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Objectives - To understand the relationship between plantar pressures and the ulcers' occurrence in individuals with neuropathic diabetic foot, using this factor as a possible method of risk assessment and identification. To investigate the association between the epidemiological data and the ulcer's occurrence. To identify an indicative value for its occurrence. Methods - A quantitative cross-sectional, correlational, and epidemiological study was carried out by collecting sociodemographic and clinical information from the participants and conducting sensitivity tests to identify neuropathy. The sample (N = 60) was divided into two groups: neuropathic diabetics and non-neuropathic diabetics. Podological evaluations were performed using a baropodometric platform, and later statistical analyses were made with the results obtained. Results - There is an association between age, gender, and increased BMI with the occurrence of neuropathy. More than half of the diabetic population in the study has associated peripheral neuropathy. The presence of deformities in the feet of the individuals in the sample was shown to have an influence on the occurrence of ulcer, as well as PPP and IPT values. It can be assumed that the value 88.06 kPa is a reference value for the development of an ulcer. Conclusions - There is a relationship between PP and the occurrence of ulcers. Podological analysis on a baropodometric platform allows us to understand whether or not the patient is at risk of developing an ulcer. This study shows a possible PPP value that serves as an indicator of the development of an ulcer on a diabetic foot. [ABSTRACT FROM AUTHOR]

Cornea is one of the most highly innervated tissues in the organism. Opioid receptors have already been detected in cornea; so the topical use of opioids is presented as an analgesic alternative in treatment of ulcerated corneas, with no damage in cicatrization. This research aimed to evaluate the corneal sensitivity of the 1% morphine sulfate solution in the intact cornea of dogs. Ten dogs with no ocular lesions were treated with one drop of saline solution on right eye (GC), and one drop of 1% morphine sulfate solution with the pH corrected for 7.2 on left eye (GM). The parameters evaluated were: tonometry, esthesiometry, Schirmer lacrimation test, pupil diameter and the presence of conjunctival hyperemia and blepharospasm with and without light source. The evaluations happened before collyrium instillation and 10, 20, 30, 60 and 240 minutes after it. It was performed variance analysis (ANOVA) for the parametric tests, comparing the means by the Tukey-Kramer test. Hyperemia and blepharospasm were evaluated by the chi-square test. The conjunctival hyperemia observed in the GM group was significantly higher (7/10) than in the CG group, which did not present hyperemia (P<0.05). Two eyes from GM showed blepharospasm with light source at 10 minutes. There were no differences in corneal sensibility, pupil diameter and Schirmer lacrimation test. The intraocular pressure was lower in the GM group compared to the GC group at 240 minutes. Topical administration of 1% morphine sulfate solution does not cause analgesia in intact cornea and promote irritation in eye and annex after instillation. [ABSTRACT FROM AUTHOR]

Background: Facial pressure ulcers are one of the most common complications associated with non-invasive ventilation (NIV ). Objectives: To determine the frequency of facial pressure ulcers in patients admitted to an intermediate care unit (ICU) and submitted to NIV, as well as to identify the associated factors. Methodology: A prospective study was conducted between September and December 2015. Inclusion criteria: age ≥ 18 years, admitted to ICU, submitted to NIV and without facial ulcers at time of admission. A sample of 30 participants was obtained. Data were collected through a questionnaire, the Braden Scale and the Glasgow Scale. Results: The frequency of facial pressure ulcers was 26.7%, 16.7% of stage II and with a mean onset of 3.3 days. Most participants were male (70.0%), and the mean age was 74.2 years. Patients undergoing more hours of VNI per day, more days of NIV and more days of hospitalization had a higher frequency of facial pressure ulcers. Conclusion: Given that the number of hours of NIV increased the frequency of Facial pressure ulcers, we suggest periods of interruption of NIV use. [ABSTRACT FROM AUTHOR]

The cytomegalovirus infection is prevalent in developed countries. The natural history of disease includes three phases: primoinfection (majority is asymptomatic), latency and reactivation. In certain immunosuppressive states, as in the case of transplantation and HIV infection, the virus can reactivate, occurring cutaneous manifestations, of what stands out the occurrence of genital ulcers. In these, co-infection with other etiologic agents is common, particularly with the herpes simplex virus, leading to more severe manifestations and difficulty in the differential diagnosis. In this context, it is relevant to know the pathogenesis of this virus and the diagnostics means available in order to optimize its therapy. [ABSTRACT FROM AUTHOR]

The herpes simplex virus is a common cause of genital ulcers. In the immunocompromised, it may have an atypical presentation, with exuberant lesions, frequently resulting in resistance to the mainstream therapeutic options, and a consequent prolonged course. A 25-year-old male with a previous history of common variable immunodeficiency, presented with herpetic extensive genital ulcerations on the inguinoscrotal region. Despite a long period of valacyclovir therapy, the patient remained symptomatic. We decided to add topical 5% imiquimod as an adjunctive therapy, and observed a completed resolution of the ulcerations. Imiquimod, working as a local immunomodulator, stimulates the anti-viral immunologic response. Therefore, it is an alternative in recalcitrant herpetic lesions, especially in the setting of immunosuppression. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the frequency of lesions in different regions of stomach of asymptomatic horses. Stomachs were evaluated macroscopically, which identified the nature of lesions. Subsequently, fragments were obtained from five regions previously mapped for histological examination, as well as from other areas with lesions. From a total of 21 animals, only one had isolated macroscopic lesion in glandular region, six in nonglandular region and 13 showed lesions in both regions. One animal showed no macroscopic lesion. Histologically, the most frequent lesions were gastritis (19/21), ulcers (14/21) and erosion (8/21). Most cases were acute ulcer and erosion, and gastritis chronic. The results of this study show the high frequency of lesions in the stomach of apparently healthy slaughter horses. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcers have been receiving increased attention due to the severity of the situations and the large number of diabetic patients, whose prevalence exceeds 10% of the Portuguese population. The lack of feet vigilance among diabetic patients is an actual problem which limits the identification of risk factors, prevention and early intervention. To overcome this problem, nurses need to be familiar with and perform procedures for regular vigilance and assessment of the risk for ulceration in diabetic patients. Therefore, this paper aims to update knowledge on diabetic foot and characterise the process of assessing the risk for foot ulceration in diabetic patients. Recent scientific papers, reports, monographs and guidelines published on this topic were analysed. Despite the different opinions and differences, we concluded that the theoretical frameworks found are a sufficiently sound basis for nursing intervention, and that the existing legal framework is relatively simple, objective and achievable. The assessment of the risk for diabetic foot ulceration is within the reach of family nurses, particularly regarding the competences of level 1 teams. [ABSTRACT FROM AUTHOR]

Treatment of an ulcerated diabetic foot was documented photographically. We adapted the ultrasonographic tissue characterization (USTC or CATUS) technique to develop a photographic image tissue characterization (p-IMTC or CATIM) method. Five photographs, taken during medical treatment of an ulcerated diabetic foot following digital amputation, were quantified using imaging software designed to determine brightness intensity in grey scale images. The grey scale median (GSM) changed from 127 to 98; 86; 76; and 83 (out of 255) during follow-up. The area of lesion was estimated by number of pixels and reduced from 17.85 cm² to 12.44; 3.68; 2.11; and 0.15 cm². The percentage of total number of pixels showing granulation tissue increased from 11% to 34%; 56%; 62%; and 75%. p-IMTC quantified treatment progress. GSM quantified generalized changes in tissues, while the area of lesion and granulation tissue were documented quantitatively. Lesions, ulcers, wounds or other tissues can be analyzed using p-IMTC, allowing quantification, characterization and control of the progression of a condition or treatment. [ABSTRACT FROM AUTHOR]

Background: The lymphatic system plays a relevant role in any type of peripheral edema. Lymphoscintigraphy is currently considered the primary test in the diagnosis of lymphatic disease of the lower limbs. Although there is an association between lymphatic edema and chronic venous ulcers, the physiopathology of such changes remains uncertain. Objective: To assess qualitative lymphoscintigraphic findings in patients with chronic venous ulcers of the lower limbs. Methods: Forty patients with unilateral chronic venous ulcer or scarwere submitted to bilateral lymphoscintigraphy of the lower limbs. The sample was comprised of 25 women and 15 men, with a mean age of 53.7 years (28 to 79) and mean ulcer duration of 71.5 months (3 to 240 months). Lymphoscintigraphic parameters were qualitatively compared among three groups of lower limbs previously classified according to the clinical, etiologic, anatomic and pathologic classification (CEAP): I, limbs without clinical signs of venous disease or with telangiectasias and/or reticular veins (classes 0 and 1); II, limbs with varicose veins, edema and/or skin and subcutaneous alterations (classes 2, 3 and 4); III, lower limbs with ulcer and/or ulcer scars (classes 5 and 6). Results: There was a significant difference (p < 0.001) in the comparison of lymphoscintigraphic findings of the lower limbs with (group III - classes 5 and 6) and without ulcers/scars (groups I and II - classes 0, 1, 2, 3 and 4). There was also a significant difference (p < 0.001) in the comparison of groups according to the clinical CEAP classification: lymphoscintigraphic abnormalitieswere present in 72.5% in group III (classes 5 and 6), in 30.8% in group II (classes 2, 3 and 4), and in 7.1% in group I (classes 0 and 1). There was a statistically significant difference between group III and the other groups with regard to radiotracer retention, inguinal adenomegaly and dermal reflux. There was no significance as to the parameters popliteal lymph node and collateral circulation. Conclusion: The more severe the venous chronic stasis, the more lymphoscintigraphic abnormalities were observed, corroborating the association between venous and lymphatic disease and between chronic venous stasis and secondary lymphedema. [ABSTRACT FROM AUTHOR]