (stroma together) and more definite form (diffuse distribution of vessels in the reticular dermis). The appearance of the closure of the injury is more consistent when compared with patients who used HC we observed the formation of a thin skin, fragile, observed in histological sections showed that a distribution of vessels in the papillary dermis. Histological sections confirmed... (Complete abstract click electronic access below)
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Saha, Dipanwita. "Studies on the role of bacteria isolated from ulcers of fishes in causing ulcer in Experimental Fish." Thesis, University of North Bengal, 1998. http://hdl.handle.net/123456789/1093.
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Embaye, H. "Microbiological aspects of oesophagogastric ulcers in pigs." Thesis, University of Liverpool, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.384377.
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Parisi, Maria Candida Ribeiro. "Estudo comparativo de tres metodos de classificação de ulcera em pe diabetico em população brasileira." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308784.
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Orientador: Denise Engelbrecht Zantut WittmannTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: O objetivo deste estudo foi comparar três sistemas de classificação de úlceras em pé diabético avaliando a capacidade de predição de cicatrização em 6 meses de tratamento e seguimento: o sistema de Wagner, o da Universidade do Texas (UT) e o sistema S(AD)SAD (área-profundidade, sepsis, arteriopatia e denervação). Estudamos e classificamos de acordo com cada sistema 94 portadores de Diabetes Mellitus tipo 2 e úlcera em pés. Analisamos a área da úlcera, profundidade, aspecto, presença de infecção, associação com neuropatia e isquemia nos membros inferiores. Desenvolvemos e avaliamos um novo escore obtido através da soma dos itens do sistema S(AD)SAD. O desfecho primário foi a ocorrência de cicatrização. A média de idade dos pacientes foi 57,6 anos, 48 úlceras (51,1%) cicatrizaram; 11 (12,2%) pacientes evoluíram com amputação menor. Diferenças significativas entre as úlceras que cicatrizaram e que não cicatrizaram foram encontradas em relação à profundidade (p=0,002), presença de infecção (p=0,006) e denervação (p=0,002) quando classificadas através do sistema S(AD)SAD, assim como com o sistema da UT, grau (p=0,002) e estágio (p=0,032), e com os graus do sistema de Wagner (p=0,002). Concluímos que os três sistemas foram bons preditores de cicatrização. Úlceras com S(AD)SAD escore =9 (total possível de 15) apresentaram 7,6 vezes mais chances de cicatrização que escores =10 (65,6% versus 20,0%, p<0,001). O S(AD)SAD escore pode representar uma boa ferramenta na rotina prática. Ao contrário de dados publicados em centros da Europa e Estados Unidos, demonstramos forte associação de ausência de infecção com maiores chances de cicatrização em pé diabético.
Abstract: Objective: The aim was to compare three ulcer classification systems as predictors of the outcome of diabetic foot ulcers: the Wagner, the University of Texas (UT) and the S(AD)SAD system in a specialist clinic in Brazil. Methods: Ulcer area, depth, appearance, infection, and associated ischaemia and neuropathy were recorded in a consecutive series of 94 subjects. A novel score, the S(AD)SAD score, was derived from the sum of individual items of the S(AD)SAD system, and was evaluated. Follow-up was for at least 6 months. The primary outcome measure was the incidence of healing. Results: Mean age was 57.6 years; 57 (60.6%) were male. 48 ulcers (51.1%) healed without surgery; 11 (12.2%) subjects underwent minor amputation. Significant differences in terms of healing were observed for depth (p=0.002), infection (p=0.006) and denervation (p=0.002) using the S(AD)SAD system, for UT Grade (p=0.002) and Stage (p=0.032), and for Wagner grades (p=0.002). Ulcers with a S(AD)SAD score of =9 (total possible 15) were 7.6 times more likely to heal than scores =10 (p<0.001). Conclusions: All three systems predicted ulcer outcome. The S(AD)SAD score of ulcer severity could represent a useful addition to routine clinical practice routine. The association between outcome and ulcer depth confirms earlier reports. The association with infection was stronger than reported from centres in Europe or N America.
Doutorado
Clinica Medica
Doutor em Ciências Médicas
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Bosnardo, Carla Aparecida Faccio. "Análise clinica prospectiva randomizada aberta, para o tratamento das úlceras de venosas, através da terapia celular com o enxerto de queratinócitos autólogos; comparada em dois grupos, associado ou não, a Diosmina Hesperidina micronizada." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313852.
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Orientadores: Ana Terezinha Guillaumon, Maria Beatriz PuzziTese (doutorado) - Universidade Estadual de Campinas. Faculdade de Ciências Médicas
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Resumo: Introdução: A úlcera venosa é uma complicação da insuficiência venosa crônica, atinge indivíduos adultos, afastando-os do trabalho e do convívio social normal. Objetivo: Demonstrar uma nova terapêutica para o tratamento das úlceras venosas através do enxerto de queratinócitos autólogos. Casuística e Método: Foram selecionados, de forma aleatória no ambulatório de Moléstias Vasculares Periféricas da Faculdade de Ciências Médicas da UNICAMP - Vinte e Cinco ( 25) doentes com úlcera de venosa, CEAP 6 , que não obtiveram cicatrização, das mesmas, com tratamentos convencionais; divididos em dois grupos, Grupo I- 11 doentes, 10 mulheres e 1 homem; Grupo II- 14 doentes, 11 mulheres e 3 homens. Ambos os grupos foram submetidos à aplicação do autoenxerto de queratinócitos sobre o leito limpo da úlcera; e ao grupo II, foi também ministrada dose de diosmina hesperidina micronizada a cada 12 horas. A todos os doentes, foi solicitado um repouso de 30 minutos em Trendelemburg para duas horas de atividade habitual. Os queratinócitos foram cultivados no Laboratório de Cultura de Células da Pele, CIPED- FCM - UNICAMP. Resultados: Após a aplicação de testes estatísticos não paramétricos, devido ao tipo da amostra, foi observada cicatrização e/ou melhora das úlceras com redução do leito nos dois grupos, sendo que o Grupo II obteve resultados mais precoces. Conclusão . Esse método mostra ser uma boa opção terapêutica no auxílio à cicatrização das úlceras venosas
Abstract: The venous stasis ulcer is the most severe complication of venous insufficiency, affecting adults and keeping them away from work and from normal social life. Objective: To demonstrate a new therapeutic method for accelerating healing. Methods: Twenty-five (25) patients with venous stasis ulcers, CEAP VI, who have not healed with conventional treatments were selected from the Clinic of Peripheral Vascular Diseases, Faculty of Medical Sciences, UNICAMP - were treated with autograft keratinocytes, grown in the skub cell culture laboratory, CIPED-FCM - UNICAMP. They were divided into two groups, Group I-11 patients, 10 female and male, Group II-14 patients, 11 female and 3 male. Both groups were treated with autograft keratinocytes on the clean ulcer bed, and group II, was also given a dose of micronized diosmin hesperidin every 12 hours. All the patients were asked to take a 30-minute rest in the Trendelenburg position for two hours of usual activity. Results: After the evaluation of data with statistics methods no parametric Healing and/or improvement of the ulcers with significant reduction of the bed in both groups were observed, with Group II obtaining precocious results. Conclusion? This method proves to be a good therapeutic option to help in the healing of stasis ulcers
Doutorado
Cirurgia
Doutor em Cirurgia
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Paz, Bailey Gabriela. "Impact of episodic acyclovir therapy on ulcer duration and HIV shedding from ulcers among men in South Africa." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.479367.
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Bérard, Anick. "Epidemiology of venous ulcers of the lower limbs." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ64513.pdf.
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Baldursson, Baldur. "Development of squamous cell carcinoma in venous ulcers /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4079-7/.
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Ruborg, Rebecca. "The significance of tranexamic acid in bleeding ulcers." Thesis, Örebro universitet, Institutionen för läkarutbildning, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-37003.
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Ahmad, Anwar. "Soluble urokinase plasminogen activator receptor in venous ulcers." Thesis, King's College London (University of London), 2014. https://kclpure.kcl.ac.uk/portal/en/theses/soluble-urokinase-plasminogen-activator-receptor-in-venous-ulcers(74f5dffc-db59-478e-bf87-46b476092e31).html.
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Compression therapy remains the only treatment option for venous ulcers with <100% success. A better understanding of the mechanisms regulating venous ulcer healing might give rise to better treatments. Urokinsae plasminogen activator receptor (uPAR), a GPI anchored 3‐domain protein exists either attached to cell wall or in soluble forms (suPARI‐III, suPARI & suPARII‐III fragments). Cleavage of uPAR results in a number of nonproteolytic functions that may be important in wound healing. Our aim was to determine whether suPAR and its fragments are present in the environment of venous ulcers and whether this receptor has a role in ulcer‐healing. Ulcer exudates and ulcer tissue biopsies were obtained from patients with confirmed venous leg ulcers. Venous ulcers that healed within 6months of compression therapy were classified as healers (H) while those that did not heal in this time were defined as non‐healers (NH). Time resolved fluorescence immunoassays (TR‐FIA) were validated for measurement of suPAR fragments. TR‐FIAs specifically detected their antigens in wound exudates, but not in tissue homogenates. All forms of suPAR fragments were detected within venous ulcer exudates. Levels of all 3 suPAR fragments were significantly higher in exudates obtained from H compared to NH. ELISA analysis of uPA and plasminogen acitvator inhibitor (PAI‐1) antigen revealed that levels were similar in ulcer exudates and tissue homogenates from H and NH. 9 Treatment of scratched keratinocyte cultures with exudates from H resulted in a greater coverage of the scratch compared with NH. Depletion of suPAR from exudates obtained from H resulted in cell death. Results from this study have shown the presence of suPAR fragments within venous ulcers with higher presence of suPAR fragments in H compared to NH. This data suggests a role of suPAR and its fragments in ulcer healing, although the precise mechanisms involved remain to be identified. Measurement of suPAR fragments may provide a prognostic indicator and a therapeutic target for the treatment of venous ulcers.
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Holt, Jim. "Critical Commentary: Test Ulcers with Culture or PCR." Digital Commons @ East Tennessee State University, 2006. https://dc.etsu.edu/etsu-works/6488.
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McGinnis, Elizabeth. "Heel pressure ulcers : a study of wound healing." Thesis, University of Leeds, 2011. http://etheses.whiterose.ac.uk/2802/.
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Background Heels are a common location for pressure ulcers (PUs); they may be physiologically different to other PU sites and their healing is poorly understood. Aim To summarise the effects of support surfaces and identify prognostic factors in healing heel PUs. Objectives 1. Review the effects of support surfaces for heel PU healing 2. Identify factors which independently impact on heel PU healing 3. Describe the characteristics of patients, current management practices and progress of heel PUs Methods Systematic review of the evidence of effectiveness for pressure relieving devices in the treatment of heel PUs. Prospective cohort study of patients with heel PUs ≥ Grade 2 in an acute hospital and followed for 18 months or up till healed. Results Systematic review identified 467 potentially relevant articles, retrieved 70 for screening and included 1in a narrative synthesis. No recommendations for practice could be made. Cohort study recruited 140 people with 183 heel ulcers. 77 (42%) ulcers healed, 88 (48%) did not heal due to death, 5 (3%) were on limbs subsequently amputated, 11 (6%) were unhealed at 18 months, 2 (1%) were lost to follow-up. Cox proportional hazards models identified 12 significant (p≤0.2) variables affecting time to healing in the univariate analysis. Eight entered the multivariate model: 2 reached significance (p≤0.1): severe (cf superficial) ulcers and the presence of (cf the absence) peripheral vascular disease (PVD) reduced the chance of healing. Ulcer area did not change in a uniform manner. Treatments e.g. support surfaces and dressings were inconsistently used. Many patients experienced non-pressure ulcer related infections during the study. Conclusion It is not known if support surfaces aid heel PU healing. The severity of the PU and the presence of PVD are independent prognostic factors for healing. Further work is needed to explore prognostic factors which change over time.
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Upright, Cheryl Ann. "Evaluating patient satisfaction in the care of ulcerating metastatic skin lesions." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28800.
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The purpose of this thesis was two-fold: first, to develop a Patient Satisfaction Questionnaire which reflects patient satisfaction with dressings used in the care of ulcerating metastatic skin lesions; and second, to evaluate patient satisfaction and patient preference with two types of dressings: Mesalt dressings and continuous wet saline dressings.
The Patient Satisfaction Questionnaire was developed to measure patient satisfaction with dressing performance. Patients with ulcerating metastatic skin lesions were asked to identify important characteristics for evaluating patient satisfaction with dressings. These questions were validated and reviewed for clarity by the patients. A visual analogue scale was used as the response scale. Testing for reliability was limited.
Mesalt dressings were compared to continuous wet saline dressings by evaluating patient satisfaction with pre-defined criteria. The criteria for evaluation included ease of application and removal, discomfort during and between dressing changes, control of odor, and patient preference. The study used a cross-over design in which each patient used one dressing for a month and the other dressing for the next month. Although 14 patients were involved in the study, only 10 were statistically analyzed. The remaining four patients were excluded because they were unable to complete a portion of each treatment.
Two major findings were identified. First, regarding the Patient Satisfaction Questionnaire, patients with ulcerating metastatic skin lesions had numerous ideas about what should be asked to evaluate patient satisfaction with dressings. They considered the questionnaire to be an appropriate format and the questions generated by the investigator to be both important and understandable.
Second, the findings of the study indicated that the Mesalt dressings received significantly more positive ratings when compared with continuous wet saline dressings for ease of application and odor control. Mesalt dressings were also significantly preferred to continuous wet saline dressings. The knowledge gained through this study is useful when helping patients decide which dressings to use in the care of ulcerating metastatic skin lesions. The Mesalt dressing appears to be a favorable choice, particularly when ease of application and odor control is important.Applied Science, Faculty of
Nursing, School of
Graduate
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Shin, Vivian Yvonne, and 冼念慈. "A mechanistic study on the adverse effects of cigarette smoke extractson the delay of gastric ulcer healing." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B3122510X.
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Walker, Natalie K. "Epidemiological studies of leg ulcers in Auckland, New Zealand." Thesis, University of Auckland, 2000. http://hdl.handle.net/2292/3351.
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A leg ulcer is generally considered to be any break in the skin on the lower leg (below the knee) or on the foot, which has been present for more than six weeks. Typically the condition is a consequence of disease of the circulatory system, and can cause considerable disability. The Auckland leg ulcer study is a community-based study of leg ulceration conducted in the North Auckland and Central Auckland health districts of New Zealand. The study aimed to determine the prevalence and incidence of leg ulcers in the community and investigate several possible risk factors for the condition. Cases were identified through notifications from health professionals and by self-notification. Cases aged between 40 and 99 years and on the electoral roll for the study region were invited to participate in a case-control study. Controls were individuals without leg ulcers and were selected from the electoral roll using a stratified random sampling process. Controls were also aged between 40 and 99 years and had to be resident within the study region to be eligible. Four hundred and twenty-six cases with current leg ulcers were identified during the 12-month study period, with 241 cases and 224 controls interviewed for the case-control study. Overall, the occurrence of leg ulcers in the general population was low, however, the prevalence and cumulative incidence increased dramatically with age, and changed according to gender and region. The average age at ulcer onset in interviewed cases was 65 years. Leg ulcers took approximately 12 months on average to heal, and recurrence occurred in 59% of cases. Treatment strategies were variable, and almost a quarter of all cases had been admitted to hospital within the last five years because of their ulcers. The average length of hospital stay was 34 days. Results from the case-control study indicated that deep vein thrombosis, lower limb surgery, leg fracture, and varicose veins were strong risk factors for the development of leg ulcers, Furthermore, nulligravida increased the risk of ulcer development while prolonged breast-feeding decreased risk, suggesting a hormonal component to the development of leg ulcers in women. These data have important implications for the prevention of this chronic condition.
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Makic, Mary Beth Flynn. "Evidence-based practice for the prevention of pressure ulcers /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2007.
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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2007.Typescript. Includes bibliographical references (leaves 195-207). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;
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Monteiro, Silvana de Abreu Pinto Soares. "Prevalence and risk factors for gastrics ulcers in swine." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2008. http://hdl.handle.net/10216/22219.
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Woodward, Nakia J. "What is the Best Treatment for Venous Stasis Ulcers." Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/8819.
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Mirchandani, Smruti S. "INVESTIGATING LOW-COST OPTICAL SPECTROSCOPY FOR SENSING PRESSURE ULCERS." Miami University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=miami1501240867911294.
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Monteiro, Silvana de Abreu Pinto Soares. "Prevalence and risk factors for gastrics ulcers in swine." Dissertação, Faculdade de Medicina da Universidade do Porto, 2008. http://hdl.handle.net/10216/22219.
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Amoussouhoui, Arnaud Setondji, Roch Christian Johnson, Ghislain Emmanuel Sopoh, Ines Elvire Agbo, Paulin Aoulou, Jean-Gabin Houezo, Albert Tingbe-Azalou, Micah Boyer, and Mark Nichter. "Steps Toward Creating A Therapeutic Community for Inpatients Suffering from Chronic Ulcers: Lessons from Allada Buruli Ulcer Treatment Hospital in Benin." PUBLIC LIBRARY SCIENCE, 2016. http://hdl.handle.net/10150/621490.
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Background Reducing social distance between hospital staff and patients and establishing clear lines of communication is a major challenge when providing in-patient care for people afflicted by Buruli ulcer (BU) and chronic ulcers. Research on hospitals as therapeutic communities is virtually non-existent in Africa and is currently being called for by medical anthropologists working in the field of health service and policy planning. This paper describes a pioneering attempt to establish a therapeutic community for patients suffering from BU and other chronic ulcers requiring long term hospital care in Benin. Methods A six-month pilot project was undertaken with the objectives of establishing a therapeutic community and evaluating its impact on practitioner and patient relations. The project was designed and implemented by a team of social scientists working in concert with the current and previous director of a hospital serving patients suffering from advanced stage BU and other chronic ulcers. Qualitative research initially investigated patients' understanding of their illness and its treatment, identified questions patients had about their hospitalization, and ascertained their level of social support. Newly designed question-answer health education sessions were developed. Following these hospital wide education sessions, open forums were held each week to provide an opportunity for patients and hospital staff to express concerns and render sources of discontent transparent. Patient group representatives then met with hospital staff to problem solve issues in a non-confrontational manner. Psychosocial support for individual patients was provided in a second intervention which took the form of drop-in counseling sessions with social scientists trained to serve as therapy facilitators and culture brokers. Results Interviews with patients revealed that most patients had very little information about the identity of their illness and the duration of their treatment. This knowledge gap surprised clinic staff members, who assumed someone had provided this information. Individual counseling and weekly education sessions corrected this information gap and reduced patient concerns about their treatment and the status of their healing process. This led to positive changes in staff-patient interactions. There was widespread consensus among both patients and staff that the quality of communication had increased significantly. Open forums providing an opportunity for patients and staff to air grievances were likewise popular and patient representative meetings resulted in productive problem solving supported by the hospital administration. Some systemic problems, however, remained persistent challenges. Patients with ulcers unrelated to BU questioned why BU patients were receiving preferential treatment, given special medicines, and charged less for their care. The idea of subsidized treatment for one disease and not another was hard to justify, especially given that BU is not contagious. Conclusion This pilot project illustrates the basic principles necessary for transforming long term residential hospitals into therapeutic communities. Although the focus of this case study was patients suffering from chronic ulcers, the model presented is relevant for other types of patients with cultural adaptation.
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Suarez-Irizarry, Vivian. "Clinical Practice Guideline for Differentiating Risk Factors for Avoidable and Unavoidable Pressure Ulcers." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5661.
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Pressure ulcers (PUs) present intrinsic risk factors that are not consistently identified by clinical assessments. The objective of this project was to develop a clinical practice guideline (CPG) to provide nurses with guidance in identifying and differentiating how intrinsic and extrinsic risk factors are associated with populations at risk for developing avoidable and unavoidable PUs. CPG development followed a systematic method to search the literature, organize findings, and assess the strength of the resulting evidence and its applicability to the CPG. Quality of the CPG was assessed by a panel of 8 health care professionals using the Appraisal of Guidelines for Research & Evaluation II instrument. Findings of the assessment indicated a high overall quality of the CPG; its immediate use was recommended and systematic evaluation was suggested to promote usage in a wider array of health care contexts. The quality domains with the highest scores were scope, purpose, applicability, editorial independence (all 100%), rigor of development (99.7%), and clarity of presentation (99.3%). The stakeholder involvement domain demonstrated the lowest--yet still robust--score (94.4%). The CPG can be used to emphasize appropriate and specific nursing competencies for making informed decisions when identifying and describing patients at risk for developing PUs. Further research and evaluation of the use of this CPG will be useful to demonstrate how CPGs can help to decrease the incidence of avoidable PUs. The potential for positive social change relative to the prevention of PUs is high. Decreased incidence of preventable PUs will eliminate unnecessary health care costs and improve overall health outcomes of patients at all levels of socioeconomic status.
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Rocasalbas, Lozano Guillermo. "Development of multifunctional biopolymeric materials for teatment of decubitus ulcers." Doctoral thesis, Universitat Politècnica de Catalunya, 2012. http://hdl.handle.net/10803/113599.
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Chronic wounds including pressure, venous, arterial and diabetic neuropathic ulcers, represent a significant burden to the healthcare system. These different chronic wound types do not share origin or cause, however they have common features as bacterial infection and continuing influx of polymorphonuclear neutrophils that release high concentrations of matrix metalloproteases (MMPs), myeloperoxidase (MPO) and reactive oxidative species causing excessive degradation of the extracellular matrix (ECM) and the growth factors. Because of the multifactorial nature of virtually all chronic wounds, the therapeutic wound healing approach should emphasize the necessity to investigate wound dressings that possess the ability to directly and indirectly modulate the biochemical environment based on the pathology of chronic to encourage the healing process.
The overall aim of the present work was to develop biopolymer wound dressings capable to improve the management of chronic wounds. The specific research objective was defined in three main targets: i) to balance the proteolytic activity of MMPs, ii) to balance the MPO activity and the oxidative environment, and iii) antimicrobial protection.
The first part of the thesis aimed to provide suitable materials to perform bioactive biopolymer-based wound dressings. The first step was to provide a versatile functionalization of chitosan platform to improve the sequestering ability over metal dependent enzymes (MMPs) in chronic wounds. In order to impart to chitosan the ability to inhibit MMP, chitosan was functionalized with deferent thiol moieties, which can chelate the zinc cation in the active site of the enzyme, modifying MMP activity. In addition the combination of -NH2 and -SH chemistry allowed grafting of other active agents on the chitosan platform.
The second step was the identification and evaluation of natural active agents as chronic wound healing promoters. Polyphenols from bark, twigs and leaf extracts from the medicinal plant Hamamelis virginiana (Witch hazel) were studied for this porpoise and it was found to have both a strong antioxidant activity and an inhibitory effect on MPO and collagenase.
The second part of the thesis was focused in the performance and evaluation of new materials for wound healing applications. To this aim, chitosan and/or thiolated chitosan were modified with H. virginiana extracts following different approaches.
The first approach was focused to develop a new method for covalent functionalization of thiolated chitosan with polyphenols from H. virginiana extracts. The novelty of this approach consists in the use of thiolysis - a common analytical method for proanthocyanidins characterization - to covalently functionalize natural macromolecules such as chitosan with bioactive phenolic moieties. The phenolics-functionalized chitosan showed improved therapeutic properties in vitro.
The second approach focused on the use of laccase-assisted cross-linking between phenolic moieties of H. virginiana with chitosan and gelatin as a functionalization method to obtain stable and bioactive hydrogel wound dressings. H. virginiana extract was oxidized by laccase in a one-step process under mild reaction conditions to covalently crosslink chitosan and gelatin. The physical and mechanical properties of these hydrogels were investigated using different analytical techniques and their potential for chronic wound treatment was evaluated in vitro in terms of antibacterial and inhibitory effect on MPO and collagenase. The results indicated that the polyphenols exerted a dual role in the hydrogel: i) "passive" being a structural element, and ii) "active" modifying the chronic wound environment by attenuating the deleterious MMPs, MPO and ROS activities, and reducing the bacterial load.
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Friberg, Elin, and Ulrika Sjöholm. "Trycksårsprevention - en litteraturstudie/Prevention of pressure ulcers - a literature review." Thesis, Kristianstad University College, Department of Health Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-4220.
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Background: Pressure ulcers are a common problem and cause great suffering for those who develop it, and are also an expensive cost to the society. Aim: To describe nursing measures for prevention of pressure ulcers among elderly people in ordinary and nursing homes. Method: A literature review by structured analyze of scientific articles. Result: The analyze resulted in six subjects for prevention of pressure ulcers. These subjects were; risk assesment, nutrition, repositioning, skin/hygiene, nurse knowledge and documentation. Conclusion: Repositioning more often did not prevent pressure ulcers better than repositioning less frequent, nursing staff should offer patient´s pads with high absorption for peaceful rest and documentation should be improved.
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Riet, Gerben ter. "Vitamin C and ultrasound in the treatment of pressure ulcers." [Maastricht : Maastricht : Rijksuniversiteit Limburg] ; University Library, Maastricht University [Host], 1994. http://arno.unimaas.nl/show.cgi?fid=6240.
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Ebbeskog, Britt. "Elderly patients with slow-healing leg ulcers : an embodied suffering /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-492-5/.
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Tuinea-Bobe, Cristina L. "A stretchable pressure sensor for early detection of pressure ulcers." Thesis, University of Ulster, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.528378.
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Mani, R. "A non-invasive study of cutaneous perfusion around leg ulcers." Thesis, University of Southampton, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.381262.
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Urrutia, Cynthia Paola Iglesias. "Issues in the evaluation of treatments for venous leg ulcers." Thesis, University of York, 2006. http://etheses.whiterose.ac.uk/9889/.
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Briggs, Michelle. "Painful leg ulcers : the prevalence, characteristics and effective topical treatments." Thesis, University of Leeds, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396588.
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Amien, Feroza. "Management of oral ulcers and oral thrush by Community Pharmacists." Thesis, University of the Western Cape, 2009. http://hdl.handle.net/11394/2834.
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Magister Chirurgiae Dentium - MChDOral ulcers and oral thrush could be indicative of serious illnesses such as oral cancer, HIV and other sexually transmitted infections (STIs), among others. There are many different health care workers that can be approached for advice and/or treatment for oral ulcers and oral thrush (sometimes referred to as mouth sores by patients), including pharmacists. In fact, the mild and intermittent nature of oral ulcers and oral thrush may most likely lead the patient to present to a pharmacist for immediate treatment. In addition, certain aspects of access are exempt at a pharmacy such as long queues and waiting times, the need to make an appointment and the cost for consultation. Thus pharmacies may serve as a reservoir of undetected cases of oral cancer, HIV and other STIs. Aim: To determine how community pharmacists in the Western Cape manage oral ulcers and oral thrush. Objectives: The data set included the prevalence of oral complaints confronted by pharmacists, how they manage oral ulcers, oral thrush and mouth sores, their knowledge about these conditions, and the influence of socio-economic status (SES) and metropolitan location (metro or non-metro) on recognition and management of the lesions. Method: A cross-sectional survey of community pharmacists in the Western Cape was conducted. A random sample of pharmacies was stratified by SES (high and low), and metropolitan location. A structured questionnaire was used to conduct a telephonic interview. The questionnaire was faxed to pharmacists 24 hours prior to the interview. Pharmacists were also telephoned 24 hours prior to the interview, but after the questionnaire was faxed, in order to gain informed consent for participation in the study, and to confirm a convenient time to conduct the interview. Results: Two thirds (63%) of pharmacists managed oral problems nearly everyday, and 30% managed these more than once a week. More pharmacists in high SES (73%) areas managed oral problems nearly everyday (Fisher Exact, p=0.0005). Just over half (56%) and 49.2% of pharmacists said that ulcers and thrush, respectively, was the most common oral problem that they encounter. The prevalence of oral thrush was significantly higher in non-metro areas (58%) (RR=0.7 (0.5-1.0) ChiSquared=4.0, p=0.04), and it was also significantly lower in low SES areas (RR=1.6 (1.1-2.4), Chi Squared=6.5, p=0.01). Half the pharmacists reported that they would manage the patient comprehensively. Most would take a history but the quality of the history is poor, thereby compromising their ability to manage these cases appropriately. Only a third would refer a simple oral ulcer, thrush or mouth sore to a doctor/dentist but all pharmacists would have referred a longstanding ulcer to a doctor/dentist. In terms of knowledge, only 33% of pharmacists were aware that oral ulcers and thrush could be indicative of HIV infection, and only 8% linked oral ulcers with oral cancer. There was no discernable pattern of management of oral ulcers and thrush, or of knowledge of the link between these lesions with underlying diseases, by SES and metropolitan locations (Chi Squared, Fisher Exact, p>0.05). Conclusion: The result of this study strengthens the current view of pharmacists as oral health advisors as they encounter oral problems regularly, most commonly oral ulcers and oral thrush. Therefore, the pharmacist can play an important role in the early detection of HIV and oral cancer. However many pharmacists fail to refer these cases to a dentist. Most pharmacists lacked specific knowledge about the relationship of oral ulcers and thrush with underlying conditions, which may explain why many pharmacists are not managing these cases correctly. There is a definite need to train pharmacists at both an under- and post-graduate level with specific emphasis on the proper management of oral ulcers, oral thrush and mouth sores, as well as comprehensive training that outlines why vigilant management of oral ulcers and oral thrush is necessary.
South Africa
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Ellis, Anna K., and L. Lee Glenn. "Challenges in Staging of Transient Pressure Ulcers Following Urologic Surgery." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7514.
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Plassmann, Peter. "Measuring area and volume of leg ulcers by structured light." Thesis, University of South Wales, 1992. https://pure.southwales.ac.uk/en/studentthesis/measuring-area-and-volume-of-leg-ulcers-by-structured-light(a5e9878a-c8d6-4933-b4d8-e6f3e7e480ce).html.
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Ulcers of the human skin are difficult to cure and a massive burden to patients. Their treatment costs in the UK are in excess of £ 100 million annually (1989). Both suffering and costs can be reduced significantly by establishing if an ulcer is responding to treatment. Any measurement device must not make any contact with the patient in order to avoid pain, damage or infection of the wound. This work describes a novel non invasive measurement method for superficial skin ulcers. Measurement is carried out using a new version of colour coded structured light method to obtain three dimensional surface data. A set of parallel stripes of light is projected onto the ulcerated skin and observed by a camera. The stripes are displaced by an amount which is related to the shape of the skin. It is shown how stripe parameters such as colour, distance, width and coding may be optimised with respect to the object of interest to maximise the performance of the method. Two newly developed stripe extraction algorithms ensure that the centre positions of the projected stripes are found with a precision better than 0.1 mm. From the position of the stripes on the skin a computer then calculates a representation of its shape by triangulation. This is stored in a three dimensional surface map. The volume of a skin ulcer is the difference between the measured base of the lesion and the original healthy skin. The work demonstrates that the original shape may be simulated by a specialised spline interpolation method which is based on the surroundings of the ulcer. The technique is implemented in a portable instrument which is capable of measuring the area and volume of a wide range of different ulcers and pressure sores with a standard deviation of less than 5% of the total figure. With the current equipment the measurement is made in half a second and its result is available after less than 5 minutes. The technique works well in subdued ambient lighting and on most ulcers. In cases where the ulcer is wet, specular reflection may cause problems but the system is usually able to correct for them. The instrument is suitable for a large variety of ulcers but is not able to measure wounds which undermine the skin, extend outside the normal field of view or are highly flexible.
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Hinkel, Brandon Jerome. "Microcapsule Containing Lactic Acid Bacteria for Treatment of Peptic Ulcers." DigitalCommons@CalPoly, 2013. https://digitalcommons.calpoly.edu/theses/967.
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Probiotics are marketed throughout the world to promote the health of the consumer by improving the microorganisms that normally occur in the intestinal tract (Tannock, 1997). It has also been suggested that probiotics can prevent pathogen infections by adhering to the intestinal mucosa (Lee, Lim, Teng, Ouwehand, Tuomola, & Salminen, 2000). While probiotics can be delivered to the infected areas in multiple fashions, microencapsulation is a newer form of delivering probiotics straight to the infected area. A whey protein microcapsule is thought to protect the probiotics from stomach acid and delivers the treatment to the affected area. To ensure this microencapsulation treatment is affective, the microcapsules will be stained and imaged to see if the microcapsules are constructed in a way which is consistent with the theory: a whey protein microcapsule surrounding bacteria and fat droplets. Through these experiments, it was shown that the microcapsule was not constructed as previously thought. Instead of a thin layer of protein surrounding the bacteria, it more closely resembled a solid ball of protein with bacteria and fat trapped inside. The bacteria are able to survive stomach like conditions (0.1M HCl for 8 hours) due to other forms of microencapsulation.
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Finlayson, Kathleen Joy. "Identification of factors contributing to recurrence of venous leg ulcers." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/39531/1/Kathleen_Finlayson_Thesis.pdf.
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Background and Significance Venous leg ulcers are a significant cause of chronic ill-health for 1–3% of those aged over 60 years, increasing in incidence with age. The condition is difficult and costly to heal, consuming 1–2.5% of total health budgets in developed countries and up to 50% of community nursing time. Unfortunately after healing, there is a recurrence rate of 60 to 70%, frequently within the first 12 months after heaing. Although some risk factors associated with higher recurrence rates have been identified (e.g. prolonged ulcer duration, deep vein thrombosis), in general there is limited evidence on treatments to effectively prevent recurrence. Patients are generally advised to undertake activities which aim to improve the impaired venous return (e.g. compression therapy, leg elevation, exercise). However, only compression therapy has some evidence to support its effectiveness in prevention and problems with adherence to this strategy are well documented. Aim The aim of this research was to identify factors associated with recurrence by determining relationships between recurrence and demographic factors, health, physical activity, psychosocial factors and self-care activities to prevent recurrence. Methods Two studies were undertaken: a retrospective study of participants diagnosed with a venous leg ulcer which healed 12 to 36 months prior to the study (n=122); and a prospective longitudinal study of participants recruited as their ulcer healed and data collected for 12 months following healing (n=80). Data were collected from medical records on demographics, medical history and ulcer history and treatments; and from self-report questionnaires on physical activity, nutrition, psychosocial measures, ulcer history, compression and other self-care activities. Follow-up data for the prospective study were collected every three months for 12 months after healing. For the retrospective study, a logistic regression model determined the independent influences of variables on recurrence. For the prospective study, median time to recurrence was calculated using the Kaplan-Meier method and a Cox proportional-hazards regression model was used to adjust for potential confounders and determine effects of preventive strategies and psychosocial factors on recurrence. Results In total, 68% of participants in the retrospective study and 44% of participants in the prospective study suffered a recurrence. After mutual adjustment for all variables in multivariable regression models, leg elevation, compression therapy, self efficacy and physical activity were found to be consistently related to recurrence in both studies. In the retrospective study, leg elevation, wearing Class 2 or 3 compression hosiery, the level of physical activity, cardiac disease and self efficacy scores remained significantly associated (p<0.05) with recurrence. The model was significant (p <0.001); with a R2 equivalent of 0.62. Examination of relationships between psychosocial factors and adherence to wearing compression hosiery found wearing compression hosiery was significantly positively associated with participants’ knowledge of the cause of their condition (p=0.002), higher self-efficacy scores (p=0.026) and lower depression scores (p=0.009). Analysis of data from the prospective study found there were 35 recurrences (44%) in the 12 months following healing and median time to recurrence was 27 weeks. After adjustment for potential confounders, a Cox proportional hazards regression model found that at least an hour/day of leg elevation, six or more days/week in Class 2 (20–25mmHg) or 3 (30–40mmHg) compression hosiery, higher social support scale scores and higher General Self-Efficacy scores remained significantly associated (p<0.05) with a lower risk of recurrence, while male gender and a history of DVT remained significant risk factors for recurrence. Overall the model was significant (p <0.001); with an R2 equivalent 0.72. Conclusions The high rates of recurrence found in the studies highlight the urgent need for further information in this area to support development of effective strategies for prevention. Overall, results indicate leg elevation, physical activity, compression hosiery and strategies to improve self-efficacy are likely to prevent recurrence. In addition, optimal management of depression and strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy. This research provides important information for development of strategies to prevent recurrence of venous leg ulcers, with the potential to improve health and decrease health care costs in this population.
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Gonçalves, Marcia Beatriz Berzoti. "Impacto do ensino a distância no conhecimento dos docentes de enfermagem para avaliação de feridas crônicas." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-20052014-202245/.
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O conhecimento embasado nas melhores evidências científicas para a assistência de enfermagem às pessoas com feridas crônicas (FC) deve alicerçar o ensino da temática na formação do enfermeiro. Diante da relevância epidemiológica do problema, o docente de enfermagem se depara com o desafio de ensinar aos estudantes, o cuidado às pessoas com essa complicação, nos diversos contextos de atenção à saúde. A etapa da avaliação da FC é fundamental para identificar e descrever o processo de cicatrização e a seleção da terapia tópica, que o favoreça. A educação à distância (EAD) tem demonstrado ser uma estratégia efetiva para atualização do conhecimento. Diante disto, o objetivo deste estudo foi identificar o impacto da EAD, no conhecimento de docentes de enfermagem e enfermeiros vinculados ao ensino superior, acerca da avaliação de FC. Tratou-se de um estudo prospectivo, quase-experimental, com coleta de dados antes e após a intervenção. Após aprovação pelo Comitê de Ética em Pesquisa, foram convidados a participar da pesquisa, docentes e enfermeiros vinculados ao ensino, de instituições de ensino superior (IES) públicas e privadas, que ministrassem disciplinas teóricas e/ ou práticas, nos cursos de graduação em Enfermagem, de um município do interior do Estado de São Paulo. A amostra foi composta por 26 docentes e enfermeiros vinculados ao ensino, que participaram do curso de atualização \"Avaliação de Feridas Crônicas na Assistência de Enfermagem\" oferecido através do Ambiente Virtual de Aprendizagem (AVA) Moodle. Entre os participantes, a média de idade de 42,3 anos (DP 9,56), e todos eram do sexo feminino. O tempo médio de experiência no ensino foi de 11,16 anos (DP 8,02), 24 (92,3%) docentes afirmaram lecionar disciplinas teóricas e/ ou práticas, dos quais, 91,7% referiram atuar no cuidado de pessoas com FC, nos cenários de prática. A ferramenta mais utilizada para a busca de informações sobre \"feridas crônicas\" pela maioria dos participantes foi a internet. O aumento na porcentagem de acertos após a intervenção foi estatisticamente significante e o domínio que obteve maior número de acertos no pré e pós-teste foi \"Dimensionamento da ferida\", com melhor desempenho ao final do curso. A correlação entre o tempo de experiência na docência e o desempenho no teste de conhecimento foi negativa, e a associação entre a utilização de outras estratégias para busca de informações, tais como troca de experiência entre os pares, participação em eventos científicos acerca do tema, melhorou o desempenho dos participantes. A utilização da EAD, como ferramenta para a intervenção educativa, visando a divulgação de recomendações para a avaliação de feridas crônicas, impactou positivamente na aquisição de conhecimentos dos participantes. A adoção de tecnologias para o aprimoramento dos docentes de enfermagem trouxe implicações que podem favorecer o ensino e gerar mudanças na prática clínica de enfermagemThe knowledge based on the best scientific evidence of care to people with chronic wounds (CW) should be the basis of this theme teaching in nursing education. Considering the epidemiological relevance of this problem, nursing faculty are faced with the challenge of teaching students how to look after people with this complication in different contexts of health care. The assessment of CW is critical to identify and describe the healing process and the selection of the best topical therapy. The effectiveness of E-learning (EL) strategy to update knowledge has been demonstrated in other studies. Therefore, the aim of this study was to identify the impact of e-learning on CW assessment knowledge of teachers and nurses involved with higher education. A prospective and quasi-experimental study was conducted with data collection before and after the intervention. After the board of ethics approval, teachers and nurses were invited to participate in the research. These teachers and nurses involved in higher education institutions, both public and private, teach theoretical subjects and or practices in nursing undergraduate courses in the municipality in the state of Sao Paulo. The sample consisted of 26 teachers and nurses who attended the update course \"Assessment of Chronic Wounds in Nursing Care\" offered through the Virtual Learning Environment (VLE) Moodle. Among participants, we identified an average age of 42.3 years (SD=9.56), and regarding gender, all subjects were female. The average teaching experience was 11.16 years (SD=8.02), 24 (92.3%) teachers reported teaching theoretical subjects and/or practices, of which 91.7% reported working with CW care in practice scenarios. The most widely used tool to search for information about \"chronic wounds\" was the internet. The increase in the percentage of correct answers after the intervention was statistically significant and the item with highest number of correct answers in both pre and posttests was \"Dimensioning the wound\", with better performance at the end of the course. The correlation between times of teaching experience and performance on the knowledge test was negative, and the association between the use of other strategies to knowledge update (such as exchange of experience among peers, participation in scientific events on the theme) was found to improved performance of the participants. The use of EL as a tool for educational intervention focused on disseminating recommendations for CW assessment positively impacted the acquisition of knowledge among participants. Adopting technologies for the improvement of nursing faculty\'s abilities had outcomes that may support education and generate changes in the clinical nursing practice
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Mourad, Mohamad Mazen. "Prognostic indicators in the gravitational syndrome." Thesis, Cardiff University, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.317158.
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Leonard, Andrea Jane. "Studies on gastric mucosal defence against pepsins." Thesis, University of Newcastle Upon Tyne, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.346421.
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Mackay, William Gordon. "Environmental reservoirs of Helicobacter pylori : an investigation into drinking water biofilms." Thesis, Robert Gordon University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301380.
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Tollow, Philippa. "Quality of life and experiences of treatment in chronic leg ulcers." Thesis, University of Surrey, 2016. http://epubs.surrey.ac.uk/812348/.
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Leg ulcers are a chronic wound of the lower leg, prone to high levels of recurrence and associated with poor quality of life (QOL). Whilst a substantial body of literature has investigated the comparative efficacy of various treatments, little research has explored patient’s qualitative experiences of these treatments or their impact on psychological outcomes. This thesis aimed to address this gap in the literature through a systematic review and four empirical studies. Firstly, a systematic review found evidence for a relationship between wound status and QOL in leg ulceration, and revealed that surgical management may be associated with greater improvements in QOL than compression therapy alone. Next, study 1 used a cross-sectional design (n = 159) to explore predictors and mediators of quality of life in individuals with leg ulcers and reinforced this relationship between clinical severity and quality of life, suggesting that negative mood may mediate the relationship between these two elements. Study 2 then employed a longitudinal design (n = 6) to investigate the QOL of individuals undergoing minimally invasive surgical management, observing a significant improvement in emotional elements of disease specific QOL at 6-months post-surgery, but no significant improvements in other aspects of QOL. Study 3 used a qualitative design (n = 11) to explore the experiences of individuals undergoing minimally-invasive surgery,. The results highlighted the importance of finding a sense of hope and empowerment not associated with other treatment approaches, and the importance of beliefs surrounding chronicity. Finally, Study 4 also used a qualitative design (n = 21) to explore patients experiences of non-surgical treatment, finding overwhelming feelings of powerlessness and frustration, whilst stressing the redemptive power of good relationships. Overall, the findings of these studies suggest that patient’s experiences of treatment for leg ulcers can be conceptualised in terms of three key themes: ‘notions of chronicity’, ‘impact of relationships’, and ‘hope and agency’. Transcending these themes is the proposal that leg ulcers and their treatment, whether surgical or not, exist in a dynamic system and that that their treatment should therefore be approached holistically.