Black salve: risky escharotic.

Introduction: Black salve ointments are variable in their composition with no standard formula. Patient's may turn to unregulated products to self-treat their conditions. Products that are accessible without a prescription are not necessarily safe and may pose risk to those who use them, as in this case with the use of black salve ointment. Methods: This case report discusses the use of black salve ointment on a nodular neck cyst in a 55-year-old Hispanic male patient. The patient applied the black salve ointment (Two Feathers Healing Ointment®) to the cyst, where the ointment remained in contact with his skin for seven days. He required oral antibiotics and was referred to wound care for follow up. Discussion: After close follow up and treatment with antibiotics, the eschar healed and left a concave scar on his neck with no other observed complications. Conclusion: Healthcare providers are encouraged to discuss complementary and alternative medicine options with patients as some may lead to dangerous effects. Lay Summary: This is a case report about a 55 year old male patient who used an over the counter product called Black Salve to treat a cyst on his neck. He came to his primary care doctor's office for a usual checkup. Just before leaving his appointment, he mentioned a dark discolored area on his neck appeared after applying the black salve ointment. The black salve caused his skin to break down, get infected, and turn black. He was treated with antibiotics and close follow up care. After the wound healed, he was left with a scar on his neck from where the ointment broke down the skin. Since this product is available without a prescription, it is important that consumers know that it is not safe for use and may cause complications. If in doubt, ask a healthcare provider about a products risks before use.

Redes comunitarias de cuidadores: acompañamiento a la movilización ciudadana para el cuidado compasivo / Community networks: facilitating the community empowerment towards compassionate care

RESUMEN Objetivo Presentar un proceso de aproximación y movilización de la comunidad para la creación de una red barrial de cuidadores en Medellín, Colombia. Métodos La sistematización de la promoción de la red barrial de cuidadores se realizó siguiendo las fases de acompañamiento según la clínica comunitaria: aproximación a la comunidad, generación de formas terapéuticas clínico-comunitarias y comprensión del proceso desde esta perspectiva. Se empleó la rehabilitación basada en la comunidad como método de trabajo. Resultados La necesidad de formación para el cuidado y la organización familiar son los mayores retos de los cuidadores de la comunidad. Los participantes tienen presente la importancia de crear redes de apoyo y han adquirido conocimientos prácticos que les son útiles en la cotidianidad y que sientan las bases para la futura construcción de red. Conclusiones La experiencia de construcción de una red barrial genera reflexiones e interrogantes alrededor de las metodologías utilizadas y de las necesidades comunitarias reales alrededor del cuidado. A pesar de las dificultades en relación con la acción colectiva, la cohesión grupal y la asistencia a los encuentros, el acompañamiento que se realizó ha dejado reflexiones para los cuidadores y conocimientos prácticos en torno al cuidado.

ABSTRACT Objective To present the process of contact and mobilization of a community, seeking to facilitate the development of a caregiving network in Medellín, Colombia. Method The systematization process of the caregiving network's promotion was conducted according to the phases of clinical community involvement: contact with the community, clinical-community therapeutic modalities and analysis of the process. The method emplo-yed was community-based rehabilitation. Results Training needs and family organization towards caregiving are the caregivers' major challenges are. The participants are aware of the relevance of creating support networks and have acquired practical knowledge useful to fulfill their daily needs, which are the foundations for future network development. Conclusions The experience of promoting the development of a community network brings insights and concerns regarding the methods used and the actual caregiving needs of the community. Despite the difficulties encountered with collective actions, group cohesion and assistance to community gatherings, caregivers were able to reflect upon and learn about caregiving networks.

Deep Brain Stimulation Surgery for Status Dystonicus: A Single-Center Experience and Literature Review.

BACKGROUND: Status dystonicus (SD) is a life-threatening complication in which episodes of dystonic movements become increasingly frequent and severe, requiring urgent hospital admission, and can lead to respiratory, metabolic, and bulbar complications. Pharmacologic treatment has been the mainstay management for this complication; however, many refractory patients will still require further treatment. Deep brain stimulation (DBS) is an established therapeutic strategy that has been used for dystonia, and now it has been proposed to be used for SD. METHODS: In this case series, we describe our experience with early DBS placement in 5 patients with SD to control symptoms that are refractory to pharmacologic therapy. In addition, we present a literature review of this therapy in the treatment of SD. RESULTS: Before discharge, symptomatic relief (decrease of dystonic movements and resolution of abnormal postures) was evidenced in all patients with a median of 3 days (interquartile range, 1-7) after surgery was performed. A follow-up Unified Dystonia Rating Scale score and Burke-Fahn-Marsden rating scale motor subscale score, at 6 months after hospital discharge with values being inferior to 20 and 30, respectively, for all cases. None of the patients had a recurrence of SD in the last follow-up period. CONCLUSIONS: DBS surgery is a suitable, versatile, reversible and adequate therapy in the treatment of SD that is refractory to initial pharmacologic treatment.

Disruption in connexin-based communication is associated with intracellular Ca²âº signal alterations in astrocytes from Niemann-Pick type C mice.

Reduced astrocytic gap junctional communication and enhanced hemichannel activity were recently shown to increase astroglial and neuronal vulnerability to neuroinflammation. Moreover, increasing evidence suggests that neuroinflammation plays a pivotal role in the development of Niemann-Pick type C (NPC) disease, an autosomal lethal neurodegenerative disorder that is mainly caused by mutations in the NPC1 gene. Therefore, we investigated whether the lack of NPC1 expression in murine astrocytes affects the functional state of gap junction channels and hemichannels. Cultured cortical astrocytes of NPC1 knock-out mice (Npc1⁻/⁻) showed reduced intercellular communication via gap junctions and increased hemichannel activity. Similarly, astrocytes of newborn Npc1⁻/⁻ hippocampal slices presented high hemichannel activity, which was completely abrogated by connexin 43 hemichannel blockers and was resistant to inhibitors of pannexin 1 hemichannels. Npc1⁻/⁻ astrocytes also showed more intracellular Ca²âº signal oscillations mediated by functional connexin 43 hemichannels and P2Y1 receptors. Therefore, Npc1⁻/⁻ astrocytes present features of connexin based channels compatible with those of reactive astrocytes and hemichannels might be a novel therapeutic target to reduce neuroinflammation in NPC disease.