RESUMO
Keloid scarring represents a pathological healing where primary healing phenomenon is deviated from normal. Pico is a single use negative pressure wound therapy system originally introduced to manage open or just closed wounds. Pico dressing is made of silicone, and distributes an 80 mmHg negative pressure across wound bed. Combination of silicon layer and continuous compression could be a valid method to manage keloid scarring. Since November 2011, three patients were enrolled and evaluated before negative pressure treatment, at end of treatment (1 month) and 2 months later, through Vancouver Scar Scale (VSS), Visual Analog Scale (VAS) and a scoring system for itching. Ultrasound (US) and colour-power-doppler (CPD) examination was performed to evaluate thickness and vascularisation of the scar. One patient was discharged from study after 1 week. In last two patients, VSS, VAS and itching significantly improved after 1 month therapy and the results were stable after 2 months without any therapy. At end of therapy, the 'appearance of palisade vessels' disappeared in both cases at CPD exam; US showed a thickness reduction (average 43·8%). We propose a well-tolerated, non invasive treatment to manage keloid scarring. Prospective studies are necessary to investigate whether these preliminary observations are confirmed.
Assuntos
Bandagens Compressivas , Queloide/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Ultrassonografia Doppler em Cores/métodos , Cicatrização , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Queloide/diagnóstico por imagem , Masculino , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
We report the case of a 72-year-old woman referred for evaluation of a chest and back pain in whom we documented the dramatic progression from intramural hematoma to dissection of the ascending aorta with cardiac tamponade.
Assuntos
Aneurisma Aórtico/diagnóstico por imagem , Dissecção Aórtica/diagnóstico por imagem , Ecocardiografia Transesofagiana , Derrame Pericárdico/diagnóstico por imagem , Idoso , Aorta , Evolução Fatal , Feminino , Humanos , Derrame Pericárdico/terapiaAssuntos
Circulação Coronária/fisiologia , Vasos Coronários/fisiopatologia , Transplante de Coração/fisiologia , Função Ventricular Esquerda/fisiologia , Idoso , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/etiologia , Doença da Artéria Coronariana/fisiopatologia , Vasos Coronários/diagnóstico por imagem , Ecocardiografia , Feminino , Transplante de Coração/efeitos adversos , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Microcirculação/fisiologia , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional/fisiologiaRESUMO
The challenges of caring for abdominal ostomy disorders have grown over the years. Because the literature shows no evidence of a tool to classify peristomal skin disorders, a study group comprised of seven enterostomal therapy nurses and four surgeons sought to provide an objective, reproducible, standardized classification instrument. A prospective, observational study was conducted among eight ostomy centers across Italy. The 339 patient participants (272 men, 67 women, average age 63 [25 to 85] years) were divided into two groups according to onset of complications (less than or greater than 1 year); 800 digital photographs were taken to enhance observation and blood samples were drawn for additional data. From the data obtained, a classification scheme was created and subsequently tested using four non-study group experts. The resulting instrument facilitated lesion interpretation and detection, including topography. Thus far, this is the first validated classification attempt not based on assessments of lesions attributable to entirely different etiopathogenetic factors. Further research to refine the tool and to correlate the additional data obtained from blood samples with the classification system is underway.