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Decubitus Ulcers [keywords]
- Multicenter comparison of the efficacy on prevention of pressure ulcer in postoperative patients between two types of pressure-relieving mattresses in China. [Journal Article]
- Int J Clin Exp Med 2014; 7(9):2820-7.
Present study is designed to evaluate the effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses.1074 surgical patients from 12 hospitals in China were divided into A group (static air mattress with repositioning every 2 hours, n = 562) and B group (power pressure air mattress with repositioning every 2 hours, n = 512). The patient was subjected to a pressure-relieving mattress and observed from 0-5 days after surgery. Indications include the Braden scores, hospital-acquired pressure ulcers (HAPU) incidence and stage.The Braden scores between two groups in five days after surgery were no significant (P > 0.05). The incidence of HAPU between two groups in same days also was no significant (1.07% vs. 0.98%, P > 0.05). The incidence of Stage I and stage II pressure ulcers in group A and B were 1.07% (6/562) and 0.98% (5/512), respectively (χ(2) = 0.148, P = 0.882).The effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses are similar, but the protocol by static air mattress with repositioning every 2 hours is benefit when no power.
- Aloe vera for treating acute and chronic wounds. [Journal Article]
- Sao Paulo Med J 2014 Dec; 132(6):382.
Aloe vera is a cactus-like perennial succulent belonging to the Liliaceae Family that is commonly grown in tropical climates. Animal studies have suggested that Aloe vera may help accelerate the wound healing process.To determine the effects of Aloe vera-derived products (for example dressings and topical gels) on the healing of acute wounds (for example lacerations, surgical incisions and burns) and chronic wounds (for example infected wounds, arterial and venous ulcers).We searched the Cochrane Wounds Group Specialised Register (9 September 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3), Ovid MEDLINE (2005 to August Week 5 2011), Ovid MEDLINE (In-Process & Other Non-Indexed Citations 8 September 2011), Ovid EMBASE (2007 to 2010 Week 35), Ovid AMED (1985 to September 2011) and EBSCO CINAHL (1982 to 9 September 2011). We did not apply date or language restrictions.We included all randomised controlled trials that evaluated the effectiveness of Aloe vera, aloe-derived products and a combination of Aloe vera and other dressings as a treatment for acute or chronic wounds. There was no restriction in terms of source, date of publication or language. An objective measure of wound healing (either proportion of completely healed wounds or time to complete healing) was the primary endpoint.Two review authors independently carried out trial selection, data extraction and risk of bias assessment, checked by a third review author.Seven trials were eligible for inclusion, comprising a total of 347 participants. Five trials in people with acute wounds evaluated the effects of Aloe vera on burns, haemorrhoidectomy patients and skin biopsies. Aloe vera mucilage did not increase burn healing compared with silver sulfadiazine (risk ratio (RR) 1.41, 95% conﬁdence interval (CI) 0.70 to 2.85). A reduction in healing time with Aloe vera was noted after haemorrhoidectomy (RR 16.33 days, 95% CI 3.46 to 77.15) and there was no difference in the proportion of patients completely healed at follow up after skin biopsies. In people with chronic wounds, one trial found no statistically signiﬁcant difference in pressure ulcer healing with Aloe vera (RR 0.10, 95% CI -1.59 to 1.79) and in a trial of surgical wounds healing by secondary intention Aloe vera signiﬁcantly delayed healing (mean difference 30 days, 95% CI 7.59 to 52.41). Clinical heterogeneity precluded meta-analysis. The poor quality of the included trials indicates that the trial results must be viewed with extreme caution as they have a high risk of bias.There is currently an absence of high quality clinical trial evidence to support the use of Aloe vera topical agents or Aloe vera dressings as treatments for acute and chronic wounds.
- Building a Framework for Implementing New Interventions. [JOURNAL ARTICLE]
- OTJR (Thorofare N J) 2014 Oct 1; 34(4):209-220.
Implementation into real-world practice of interventions previously studied in randomized controlled trials is an ongoing challenge. In this article, we describe the methodology we used for the first phase of a project for the implementation and outcomes assessment of an occupational therapy pressure ulcer prevention intervention for people with spinal cord injury in the Veterans Health Administration. This first phase of the project was guided by practice-based evidence research methodology and resulted in an intervention manual tailored to meet the needs of Veterans and the establishment of a system for documenting and monitoring care processes, patient characteristics, and intervention outcomes. This system, in turn, will provide the data-gathering template for the next phase in which the beneficial effects of the intervention will be assessed. We conclude by recommending that clinicians explore the utility of this approach for the implementation of other novel interventions. [OTJR: Occupation, Participation and Health. 2014; 34(4):209-220.].
- Ethical issues and accountability in pressure ulcer prevention. [Journal Article]
- Nurs Stand 2014 Oct 22; 29(8):56-63.
Pressure ulcers represent a considerable cost, both in terms of healthcare spending and quality of life. They are increasingly viewed in terms of patient harm. For clinicians involved in pressure ulcer prevention, ethical issues surrounding accountability may arise from both policy and practice perspectives. It may be useful for clinicians to refer to ethical theories and principles to create frameworks when addressing ethical dilemmas. However, such theories and principles have been criticised for their simplicity and over-generalisation. Alternative theories, for example, virtue ethics and experiential learning, can provide more comprehensive guidance and promote a pluralistic approach to tackling ethical dilemmas.
- Development of intelligent model for personalized guidance on wheelchair tilt and recline usage for people with spinal cord injury: Methodology and preliminary report. [Journal Article]
- J Rehabil Res Dev 2014; 51(5):775-88.
Wheelchair tilt and recline functions are two of the most desirable features for relieving seating pressure to decrease the risk of pressure ulcers. The effective guidance on wheelchair tilt and recline usage is therefore critical to pressure ulcer prevention. The aim of this study was to demonstrate the feasibility of using machine learning techniques to construct an intelligent model to provide personalized guidance to individuals with spinal cord injury (SCI). The motivation stems from the clinical evidence that the requirements of individuals vary greatly and that no universal guidance on tilt and recline usage could possibly satisfy all individuals with SCI. We explored all aspects involved in constructing the intelligent model and proposed approaches tailored to suit the characteristics of this preliminary study, such as the way of modeling research participants, using machine learning techniques to construct the intelligent model, and evaluating the performance of the intelligent model. We further improved the intelligent model's prediction accuracy by developing a two-phase feature selection algorithm to identify important attributes. Experimental results demonstrated that our approaches held the promise: they could effectively construct the intelligent model, evaluate its performance, and refine the participant model so that the intelligent model's prediction accuracy was significantly improved.
- Nurse Assistant Communication Strategies About Pressure Ulcers in Nursing Homes. [JOURNAL ARTICLE]
- West J Nurs Res 2014 Oct 20.
There is growing recognition of benefits of sophisticated information technology (IT) in nursing homes (NHs). In this research, we explore strategies nursing assistants (NAs) use to communicate pressure ulcer prevention practices in NHs with variable IT sophistication measures. Primary qualitative data were collected during focus groups with NAs in 16 NHs located across Missouri. NAs (n = 213) participated in 31 focus groups. Three major themes referencing communication strategies for pressure ulcer prevention were identified, including Passing on Information, Keeping Track of Needs and Information Access. NAs use a variety of strategies to prioritize care, and strategies are different based on IT sophistication level. NA work is an important part of patient care. However, little information about their work is included in communication, leaving patient records incomplete. NAs' communication is becoming increasingly important in the care of the millions of chronically ill elders in NHs.
- [Current decubitus prevention and treatment algorhytm]. [English Abstract, Journal Article]
- Acta Med Croatica 2014 Oct.:109-16.
Decubitus ulcer treatment options, as well as the etiology, classification and prevention guidelines are presented. The importance of a multidisciplinary approach along with prevention and education is emphasized. The National Pressure Ulcer Advisory Panel guidelines ensure contemporary decubitus ulcer treatment all over the world, while adoption of the basic algorithm is a precondition of good medical practice and nursing care. Upgrading the patient quality of life and complete healing of decubitus ulcer is definitely achievable by strict application of these recommendations.
- An innovative solid oral nutritional supplement to fight weight loss and anorexia: opened, randomised controlled trial of efficacy in institutionalised, malnourished older adults. [JOURNAL ARTICLE]
- Age Ageing 2014 Oct 16.
to evaluate the impact of a solid nutritional supplement on the weight gain of institutionalised older adults >70 years with protein-energy malnutrition. The innovation of these high-protein and high-energy cookies was the texture adapted to edentulous patients (Protibis(®), Solidages, France).an open, multicentre, randomised controlled trial.seven nursing homes.one hundred and seventy-five malnourished older adults, aged 86 ± 8 years.all participants received the standard institutional diet. In addition, Intervention group participants received eight cookies daily (11.5 g protein; 244 kcal) for 6 weeks (w0-w6).five visits (w-4, w0, w6, w10 and w18). Main outcome: percentage of weight gain from w0 to w6 (body mass in kg). Secondary outcomes: appetite, rated using a numerical scale (0: no appetite to 10: extremely good appetite); current episodes of pressure ulcers and diarrhea.average weight increased in Intervention group (n = 88) compared with Control group (n = 87) without cookies supplementation (+1.6 versus -0.7%, P = 0.038). Weight gain persisted 1 month (+3.0 versus -0.2%, P = 0.025) and 3 months after the end of cookies consumption (+3.9 versus -0.9%, P = 0.003), with diarrhea reduction (P = 0.027). There was a synergistic effect with liquid/creamy dietary supplements. Subgroup analysis confirmed the positive impact of cookies supplementation alone on weight increase (P = 0.024), appetite increase (P = 0.009) and pressure ulcers reduction (P = 0.031).the trial suggested that, to fight against anorexia, the stimulation of touch (finger food; chewing, even on edentulous gums) and hearing (intra-oral sounds) could be valuable alternatives to sight, smell and taste alterations.
- [Orthopaedic footwear against foot ulcers in diabetes]. [English Abstract, Journal Article]
- Ned Tijdschr Geneeskd 2014; 158(0):A7497.
- In people with diabetes mellitus, foot ulcers are a major problem because they increase the risk of a foot infection and amputation and reduce quality of life.- After a foot ulcer has healed, the risk of recurrence is high. - Orthopaedic shoes and orthotics are often prescribed to high risk patients and aim to reduce the mechanical pressure on the plantar surface of the foot. - Orthopaedic footwear that is modified to reduce pressure is not much more effective in preventing foot ulcer recurrence than orthopaedic footwear that did not undergo such modification, unless the shoes are worn as recommended. In that case, the risk of ulcer recurrence is reduced by 46%. - In patients with a history of ulceration, compliance in wearing orthopaedic shoes at home is low, while these patients walk more inside the house than outside the house.- Foot pressure measurements should be part of the prescription and evaluation of orthopaedic footwear for patients at high risk for foot ulceration.
- Epidemiological and genome-wide association study of gastritis or gastric ulcer in korean populations. [Journal Article]
- Genomics Inform 2014 Sep; 12(3):127-33.
Gastritis is a major disease that has the potential to grow as gastric cancer. Gastric cancer is a very common cancer, and it is related to a very high mortality rate in Korea. This disease is known to have various reasons, including infection with Helicobacter pylori, dietary habits, tobacco, and alcohol. The incidence rate of gastritis has reported to differ between age, population, and gender. However, unlike other factors, there has been no analysis based on gender. So, we examined the high risk factors of gastritis in each gender in the Korean population by focusing on sex. We performed an analysis of 120 clinical characteristics and genome-wide association studies (GWAS) using 349,184 single-nucleotide polymorphisms from the results of Anseong and Ansan cohort study in the Korea Association Resource (KARE) project. As the result, we could not prove a strong relation with these factors and gastritis or gastric ulcer in the GWAS. However, we confirmed several already-known risk factors and also found some differences of clinical characteristics in each gender using logistic regression. As a result of the logistic regression, a relation with hyperlipidemia, coronary artery disease, myocardial infarction, hyperlipidemia therapy, hypotensive or antihypotensive drug, diastolic blood pressure, and gastritis was seen in males; the results of this study suggest that vascular disease has a potential association with gastritis in males.