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Buschke-Lowenstein tumors (BTL) or giant genital warts are verrucous carcinomas. It is a pseudoepithelioma tumor that is characterized by aggressive local spread that destroys the tissues in which it is located. The spread is very rapid and consists of exophytic and endophytic papillomatosis of viral origin (human papillomavirus), which colonizes the perineal anorectal region and can also colonize the oral mucosa and the penis, representing 5% of penile tumors. Clinically, Buschke-Lowenstein tumor is a proliferative lesion with a cauliflower appearance; It initially originates in the glans-preputial and foreskin region, extends superficially and deeply through the penis and scrotum, penetrates the glans, and penetrates the corpus cavernosum and forms an ulcer, destroys the urethra, and forms a fistula. A 45-year-old male patient is reported who presents with giant condyloma compatible with Human Papillomavirus., Los tumores de Buschke-Lowenstein (TLB) o las verrugas genitales gigantes son carcinomas verrugosos. Es un tumor pseudoepitelioma que se caracteriza por una diseminación local agresiva que destruye los tejidos en los que se localiza. La diseminación es muy rápida y consiste en papilomatosis exofítica y endofítica de origen viral (virus del papiloma humano), que coloniza la región anorrectal perineal y puede colonizar también la mucosa oral y el pene, representando el 5% de los tumores de pene. Clínicamente, el tumor de Buschke-Lowenstein es una lesión proliferativa con apariencia de coliflor; Inicialmente se origina en la región del glande-prepucial y el prepucio, se extiende superficial y profundamente a través del pene y el escroto, penetra en el glande y penetra en el cuerpo cavernoso y forma una úlcera, destruye la uretra y forma una fístula. Se reporta un paciente masculino de 45 años el cual presenta condiloma gigante compatible con Virus del Papiloma Humano.

Introduction: Overprescribing of acid suppressants is a common phenomenon in human and small animal patients, leading to potential deleterious gastrointestinal (GI) and non-GI consequences. The impact of consensus statements on veterinary prescribing habits in clinical practice have not been fully evaluated. This study aimed to compare the prescribing habits of the proton pump inhibitor (PPI), omeprazole, in dogs in an academic veterinary teaching hospital before and after the publication of the American College of Veterinary Internal Medicine (ACVIM) consensus statement on rational use of gastrointestinal protectants. Methods: Evaluation of the prescribing habits of omeprazole in dogs during the years 2017 and 2021 was retrospectively compared. These years were selected to reflect a 12-month period prior to and following the publication of the consensus statement. One hundred dogs from each year were randomly selected. Dose, frequency of administration, duration of treatment, concurrent prescription of more than one gastroprotectant and indications for prescribing omeprazole were analyzed. Results: A significant increase in the cases that received omeprazole q12h (p < 0.0001) or that underwent a tapering dose after ≥4 week-therapy (p > 0.0001) was detected after the publication of the 2018 ACVIM consensus statement. Considering the indications, there was also a significant increase in the appropriate prescription of omeprazole in the second compared to the first period of study (p < 0.0001). Fifteen of 16 clinicians (94%) involved in the prescription of omeprazole indicated that their reading of the consensus statement had changed their clinical practice regarding PPI administration in dogs. Discussion: These results support the beneficial impact of the ACVIM consensus statement on the judicious prescribing of omeprazole in an academic veterinary hospital. These results should not be extrapolated to first-opinion veterinary practices, and further efforts should be, Depto. de Medicina y Cirugía Animal, Fac. de Veterinaria, TRUE, pub

2023 Acuerdos transformativos CRUE, Background A systematic review was conducted to investigate the prevalence of onychomycosis in patients with diabetes. The association of onychomycosis with risk factors in patients with diabetic foot syndrome was also examined. Methods The recommendations in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist were applied, and the included studies were assessed using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) method. Searches were conducted in October 2022 using PubMed (Medline) and Scopus for clinical studies, clinical trials, comparative studies, observational studies, and randomised clinical trials or controlled clinical trials addressing the prevalence and consequences of onychomycosis in patients with diabetes, diagnoses or treatments. Two authors performed the study selection and data extraction, and any discrepancies between the two reviewers were resolved through discussion with a third reviewer. Results The systematic review included ten studies that met the inclusion criteria, and these studies enrolled 5664 patients with diabetes. Among these patients, 29.18% had onychomycosis that was mainly caused by Trichophyton rubrum. A significant association was found between the occurrence of onychomycosis and the presence of diabetic neuropathy (p = .012) and elevated glycosylated haemoglobin values (p = .039). There was no significant association between onychomycosis and ulceration (p = .185). Eight studies had a grade 4 level of evidence and a grade C recommendation, and one study had a grade 1b level of evidence and a grade A recommendation. Conclusion The information described in the literature is insufficient and heterogeneous regarding the association of risk factors and ulceration in patients with diabetic foot compared with developing onychomycosis. There is also a need to implement onychomycosis diagnostic testing instead of relying only on a clinical diagnosis. Additional pro, Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub, APC financiada por la UCM

INTRODUCTION: Overprescribing of acid suppressants is a common phenomenon in human and small animal patients, leading to potential deleterious gastrointestinal (GI) and non-GI consequences. The impact of consensus statements on veterinary prescribing habits in clinical practice have not been fully evaluated. This study aimed to compare the prescribing habits of the proton pump inhibitor (PPI), omeprazole, in dogs in an academic veterinary teaching hospital before and after the publication of the American College of Veterinary Internal Medicine (ACVIM) consensus statement on rational use of gastrointestinal protectants. METHODS: Evaluation of the prescribing habits of omeprazole in dogs during the years 2017 and 2021 was retrospectively compared. These years were selected to reflect a 12-month period prior to and following the publication of the consensus statement. One hundred dogs from each year were randomly selected. Dose, frequency of administration, duration of treatment, concurrent prescription of more than one gastroprotectant and indications for prescribing omeprazole were analyzed. RESULTS: A significant increase in the cases that received omeprazole q12h (p < 0.0001) or that underwent a tapering dose after ≥4 week-therapy (p > 0.0001) was detected after the publication of the 2018 ACVIM consensus statement. Considering the indications, there was also a significant increase in the appropriate prescription of omeprazole in the second compared to the first period of study (p < 0.0001). Fifteen of 16 clinicians (94%) involved in the prescription of omeprazole indicated that their reading of the consensus statement had changed their clinical practice regarding PPI administration in dogs. DISCUSSION: These results support the beneficial impact of the ACVIM consensus statement on the judicious prescribing of omeprazole in an academic veterinary hospital. These results should not be extrapolated to first-opinion veterinary practices, and further efforts s

PURPOSE: This study sought to identify the sources of differential performance and misclassification error among local (Indian) and external (non-Indian) corneal specialists in identifying bacterial and fungal keratitis based on corneal photography. METHODS: This study is a secondary analysis of survey data assessing the ability of corneal specialists to identify acute bacterial versus fungal keratitis by using corneal photography. One-hundred images of 100 eyes from 100 patients with acute bacterial or fungal keratitis in South India were previously presented to an international cohort of cornea specialists for interpretation over the span of April to July 2021. Each expert provided a predicted probability that the ulcer was either bacterial or fungal. Using these data, we performed multivariable linear regression to identify factors predictive of expert performance, accounting for primary practice location and surrogate measures to infer local fungal ulcer prevalence, including locality, latitude, and dew point. In addition, Brier score decomposition was used to determine experts reliability (calibration) and resolution (boldness) and were compared between local (Indian) and external (non-Indian) experts. RESULTS: Sixty-six experts from 16 countries participated. Indian practice location was the only independently significant predictor of performance in multivariable linear regression. Resolution among Indian experts was significantly better (0.08) than among non-Indian experts (0.01; P < 0.001), indicating greater confidence in their predictions. There was no significant difference in reliability between the two groups ( P = 0.40). CONCLUSION: Local cornea experts outperformed their international counterparts independent of regional variability in tropical risk factors for fungal keratitis. This may be explained by regional characteristics of infectious ulcers with which local corneal specialists are familiar.

The aim of this article was to assess the ability to predict reulceration in people with diabetes and a history of minor amputation according to the formula proposed by Miller et al. A retrospective study was performed on 156 consecutive records of patients with a recent history of simple or multiple forefoot amputation. The sample was divided according to Miller's formula into patients at low risk of reulceration and those at high risk; those were further divided into two subgroups according to whether or not the first segment of the forefoot had been amputated. Forty-eight (47·1%) individuals suffered forefoot reulceration, showing a median reulceration-free survival time of 8 months [interquartile range (IR) 3·6-14·8]. Nephropathy (P = 0.005) and Miller's formula (P = 0.028) were risk factors for reulceration-free survival time in the univariate analysis. The pattern relating to the first segment amputated [hazard ratio (HR) 2·853; P = 0·004; 95% confidence interval (CI) 1·391-5·849] and nephropathy (HR 2·468; P = 0.004; 95% CI 1.328-4.587) showed a significant hazard ratio in the multivariate Cox model. Participants with first segment amputation and one other amputation showed an association with the probability of reulceration in comparison with any other specific type of minor amputation., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

De patienter som främst drabbas av svårläkta sår är ur den äldre befolkningen vilket är den del av befolkningen som kommer att öka mest inom de närmsta decennierna. Forskning har visat att malnutrition har en stor betydelse när det gäller uppkomst och läkningsprocess av svårläkta sår. Distriktssköterskor har en betydande roll i arbetet att förebygga malnutrition och underhålla en fullgod nutrition hos patienterna. Målet är att främja sårläkning och förbättra patientens livssituation genom en holistisk syn på patienternas hälsa och näringssituation. Syftet med studien var att belysa distriktssköterskors upplevelser av att arbeta med nutrition hos patienter med svårläkta sår eller risk för sår. Metoden som användes var kvalitativ innehållsanalys med induktiv ansats. Nio distriktssköterskor intervjuades. Resultatet utmynnade i tre huvudkategorier och tolv underkategorier enligt följande; Främja vårdkvalitén, Teamsamverkan och Upplevelsen om behovet av att upprätthålla kvalitativ vård. Det finns en delad uppfattning bland distriktssköterskorna angående organisation, struktur och rutiner. Det fungerar bra på vård -och omsorgsboendet men sämre på vårdcentral och hemsjukvård. Gemensamt för distriktssköterskorna är att de upplever att det ibland är svårt att hantera patientens autonomi och omvårdnadspersonalen/hemtjänstpersonalens brist på engagemang. I diskussionen framhålls att det behövs bättre kommunikation mellan olika professioner och att det behövs understöd på överordnad nivå i organisationen för att understödja utrymme för tid. Det framkommer att distriktssköterskorna tycker att nutritionen har en betydande roll för uppkomst och läkning av svårläkta sår, men att de kan känna sig ensamma i sin strävan för att uppnå patientens nutritionsmål., The patients most affected by difficult-to-heal wounds are the elderly population, which is the segment of the population that will increase in the coming decades. Research has shown that malnutrition plays a significant role in the occurrence and healing of difficult wounds. District nurses have a significant role in the work, especially in preventing malnutrition and maintaining adequate nutrition in patients. The goal is to promote wound healing and improve the patient's life situation through a holistic approach to the patient's health and nutritional status. The purpose of the study was to highlight district nurses' experiences of working with nutrition in patients with difficult-to-heal wounds or a risk of wounds. The method used was qualitative content analysis with an inductive approach. Nine district nurses were interviewed. The result led to three main categories and twelve subcategories and as follows: Promoting care quality, Team collaboration, And the experience of the need to maintain quality care. There is a divided opinion among district nurses regarding organization, structure, and procedures. It works well in nursing homes but less effectively in primary care and home care. Common for district nurses is the experience that it is sometimes difficult to handle the patient's autonomy and the lack of engagement from care personnel/homecare personnel. In the discussion, it is emphasized that better communication is needed between different professions and that support from the organization is needed to provide space for time. It emerges that district nurses believe that nutrition plays a significant role in the occurrence and healing of difficult wounds but that they may feel lonely in their efforts to achieve the patient's nutritional goals.

De patienter som främst drabbas av svårläkta sår är ur den äldre befolkningen vilket är den del av befolkningen som kommer att öka mest inom de närmsta decennierna. Forskning har visat att malnutrition har en stor betydelse när det gäller uppkomst och läkningsprocess av svårläkta sår. Distriktssköterskor har en betydande roll i arbetet att förebygga malnutrition och underhålla en fullgod nutrition hos patienterna. Målet är att främja sårläkning och förbättra patientens livssituation genom en holistisk syn på patienternas hälsa och näringssituation. Syftet med studien var att belysa distriktssköterskors upplevelser av att arbeta med nutrition hos patienter med svårläkta sår eller risk för sår. Metoden som användes var kvalitativ innehållsanalys med induktiv ansats. Nio distriktssköterskor intervjuades. Resultatet utmynnade i tre huvudkategorier och tolv underkategorier enligt följande; Främja vårdkvalitén, Teamsamverkan och Upplevelsen om behovet av att upprätthålla kvalitativ vård. Det finns en delad uppfattning bland distriktssköterskorna angående organisation, struktur och rutiner. Det fungerar bra på vård -och omsorgsboendet men sämre på vårdcentral och hemsjukvård. Gemensamt för distriktssköterskorna är att de upplever att det ibland är svårt att hantera patientens autonomi och omvårdnadspersonalen/hemtjänstpersonalens brist på engagemang. I diskussionen framhålls att det behövs bättre kommunikation mellan olika professioner och att det behövs understöd på överordnad nivå i organisationen för att understödja utrymme för tid. Det framkommer att distriktssköterskorna tycker att nutritionen har en betydande roll för uppkomst och läkning av svårläkta sår, men att de kan känna sig ensamma i sin strävan för att uppnå patientens nutritionsmål., The patients most affected by difficult-to-heal wounds are the elderly population, which is the segment of the population that will increase in the coming decades. Research has shown that malnutrition plays a significant role in the occurrence and healing of difficult wounds. District nurses have a significant role in the work, especially in preventing malnutrition and maintaining adequate nutrition in patients. The goal is to promote wound healing and improve the patient's life situation through a holistic approach to the patient's health and nutritional status. The purpose of the study was to highlight district nurses' experiences of working with nutrition in patients with difficult-to-heal wounds or a risk of wounds. The method used was qualitative content analysis with an inductive approach. Nine district nurses were interviewed. The result led to three main categories and twelve subcategories and as follows: Promoting care quality, Team collaboration, And the experience of the need to maintain quality care. There is a divided opinion among district nurses regarding organization, structure, and procedures. It works well in nursing homes but less effectively in primary care and home care. Common for district nurses is the experience that it is sometimes difficult to handle the patient's autonomy and the lack of engagement from care personnel/homecare personnel. In the discussion, it is emphasized that better communication is needed between different professions and that support from the organization is needed to provide space for time. It emerges that district nurses believe that nutrition plays a significant role in the occurrence and healing of difficult wounds but that they may feel lonely in their efforts to achieve the patient's nutritional goals.

Objective: To conduct a review of the literature on the effec-tiveness of negative pressure therapy in diabetic foot ulcers. Method: A review of the literature was carried out by con-sulting the electronic databases of PubMed, Lilacs, CENTRAL, WoS and SciELO. The risk of bias of the included studies was assessed using the Cochrane Handbook tool. Results: The total number of participants was 614 from a total of five randomized controlled clinical trials. Negative pressure therapy is effective in diabetic foot ulcers. Conclusions: Negative pressure therapy reduces the size of the diabetic foot ulcer, decreases closure time, and accel-erates healing by producing greater formation of granulation tissue. With this therapy, fewer dressing changes are needed, and the reparative processes are faster than stand-ard care., Objetivo: Realizar una revisión de la literatura sobre la eficacia de la terapia de presión negativa en úlceras de pie diabético. Método: Se elaboró una revisión de la literatura consultando las bases de datos electrónicas de PubMed, Lilacs, CENTRAL, WoS y SciELO. El riesgo de sesgo de los estu-dios incluidos se evaluó usando la herramienta del Manual Cochrane. Resultados: El número total de participantes fue de 614 de un total de cinco ensayos clínicos aleatorizados y controla-dos. La terapia de presión negativa fue eficaz en las úlceras de pie diabético. Conclusiones: La terapia de presión negativa reduce el tamaño de la úlcera de pie diabético, disminuye el tiempo de cierre, y acelera la curación produciendo mayor formación de tejido de granulación. Con esta terapia se necesitan me-nos cambios de apósitos, y presenta mayor rapidez de los procesos reparativos que la atención estándar.

Viminacium (Stari Kostolac) was the largest and the most important city in Moesia Superior (Upper Moesia). It was the provincial capital, administrative, religious, military and trade centre. It was built on a strategic location at the confluence of the river Mlava and the Danube, on the crossroad of both land and river routes with large military and trade potential. In one of the necropoles of Viminacium, Pirivoj, in grave no. 325, skeletal remains of a juvenile female individual were discovered. The burial is dated into the first half of the 3rd century. The deceased juvenile was laid on the back with hands clasped on her stomach. The orientation of the grave was North–South. Anthropological analyses revealed traces of osteomyelitis or cancer with proliferative periostitis on the left tibia and left fibula. The source of infection was related to a large ulcer on the left tibia. The current appearance of the bone shows poor health treatment of the ulcer and active inflammation at the time of death. In this text, we will also focus on the ulcer aetiology and possibility of its’ treatment in Antiquity. Treatments will also be briefly discussed, with preparations based on silver and lead, vinegar, honey, etc.

Leishmaniasis is a group of infectious diseases caused by the protozoan of the genus Leishmania spp., which has the ability to infect the reticuloendothelial system of macrophages. This is transmitted through a vector, mosquitoes of the genus Phlebotomus and Lutzomyia, with approximately 30 documented species. The reservoir is wild and domestic mammals, sometimes asymptomatic, and other times presenting with obvious clinical manifestations, as is the case in humans. The main clinical forms are visceral, mucocutaneous and cutaneous. Diagnosis is difficult due to the nonspecificity of the symptoms and the slow growth of the parasite in culture. There are different therapeutic options, so each case must be evaluated individually according to the characteristics of the lesion, the causative species and the potential for mucosal involvement. In our country, the first line of treatment consists of intralesional pentavalent antimonials. A 9-year-old patient who comes with his mother because he has had three ulcerative lesions located in the abdominal region for 1 month, measuring approximately 3 x 4 cm, accompanied by the presence of purulent fluid, which is why he comes., Las leishmaniasis es un grupo de enfermedades infecciosas ocasionadas por el protozoario del género Leishmania spp., el cual tiene la facultad de infectar el sistema reticuloendotelial de los macrófagos. Esta se transmite mediante un vector, los mosquitos del género Phlebotomus y Lutzomyia, con aproximadamente 30 especies documentadas. El reservorio son los mamíferos salvajes y domésticos, algunas veces de forma asintomática, y otras cursando con manifestaciones clínicas evidentes como es el caso en los humanos. Las principales formas clínicas son la visceral, la mucocutánea y la cutánea. El diagnóstico es difícil por la inespecificidad de la clínica y el lento crecimiento del parásito en cultivo. Existen distintas opciones terapéuticas, por lo que cada caso debe ser valorado individualmente según las características de la lesión, la especie causante y el potencial de afectación mucosa. En nuestro país, la primera línea de tratamiento está constituida por los antimoniales pentavalentes intralesionales. Paciente de 9 años que acude junto a su madre por presentar desde hace 1 meses, tres lesiones ulcerosas localizadas en región abdominal, de aproximadamente 3 x 4 cm, acompañadas con presencia de líquido purulento motivo por el cual acude.

It has long been known that medicinal plants include traditional therapeutic ingredients for the treatment and prevention of illnesses and disorders. In order to find out if hydroalcoholic extracts of fenugreek seeds may be used to treat ulcers, this study tested the extracts' capacity to neutralize acids and their ability to block H+/K+ - ATPase. A 1000 mg/ml concentration of the Seeds extract significantly reduced the acidity from 11.90 at the normal 500 mg/ml of Aluminium hydroxide + Magnesium hydroxide to 6.10. The maximum percentage of inhibition of the H+/K+ - ATPase was shown by petals extract at a concentration of 400 g/ml, which is less than the typical dose of esmoprazole (73.82%). The IC 50 value of extract of fenugreek seeds is shown to be 100 g/ml when compared to the average dose of esmoprazole, which is 82.5 g/ml. According to the findings of this study, fenugreek seeds contain compounds that have the ability to neutralize acids and block enzymes, making them a potential alternative treatment for digestive problems.

Many people suffer from ulcer, a disorder of the digestive tract. Simply put, it's an inflamed break in the skin or the mucus membrane lining the digestive tract. Whenever there is a change in the equilibrium, such as increased aggression or decreased mucosal resistance, ulceration develops. Reasons for this could include drug use, poor diet, stress, and other similar factors. Peptic ulcers are a general term for any type of stomach or duodenal ulcer. To develop, peptic ulcers need mucosal defences to be compromised in addition to gastric juice acid and peptic activity. Ulcers can be treated with a variety of synthetic medications. However, compared to herbal remedies, these drugs are more costly and more likely to cause side effects. According to the research, many different ayurvedic doctors and traditional medicine practitioners use different medicinal plants and polyherbal formulations to treat ulcers. Peptic ulcer disease treatment should focus on symptom alleviation, ulcer healing, and preventing recurrence. In this article, we'll take a look at some medicinal plants that have been studied for their potential use in peptic ulcer treatment and prevention, both in ayurveda and Western medicine.

It has long been known that medicinal plants include traditional therapeutic ingredients for the treatment and prevention of illnesses and disorders. In order to find out if hydroalcoholic extracts of fenugreek seeds may be used to treat ulcers, this study tested the extracts' capacity to neutralize acids and their ability to block H+/K+ - ATPase. A 1000 mg/ml concentration of the Seeds extract significantly reduced the acidity from 11.90 at the normal 500 mg/ml of Aluminium hydroxide + Magnesium hydroxide to 6.10. The maximum percentage of inhibition of the H+/K+ - ATPase was shown by petals extract at a concentration of 400 g/ml, which is less than the typical dose of esmoprazole (73.82%). The IC 50 value of extract of fenugreek seeds is shown to be 100 g/ml when compared to the average dose of esmoprazole, which is 82.5 g/ml. According to the findings of this study, fenugreek seeds contain compounds that have the ability to neutralize acids and block enzymes, making them a potential alternative treatment for digestive problems.

Many people suffer from ulcer, a disorder of the digestive tract. Simply put, it's an inflamed break in the skin or the mucus membrane lining the digestive tract. Whenever there is a change in the equilibrium, such as increased aggression or decreased mucosal resistance, ulceration develops. Reasons for this could include drug use, poor diet, stress, and other similar factors. Peptic ulcers are a general term for any type of stomach or duodenal ulcer. To develop, peptic ulcers need mucosal defences to be compromised in addition to gastric juice acid and peptic activity. Ulcers can be treated with a variety of synthetic medications. However, compared to herbal remedies, these drugs are more costly and more likely to cause side effects. According to the research, many different ayurvedic doctors and traditional medicine practitioners use different medicinal plants and polyherbal formulations to treat ulcers. Peptic ulcer disease treatment should focus on symptom alleviation, ulcer healing, and preventing recurrence. In this article, we'll take a look at some medicinal plants that have been studied for their potential use in peptic ulcer treatment and prevention, both in ayurveda and Western medicine.

Leishmaniasis is a widespread vector-borne parasitic disease caused by several species of obligate intracellular protozoa of the genus Leishmania and transmitted by the bites of infected flies. Approximately 23 species of leishmaniasis cause one of three clinical forms of the disease: cutaneous, mucosal, and visceral leishmaniasis. The disease is endemic in 98 countries with approximately 2 million new cases per year, putting more than 350 million people at risk. It is an important disease with a wide range of clinical manifestations and a public health problem in many parts of the world. It presents in different clinical forms depending on the Leishmania species involved and factors related to the host. The usual clinical types do not cause diagnostic difficulties. Abnormal presentation sometimes leads to diagnostic difficulties and delays in treatment. In addition to the classic clinical manifestations, in recent years some rare and atypical signs of the disease have been described. A 28-year-old female patient is reported with a crusty ulcerative lesion located on the upper lip, with an evolution of approximately 1 month., La leishmaniasis es una enfermedad parasitaria generalizada transmitida por vectores causada por varias especies de protozoos intracelulares obligados del género Leishmania y transmitida por picaduras de moscas infectadas. Aproximadamente 23 especies de leishmaniasis causan una de las tres formas clínicas de la enfermedad: leishmaniasis cutánea, mucosa y visceral. La enfermedad es endémica en 98 países con aproximadamente 2 millones de casos nuevos por año lo que pone en riesgo a más de 350 millones de personas. Es una enfermedad importante con una amplia gama de manifestaciones clínicas y un problema de salud pública en muchas partes del mundo. Se presenta en diferentes formas clínicas dependiendo de la especie de Leishmania involucrada y de factores relacionados con el huésped. Los tipos clínicos habituales no provocan dificultades diagnósticas. La presentación anormal a veces conduce a dificultades de diagnóstico y retrasos en el tratamiento. Además de las manifestaciones clínicas clásicas, en los últimos años se han descrito algunos signos raros y atípicos de la enfermedad. Se reporta una paciente femenina de 28 años con lesión ulcerosa costrosa localizada en labio superior, con evolución de aproximadamente 1 mes.

Leishmaniasis is a group of infectious diseases caused by the protozoan of the genus Leishmania spp., which has the ability to infect the reticuloendothelial system of macrophages. This is transmitted through a vector, mosquitoes of the genus Phlebotomus and Lutzomyia, with approximately 30 documented species. The reservoir is wild and domestic mammals, sometimes asymptomatic, and other times presenting with obvious clinical manifestations, as is the case in humans. The main clinical forms are visceral, mucocutaneous and cutaneous. Diagnosis is difficult due to the nonspecificity of the symptoms and the slow growth of the parasite in culture. There are different therapeutic options, so each case must be evaluated individually according to the characteristics of the lesion, the causative species and the potential for mucosal involvement. In our country, the first line of treatment consists of intralesional pentavalent antimonials. A 9-year-old patient who comes with his mother because he has had three ulcerative lesions located in the abdominal region for 1 month, measuring approximately 3 x 4 cm, accompanied by the presence of purulent fluid, which is why he comes., Las leishmaniasis es un grupo de enfermedades infecciosas ocasionadas por el protozoario del género Leishmania spp., el cual tiene la facultad de infectar el sistema reticuloendotelial de los macrófagos. Esta se transmite mediante un vector, los mosquitos del género Phlebotomus y Lutzomyia, con aproximadamente 30 especies documentadas. El reservorio son los mamíferos salvajes y domésticos, algunas veces de forma asintomática, y otras cursando con manifestaciones clínicas evidentes como es el caso en los humanos. Las principales formas clínicas son la visceral, la mucocutánea y la cutánea. El diagnóstico es difícil por la inespecificidad de la clínica y el lento crecimiento del parásito en cultivo. Existen distintas opciones terapéuticas, por lo que cada caso debe ser valorado individualmente según las características de la lesión, la especie causante y el potencial de afectación mucosa. En nuestro país, la primera línea de tratamiento está constituida por los antimoniales pentavalentes intralesionales. Paciente de 9 años que acude junto a su madre por presentar desde hace 1 meses, tres lesiones ulcerosas localizadas en región abdominal, de aproximadamente 3 x 4 cm, acompañadas con presencia de líquido purulento motivo por el cual acude.

Leishmaniasis is a widespread vector-borne parasitic disease caused by several species of obligate intracellular protozoa of the genus Leishmania and transmitted by the bites of infected flies. Approximately 23 species of leishmaniasis cause one of three clinical forms of the disease: cutaneous, mucosal, and visceral leishmaniasis. The disease is endemic in 98 countries with approximately 2 million new cases per year, putting more than 350 million people at risk. It is an important disease with a wide range of clinical manifestations and a public health problem in many parts of the world. It presents in different clinical forms depending on the Leishmania species involved and factors related to the host. The usual clinical types do not cause diagnostic difficulties. Abnormal presentation sometimes leads to diagnostic difficulties and delays in treatment. In addition to the classic clinical manifestations, in recent years some rare and atypical signs of the disease have been described. A 28-year-old female patient is reported with a crusty ulcerative lesion located on the upper lip, with an evolution of approximately 1 month., La leishmaniasis es una enfermedad parasitaria generalizada transmitida por vectores causada por varias especies de protozoos intracelulares obligados del género Leishmania y transmitida por picaduras de moscas infectadas. Aproximadamente 23 especies de leishmaniasis causan una de las tres formas clínicas de la enfermedad: leishmaniasis cutánea, mucosa y visceral. La enfermedad es endémica en 98 países con aproximadamente 2 millones de casos nuevos por año lo que pone en riesgo a más de 350 millones de personas. Es una enfermedad importante con una amplia gama de manifestaciones clínicas y un problema de salud pública en muchas partes del mundo. Se presenta en diferentes formas clínicas dependiendo de la especie de Leishmania involucrada y de factores relacionados con el huésped. Los tipos clínicos habituales no provocan dificultades diagnósticas. La presentación anormal a veces conduce a dificultades de diagnóstico y retrasos en el tratamiento. Además de las manifestaciones clínicas clásicas, en los últimos años se han descrito algunos signos raros y atípicos de la enfermedad. Se reporta una paciente femenina de 28 años con lesión ulcerosa costrosa localizada en labio superior, con evolución de aproximadamente 1 mes.

Information on the presentation and predisposing factors of Mule Gastric Ulcer Syndrome (MGUS) is scarce, compared to Equine Gastric Ulcer Syndrome (EGUS) and donkeys. Within the multifactorial nature of this syndrome, helicobacteriosis has been studied in other species. The objective of this work was to establish the presence of Helicobacter spp. in gastric mucosa of mules, through the rapid urease test (RUT) and histopathological analysis. Less than 27% of the samples reacted to RUTs, with prolonged reaction times, and Urea Agar (gold test), with a lower percentage of positivity. Histopathology revealed chronic inflammatory processes, without the presence of curved-spiral bacteria. The RUTs were not conclusive in the determination of Helicobacter spp., a similar behavior reported in horses. More specific diagnostic tests and complementary procedures are required to explore the regions of the stomach in consideration of the number of representative samples., La información sobre la presentación y los factores predisponentes del síndrome de úlcera gástrica en mulas (SUGM) es escasa en comparación con el síndrome de úlcera gástrica en equinos (SUGE) y asnales. Debido a la naturaleza multifactorial de este síndrome, la helicobacteriosis ha sido estudiada en otras especies. El objetivo fue establecer la presencia de Helicobacter spp. en mucosa gástrica de mulas a través de la prueba rápida de la ureasa (PRU) y de análisis histopatológico. Menos del 27% de las muestras reaccionaron a la PRU, con tiempos prolongados de reacción, y al Agar Urea (prueba de oro), con menor porcentaje de positividad. La histopatología reveló procesos inflamatorios crónicos, sin presencia de bacterias curvoespiraladas. Las PRU no fueron conclusivas en la determinación de Helicobacter spp., comportamiento similar reportado en equinos. Se requieren exámenes diagnósticos específicos y procedimientos complementarios que explore regiones del estómago en consideración del número de muestras representativas.

Information on the presentation and predisposing factors of Mule Gastric Ulcer Syndrome (MGUS) is scarce, compared to Equine Gastric Ulcer Syndrome (EGUS) and donkeys. Within the multifactorial nature of this syndrome, helicobacteriosis has been studied in other species. The objective of this work was to establish the presence of Helicobacter spp. in gastric mucosa of mules, through the rapid urease test (RUT) and histopathological analysis. Less than 27% of the samples reacted to RUTs, with prolonged reaction times, and Urea Agar (gold test), with a lower percentage of positivity. Histopathology revealed chronic inflammatory processes, without the presence of curved-spiral bacteria. The RUTs were not conclusive in the determination of Helicobacter spp., a similar behavior reported in horses. More specific diagnostic tests and complementary procedures are required to explore the regions of the stomach in consideration of the number of representative samples., La información sobre la presentación y los factores predisponentes del síndrome de úlcera gástrica en mulas (SUGM) es escasa en comparación con el síndrome de úlcera gástrica en equinos (SUGE) y asnales. Debido a la naturaleza multifactorial de este síndrome, la helicobacteriosis ha sido estudiada en otras especies. El objetivo fue establecer la presencia de Helicobacter spp. en mucosa gástrica de mulas a través de la prueba rápida de la ureasa (PRU) y de análisis histopatológico. Menos del 27% de las muestras reaccionaron a la PRU, con tiempos prolongados de reacción, y al Agar Urea (prueba de oro), con menor porcentaje de positividad. La histopatología reveló procesos inflamatorios crónicos, sin presencia de bacterias curvoespiraladas. Las PRU no fueron conclusivas en la determinación de Helicobacter spp., comportamiento similar reportado en equinos. Se requieren exámenes diagnósticos específicos y procedimientos complementarios que explore regiones del estómago en consideración del número de muestras representativas.

Background: Despite the fact that Helicobacter spp. has been detected in equine gastric mucosa, no evidence exists about this infection in Colombian horses affected by equine ulcerative gastric syndrome (EGUS), nor in dental tartar. Objective: To detect Helicobacter spp. DNA in equine gastric mucosa and dental tartar and determine the relationship between the presence of Helicobacter spp. and gastric lesions. Methods: Samples of glandular gastric mucosa and dental tartar were collected from 30 equine slaughterhouses. Macroscopic lesions of the stomachs were classified and the total DNA in all samples was extracted using a commercial extraction kit. A final-point PCR was performed using primers for amplification of a segment of 251 bp of the gene encoding the 16s rRNA region; the amplified fragments were subjected to a second PCR to determine the presence of H. pylori, the VacA gene was typified. The resulting amplicons were sequenced. Results: It was possible to amplify 16s rRNA in several samples but there was no amplification of VacA. Fragments of the sequences were compatible with H. heilmannii. The 23.3 and 10% of gastric and tartar samples were positive for 16s rRNA of Helicobacter spp., respectively. Conclusion: Although genetic material of Helicobacter spp. was found in some animals, there was no relationship with gastric lesions. It is possible that helicobacteriosis has no bearing in EGUS etiology., Antecedentes: Apesar do Helicobacter spp. ter sido detectado na mucosa gástrica de equinos, não há evidências dessa infecção em cavalos crioulos colombianos afetados pela síndrome ulcerativa gástrica (SUGE), ou no sarro. Objetivo: Detectar ADN de Helicobacter spp. na mucosa gástrica e do sarro dental de equinos, e determinar a relação entre a presença de Helicobacter spp. e lesões gástricas. Métodos: Amostras de mucosa gástrica glandular e sarro dental foram coletadas de 30 equinos de abatedouro, as lesões macroscópicas dos estômagos foram classificadas. Se realizou extração de ADN total em todas as amostras através de kit comercial. Realizou-se PCR ponto final, amplificando o segmento de 251 pb do gene que codifica para a região 16s ARNr; os fragmentos amplificados foram sometidos novamente a PCR para determinar a presença de H. pylori, ao tipificar o gene VacA, e seguidamente foram sequenciados. Resultados: O houve amplificação do 16s ARNr em várias amostras, mas não amplificação de VacA. Fragmentos das sequencias foram compatíveis com H. heilmannii. O 23,3 e 10% das amostras gástricas e do sarro foram positivas para 16s ARNr de Helicobacter, respectivamente. Conclusão: Embora material genético de Helicobacter spp. encontrou-se em algumos animais não houve relação com lesões gástricas. Possivelmente a helicobacterioses não tem papel relevante na etiologia da SUGE., Antecedentes: A pesar de que se ha detectado Helicobacter spp. en mucosa gástrica equina, no existe evidencia de esta infección en caballos criollos colombianos afectados por síndrome ulcerativo gástrico (SUGE), ni tampoco reportes en sarro dental. Objetivo: Detectar ADN de Helicobacter spp. en sarro dental y mucosa gástrica de equinos, y determinar la relación entre la presencia de la bacteria y lesiones gástricas. Métodos: Las muestras de mucosa glandular gástrica y sarro dental fueron colectadas de 30 equinos que se encontraban en planta de beneficio. Las lesiones macroscópicas fueron clasificadas y el ADN total de las muestras fue extraído utilizando un kit comercial. Se desarrolló PCR convencional usando cebadores específicos para la amplificación de un segmento de 251 pb de un gen que codifica la región 16S del ARNr; los fragmentos amplificados fueron sometidos a una segunda PCR para determinar la presencia de H. pylori mediante la amplificación del gen VacA. Los amplificados resultantes fueron secuenciados. Resultados: Fue posible amplificar 16s ARNr en varias muestras, pero no hubo amplificación de VacA. Los fragmentos de las secuencias fueron compatibles con H. heilmannii. El 23,3 y 10% de las muestras gástricas y sarro fueron positivas para 16s ARNr de Helicobacter spp., respectivamente. Conclusión: Aunque el material genético de Helicobacter spp. se encontró en algunos animales, no hubo relación con las lesiones gástricas. Es posible que la helicobacteriosis no tenga incidencia en la etiología del EGUS.

type:Text, Systemic sclerosis is a complex disease characterized by extensive fibrosis, microvascular alterations, and additional sequelae. Microvascular alterations can cause painful ulcers and necrosis; however, conservative or surgical treatment is often challenging in terms of healing. The study aimed to describe a toe ulcer with systemic sclerosis and its' successful treatment with spinal cord stimulation. An 83-year-old woman, who was diagnosed with systemic sclerosis over the past decade, was distressed by a non-healing toe ulcer for an extended period of time. The patient underwent spinal cord stimulation treatment with the expectation of pain relief and an improvement in microcirculatory insufficiency. Her pain scales and microcirculation improved, and the toe ulcer healed. Furthermore, the frequency of Raynaud's symptoms was reduced, and the patient's pain decreased. There was no recurrence of the ulcer and she no longer needed a cane for walking.

Objective: to analyze the healing process of venous ulcers treated with an Unna’s boot. Methods: longitudinal study, prospective, with 14 individuals with chronic venous ulcers, followed at four different moments of time. Data collection was based on clinical and sociodemographic profile and clinical evaluation of the lesions. Data were analyzed using the Friedman test. Wilcoxon’s signed ranks test was used to compare means, and for multiple comparisons Bonferroni’s correction was used (p<0.05). Results: the Bonferroni post hoc test revealed a reduction in pain scores (p=0.038), amount of exudate (p=0.005) and dry border (p=0.044). Improvement in healing was observed by means of the Pressure Ulcer Scale for Healing (p=0.004) after use of the Unna boot between the first and fourth moments. Conclusion: there was a reduction in the Pressure Ulcer Scale for Healing indicators, pain, amount of exudate and dry border of the lesion in patients using Unna’s boot after four weeks. Contributions to practice: the need to manage indicators such as Pressure Ulcer Scale for Healing classification, pain, amount of exudate, and dry border based on the Unna Boot is highlighted., Objetivo: analisar o processo cicatricial de úlceras venosas tratadas com bota de Unna. Métodos: estudo longitudinal, prospectivo, com 14 indivíduos acometidos de úlcera venosa crônica, acompanhados em quatro momentos distintos. A coleta de dados foi realizada com base no perfil clínico, sociodemográfico e avaliação clínica das lesões. Dados analisados por meio dos testes de Friedman. Para a comparação das médias, utilizou-se o teste dos postos assinalados de Wilcoxon e, para as comparações múltiplas, utilizou-se a correção de Bonferroni (p<0,05). Resultados: o teste post hoc de Bonferroni revelou redução nos escores de dor (p=0,038), quantidade de exsudato (p=0,005) e borda seca (p=0,044). Observou-se melhora da cicatrização por meio da escala Pressure Ulcer Scale for Healing (p=0,004) após uso da bota de Unna entre o primeiro e quarto momento. Conclusão: houve redução dos indicadores da Pressure Ulcer Scale for Healing, dor, quantidade de exsudato e borda seca da lesão em paciente em uso de bota de Unna depois de quatro semanas. Contribuições para a prática: evidencia-se a necessidade de manejar indicadores como classificação de Pressure Ulcer Scale for Healing, dor, quantidade de exsudato e borda seca com base na Bota de Unna.

Background: The treatment of solitary rectal ulcer (SRU) is challenging and controversial; generally, no response to conventional treatments can be obtained, particularly in patients with dyssynergic defecation (DD). We assessed the efficiency of biofeedback therapy (BFT) in patients who did not respond to conservative treatments and had coexistence of SRU and DD. Methods: BFT responses, as well as anorectal manometry and rectoscopy results of 20 patients with the coexistence of SRU and DD, were assessed. Results: Mean age was 32.5 years. Of the patients, 12 were female, and 8 of them were male. An average of 12 sessions of BFT was performed on the patients. Ulcer disappeared in 11 patients (55%) after BFT, and the ulcer size decreased in 3 patients (15%). However, ulcers healed in 9 (90%) of 10 patients whose DD pattern disappeared following BFT, and ulcers healed in only 20% of patients whose DD pattern continued (p = 0.005). The change in anal resting pressure after BFT was significant (p = 0.016). Ulcers were healed in 87.5% (7/8) of the patients whose anal resting pressure decreased after BFT and whose DD disappeared, while ulcers remained untreated in 85.7% of the patients whose anal resting pressure decreased, but the DD pattern continued (p = 0.005). Conclusions: SRU patients with DD are typically unresponsive to medical treatments. Ameliorating anorectal dyssynergia should be the priority of treatment in these patients. BFT is an effective treatment for DD. BFT enhances the healing of ulcers in patients with SRU by restoring coordination of the pelvic floor. © 2022 S. Karger AG, Basel. Copyright: All rights reserved.

Background: The treatment of solitary rectal ulcer (SRU) is challenging and controversial; generally, no response to conventional treatments can be obtained, particularly in patients with dyssynergic defecation (DD). We assessed the efficiency of biofeedback therapy (BFT) in patients who did not respond to conservative treatments and had coexistence of SRU and DD. Methods: BFT responses, as well as anorectal manometry and rectoscopy results of 20 patients with the coexistence of SRU and DD, were assessed. Results: Mean age was 32.5 years. Of the patients, 12 were female, and 8 of them were male. An average of 12 sessions of BFT was performed on the patients. Ulcer disappeared in 11 patients (55%) after BFT, and the ulcer size decreased in 3 patients (15%). However, ulcers healed in 9 (90%) of 10 patients whose DD pattern disappeared following BFT, and ulcers healed in only 20% of patients whose DD pattern continued (p = 0.005). The change in anal resting pressure after BFT was significant (p = 0.016). Ulcers were healed in 87.5% (7/8) of the patients whose anal resting pressure decreased after BFT and whose DD disappeared, while ulcers remained untreated in 85.7% of the patients whose anal resting pressure decreased, but the DD pattern continued (p = 0.005). Conclusions: SRU patients with DD are typically unresponsive to medical treatments. Ameliorating anorectal dyssynergia should be the priority of treatment in these patients. BFT is an effective treatment for DD. BFT enhances the healing of ulcers in patients with SRU by restoring coordination of the pelvic floor. © 2022 S. Karger AG, Basel. Copyright: All rights reserved.

Around the course of the past few decades, essential oils have been an increasingly prominent subject of research all over the world. These naturally occurring chemicals may find applications in a wide variety of medical and biotechnological fields. In light of the urgent need to find new anti-ulcer agents and the significant amount of effort that has been put into developing medications for the treatment of ulcers, the purpose of this review is to investigate the anti-ulcer activities of fifteen different bioactive compounds that can be found in essential oils.

Around the course of the past few decades, essential oils have been an increasingly prominent subject of research all over the world. These naturally occurring chemicals may find applications in a wide variety of medical and biotechnological fields. In light of the urgent need to find new anti-ulcer agents and the significant amount of effort that has been put into developing medications for the treatment of ulcers, the purpose of this review is to investigate the anti-ulcer activities of fifteen different bioactive compounds that can be found in essential oils.

Around the course of the past few decades, essential oils have been an increasingly prominent subject of research all over the world. These naturally occurring chemicals may find applications in a wide variety of medical and biotechnological fields. In light of the urgent need to find new anti-ulcer agents and the significant amount of effort that has been put into developing medications for the treatment of ulcers, the purpose of this review is to investigate the anti-ulcer activities of fifteen different bioactive compounds that can be found in essential oils.

Background: Despite the fact that Helicobacter spp. has been detected in equine gastric mucosa, no evidence exists about this infection in Colombian horses affected by equine ulcerative gastric syndrome (EGUS), nor in dental tartar. Objective: To detect Helicobacter spp. DNA in equine gastric mucosa and dental tartar and determine the relationship between the presence of Helicobacter spp. and gastric lesions. Methods: Samples of glandular gastric mucosa and dental tartar were collected from 30 equine slaughterhouses. Macroscopic lesions of the stomachs were classified and the total DNA in all samples was extracted using a commercial extraction kit. A final-point PCR was performed using primers for amplification of a segment of 251 bp of the gene encoding the 16s rRNA region; the amplified fragments were subjected to a second PCR to determine the presence of H. pylori, the VacA gene was typified. The resulting amplicons were sequenced. Results: It was possible to amplify 16s rRNA in several samples but there was no amplification of VacA. Fragments of the sequences were compatible with H. heilmannii. The 23.3 and 10% of gastric and tartar samples were positive for 16s rRNA of Helicobacter spp., respectively. Conclusion: Although genetic material of Helicobacter spp. was found in some animals, there was no relationship with gastric lesions. It is possible that helicobacteriosis has no bearing in EGUS etiology., Antecedentes: Apesar do Helicobacter spp. ter sido detectado na mucosa gástrica de equinos, não há evidências dessa infecção em cavalos crioulos colombianos afetados pela síndrome ulcerativa gástrica (SUGE), ou no sarro. Objetivo: Detectar ADN de Helicobacter spp. na mucosa gástrica e do sarro dental de equinos, e determinar a relação entre a presença de Helicobacter spp. e lesões gástricas. Métodos: Amostras de mucosa gástrica glandular e sarro dental foram coletadas de 30 equinos de abatedouro, as lesões macroscópicas dos estômagos foram classificadas. Se realizou extração de ADN total em todas as amostras através de kit comercial. Realizou-se PCR ponto final, amplificando o segmento de 251 pb do gene que codifica para a região 16s ARNr; os fragmentos amplificados foram sometidos novamente a PCR para determinar a presença de H. pylori, ao tipificar o gene VacA, e seguidamente foram sequenciados. Resultados: O houve amplificação do 16s ARNr em várias amostras, mas não amplificação de VacA. Fragmentos das sequencias foram compatíveis com H. heilmannii. O 23,3 e 10% das amostras gástricas e do sarro foram positivas para 16s ARNr de Helicobacter, respectivamente. Conclusão: Embora material genético de Helicobacter spp. encontrou-se em algumos animais não houve relação com lesões gástricas. Possivelmente a helicobacterioses não tem papel relevante na etiologia da SUGE., Antecedentes: A pesar de que se ha detectado Helicobacter spp. en mucosa gástrica equina, no existe evidencia de esta infección en caballos criollos colombianos afectados por síndrome ulcerativo gástrico (SUGE), ni tampoco reportes en sarro dental. Objetivo: Detectar ADN de Helicobacter spp. en sarro dental y mucosa gástrica de equinos, y determinar la relación entre la presencia de la bacteria y lesiones gástricas. Métodos: Las muestras de mucosa glandular gástrica y sarro dental fueron colectadas de 30 equinos que se encontraban en planta de beneficio. Las lesiones macroscópicas fueron clasificadas y el ADN total de las muestras fue extraído utilizando un kit comercial. Se desarrolló PCR convencional usando cebadores específicos para la amplificación de un segmento de 251 pb de un gen que codifica la región 16S del ARNr; los fragmentos amplificados fueron sometidos a una segunda PCR para determinar la presencia de H. pylori mediante la amplificación del gen VacA. Los amplificados resultantes fueron secuenciados. Resultados: Fue posible amplificar 16s ARNr en varias muestras, pero no hubo amplificación de VacA. Los fragmentos de las secuencias fueron compatibles con H. heilmannii. El 23,3 y 10% de las muestras gástricas y sarro fueron positivas para 16s ARNr de Helicobacter spp., respectivamente. Conclusión: Aunque el material genético de Helicobacter spp. se encontró en algunos animales, no hubo relación con las lesiones gástricas. Es posible que la helicobacteriosis no tenga incidencia en la etiología del EGUS.

[Resumen] la terapia larval es una técnica que permite tratar heridas crónicas mediante el uso de larvas estériles de Lucilia sericata y cuyo fin es el desbridamiento, desinfección y cicatrización de estas. Estas larvas segregan enzimas proteolíticas que deshacen la escara necrótica para ser posteriormente digerida y, además, inhiben el crecimiento de patógenos responsables de infecciones en las úlceras. En la actualidad, puede ser una alternativa adecuada a otros tratamientos por su rapidez, su efectividad y, relacionado con el aumento de las resistencias a antibióticos, su capacidad antimicrobiana. Objetivo: conocer la evidencia científica sobre la terapia larval en el tratamiento de heridas crónicas. Metodología: se realizó una revisión sistemática. Se llevó a cabo una búsqueda de revisiones sistemáticas y ensayos clínicos en las principales bases de datos (Pubmed, Web of Science y Scopus). La selección de estudios se realizó mediante una lectura del título, resumen y texto completo. En total se seleccionaron 2 revisiones sistemáticas y 9 estudios de investigación. Las variables clínicas de estudio han sido la capacidad de desbridamiento, la actividad antimicrobiana, la promoción del tejido de granulación, la promoción de la cicatrización y el dolor. Resultados: la terapia larval es un método rápido y eficaz para el tratamiento de heridas crónicas. Los tres mecanismos de acción más destacados son la capacidad de desbridamiento (12,6 días de media), la actividad antimicrobiana (inhibe el crecimiento de patógenos) y la promoción del tejido de granulación (favorece la formación de fibroblastos). Aunque es una técnica psicológicamente aceptada por el paciente, en algunos casos puede aumentar el dolor. Conclusión: la terapia larval es un método seguro, eficaz, rápido y costo-efectivo, por lo que mejora la calidad de vida de los pacientes. La enfermería debe conocer la evidencia científica actual para dar a conocer este tipo de tratamiento y tenerlo en cuenta entre las, [Abstract] maggot therapy is a technique to treat chronic wounds using sterile Lucilia Sericata larvae for debridement, disinfection and wound healing. These larvae secrete proteolytic enzymes that break down the necrotic slough for further digestion and inhibit the growth of pathogens responsible for ulcer infections. Currently, it may be a suitable alternative to other treatments because of its speed, effectiveness and, related to increasing antibiotic resistance, its antimicrobial capacity. Objective: to know the scientific evidence of maggot therapy in the treatment of chronic wounds. Methodology: a systematic review was made. A search for systematic reviews and clinical trials was carried out in major databases (PubMed, Web of Science and Scopus). The studies selection was made by title, abstract and full text. A total of 9 research studies and 2 systematic reviews were selected. The variables studied were debridement capacity, antimicrobial activity, promotion of granulation tissue, promotion of healing and pain. Results: larval therapy is a fast and effective method for the treatment of chronic wounds. The three most prominent mechanisms of action are debridement (12,6 days on average), antimicrobial activity (inhibits the growth of pathogens) and promotion of granulation tissue (promotes fibroblast formation). Although it is a psychologically accepted technique by the patient, in some cases it may increase pain. Conclusion: maggot therapy is a safe, effective, fast and cost-effective method, which improves the quality of life of patients. Nurses should be aware of the current scientific evidence in order to raise awareness of this type of treatment and take it into account among the different options for dealing with chronic wounds., [Abstract] a terapia larval é unha técnica que permite tratar feridas crónicas mediante o uso de larvas estériles de Lucilia Sericata e cuxo fin é o desbridamento, desinfección e cicatrización destas. Estas larvas segregan encimas proteolíticas que desfán a escara necrótica para ser posteriormente dixerida e, ademais, inhiben o crecemento de patóxenos responsables de infeccións nas úlceras. Na actualidade, pode ser unha alternativa adecuada a outros tratamentos pola súa rapidez, a súa efectividade e, relacionado co aumento das resistencias a antibióticos, a súa capacidade antimicrobiana. Obxectivo: coñecer a evidencia científica sobre a terapia larval no tratamento de feridas crónicas. Metodoloxía: realizouse unha revisión sistemática. Levouse a cabo unha procura de revisións sistemáticas e ensaios clínicos nas principais bases de datos (Pubmed, Web of Science e Scopus). A selección de estudos realizouse mediante unha lectura do título, resumo e texto completo. Seleccionáronse un total de 9 estudos de investigación e 2 revisións sistemáticas. As variables clínicas de estudo foron a capacidade de desbridamento, a actividade antimicrobiana, a promoción do tecido de granulación, a promoción da cicatrización e a dor. Resultados: a terapia larval é un método rápido e eficaz para o tratamento de feridas crónicas. Os tres mecanismos de acción máis destacados son a capacidade de desbridamento (12,6 días de media), a actividade antimicrobiana (inhibe o crecemento de patóxenos) e a promoción do tecido de granulación (favorece a formación de fibroblastos). Aínda que é unha técnica psicoloxicamente aceptada polo doente, nalgúns casos pode aumentar a dor. Conclusión: a terapia larval é un método seguro, eficaz, rápido e custo-efectivo, polo que mellora a calidade de vida dos doentes. A enfermería debe coñecer a evidencia científica actual para dar a coñecer este tipo de tratamento e telo en conta entre as diferente opcións de abordaxe dunha ferida crónica.

SCOPUS: le.j, info:eu-repo/semantics/published

[Resumen] Objetivo. Los pacientes diabéticos tienen entre un 15% y un 25% de posibilidades de desarrollar una úlcera a lo largo de su vida. El proceso de curación de estas heridas crónicas se encuentra entorpecido debido a una pérdida del equilibrio en el mecanismo fisiológico de estos pacientes en comparación con aquellos sanos. El objetivo de esta revisión sistemática es investigar y evaluar la eficacia de las diferentes alterativas de tratamiento para estimular el proceso de cicatrización y reepitelización de úlceras en pie diabético. Metodología. Para la realización de esta revisión sistemática se ha realizado una búsqueda bibliográfica en cuatro bases de datos: Pubmed, Scopus, Cinahl y Medline, extrayendo de ellas los resultados más relevantes y aquellos que estén bajo evidencia científica. Con el fin de que los resultados fuesen lo más actualizados posibles, se estableció entre ellas el filtro de recoger artículos publicados en los últimos 5 años. Además, se emplearon térmicos MeSH y DeCS para facilitar la búsqueda mediante palabras clave. Finalmente, un total de 11 artículos fueron incluidos para la realización de esta revisión sistemática. Resultados. Existe evidencia científica de la eficacia de diversos tipos de tratamientos que favorecen la cicatrización de úlceras diabéticas, entre los que podemos destacar la terapia de presión negativa, la fotobiomodulación y la oxigenoterapia. Otras opciones terapéuticas más innovadoras que también tienen efectos positivos en este proceso fisiológico es el uso de factores de crecimiento, células madre, plasma rico en plaquetas y el empleo de apósitos elaborados con nanomateriales como la plata. Conclusión. Las distintas alternativas terapéuticas presentadas han demostrado tener éxito en esta etapa y dar así una esperanza de curación en estas heridas crónicas de tan difícil manejo. A pesar de ello, es necesario seguir investigando en ellas para concretar en mayor medida sus parámetros de aplicación y su relación coste-e

44 p. -- Bibliogr.: p. 24-28, Introducción: Las heridas crónicas suponen un problema de salud importante a nivel global, por la repercusión psicosocial que tienen a nivel del individuo que la padece, así como por el gran gasto sanitario asociado. El Plasma Rico en Plaquetas (PRP), es un compuesto rico en factores de crecimiento, que podría ser una terapia eficaz en aquellas heridas crónicas que no se resuelven con el tratamiento convencional. Objetivo: Analizar la efectividad del PRP autólogo como tratamiento local de heridas crónicas. Metodología: Se realizó una revisión crítica de la literatura. En primer lugar, se extrajeron palabras clave como Platelet Rich Plasma”; “Platelet Derived Growth factor”; “Wound chronic”;” Diabetic Foot”; “Foot Ulcer”; “Varicose Ulcer”;” Venous ulcer”; “Pressure Ulcer”;” Ulcer”; “Skin Ulcer”. Posteriormente, se revisaron las bases de datos de Medline, Cinhal, Cuiden, Lillacs y Cochrane y se realizó una búsqueda manual en science direct, springer link. Resultados: Para dar respuesta al objetivo se seleccionaron 17 artículos: 8 ECAS, 5 estudios cuasi-experimentales, 3 ensayos observacionales y 1 revisión sistemática. De dichos estudios se analizaron las siguientes categorías: reducción de área de la herida crónica, tasa de cicatrización completa, tiempo de cicatrización y dolor. Conclusiones: El uso de PRP en la cura de heridas crónicas parece tener un efecto positivo en la reducción del área de la herida crónica y el tiempo de cicatrización. Aun así, la gran variabilidad en cuanto al tamaño de la lesión y metodología de obtención y aplicación del PRP, entre otros, dificulta la extracción de conclusiones firmes, haciendo necesario la realización de nuevos estudios clínicos de mayor consistencia para determinar la efectividad del PRP

56 p. -- Bibliogr.: p. 23-25, Nuestro sistema sanitario debe hacer frente, desde las últimas décadas, a los problemas de salud derivados del aumento de la esperanza de vida, como, por ejemplo, la diabetes y sus complicaciones. En concreto, el pie diabético supone una gran cantidad de recursos al sistema sanitario, y por ello, se buscan nuevas vías de tratamiento, entre ellas, la oxigenoterapia hiperbárica. Este tratamiento pretende favorecer la revascularización, reduciendo la hipoxia de los tejidos, y por tanto, favorecer la curación de la úlcera. Por medio de mi TFG (trabajo de fin de grado) trato de analizar la eficacia de la terapia de oxigenación hiperbárica en la curación de las úlceras del pie diabético. Para ello, realicé una búsqueda bibliográfica, de los últimos 10 años, en diversas fuentes: Medline Ovid, Cinahl, Dialnet, CoChrane, Cuiden y ResearchGate. Utilicé palabras clave como “Diabetic Foot”, “Ulcer” “Hyperbaric oxygenation”, “Wound Healing” … Tras la revisión, procedí a realizar una lectura crítica de 15 artículos para esclarecer los beneficios de la terapia de oxigenación hiperbárica sobre las úlceras del pie diabético. Una vez realizada la lectura crítica y analizar los resultados, se puede determinar que la terapia de oxigenación hiperbárica mejora la tasa de curación del pie diabético, reduciendo el tamaño y profundidad de la úlcera. Además, reduce la tasa de amputación y mejora la glucemia y el estado inflamatorio, lo que repercute en una mejora subjetiva de la calidad de vida de los pacientes.

Background and Aim: The most commonly used diagnostic instrument to detect inflammation of an ileal pouch-anal anastomosis (IPAA) is the 18-point Pouchitis Disease Activity Index (PDAI). A total PDAI score of >= 7 or a modified PDAI (mPDAI) score of >= 5 is considered diagnostic for pouchitis. The consistency of scoring between endoscopists using the PDAI is poor, likely owing to the variable interrater reliability of the endoscopic components of the score; therefore, alternative scoring systems have been proposed.We aimed to assess the interrater reliability of endoscopic findings and compare the diagnostic utility of a simpler version of the PDAI. Method(s): We conducted a prospective, observational study at a single tertiary center. Consecutive patients with an IPAA were recruited. Clinical, endoscopic, and histological data were collected. Pouchoscopies occurred a median of 37 days after clinical review and were reviewed by two experienced gastroenterologists, while biopsies were reviewed by a single pathologist, all of whom were blinded to the clinical history. We assessed the interrater reliability and diagnostic performance of three disease activity scores: the traditional PDAI; a proposed alternative score combined with clinical PDAI; and a simplified PDAI (sPDAI), which uses only PDAI endoscopy items with at least high-moderate interrater reliability (Cohen's kappa >= 0.5). Interrater reliability was assessed by calculating observed agreement and Cohen's kappa coefficient. Diagnostic performance was analyzed using receiver operator characteristic (ROC) analysis. Result(s): A total of 35 patients (mean age, 52 years; 72% male) underwent a pouchoscopy. All had a J pouch. The mean age of the pouches was 12.8 years (1-27). Seven patients had a normal pouch, 13 had antibiotic-responsive pouchitis, eight had antibiotic-dependent pouchitis, three had antibiotic-refractory pouchitis, and three had Crohn's disease of the pouch. Of the PDAI endoscopic components, onl

Background and Aim: The most commonly used diagnostic instrument to detect inflammation of an ileal pouch-anal anastomosis (IPAA) is the 18-point Pouchitis Disease Activity Index (PDAI). A total PDAI score of >= 7 or a modified PDAI (mPDAI) score of >= 5 is considered diagnostic for pouchitis. The consistency of scoring between endoscopists using the PDAI is poor, likely owing to the variable interrater reliability of the endoscopic components of the score; therefore, alternative scoring systems have been proposed.We aimed to assess the interrater reliability of endoscopic findings and compare the diagnostic utility of a simpler version of the PDAI. Method(s): We conducted a prospective, observational study at a single tertiary center. Consecutive patients with an IPAA were recruited. Clinical, endoscopic, and histological data were collected. Pouchoscopies occurred a median of 37 days after clinical review and were reviewed by two experienced gastroenterologists, while biopsies were reviewed by a single pathologist, all of whom were blinded to the clinical history. We assessed the interrater reliability and diagnostic performance of three disease activity scores: the traditional PDAI; a proposed alternative score combined with clinical PDAI; and a simplified PDAI (sPDAI), which uses only PDAI endoscopy items with at least high-moderate interrater reliability (Cohen's kappa >= 0.5). Interrater reliability was assessed by calculating observed agreement and Cohen's kappa coefficient. Diagnostic performance was analyzed using receiver operator characteristic (ROC) analysis. Result(s): A total of 35 patients (mean age, 52 years; 72% male) underwent a pouchoscopy. All had a J pouch. The mean age of the pouches was 12.8 years (1-27). Seven patients had a normal pouch, 13 had antibiotic-responsive pouchitis, eight had antibiotic-dependent pouchitis, three had antibiotic-refractory pouchitis, and three had Crohn's disease of the pouch. Of the PDAI endoscopic components, onl

Background: Antimicrobial resistance (AMR) is one of the most serious health threats globally. The development of new antimicrobials is not keeping pace with the evolution of resistant microorganisms, and novel ways of tackling this problem are required. One of such initiatives has been the development of antimicrobial stewardship programmes (AMS). The use of wound dressings that employ a physical sequestration and retention approach to reduce bacterial burden offers a novel approach to support AMS. Bacterial-binding by dressings and their physical removal can minimise their damage and prevent the release of harmful endotoxins. Objective: To highlight AMS to promote the correct use of antimicrobials and to investigate how dialkylcarbamyl chloride (DACC)-coated dressings can support AMS. Method: MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar were searched to identify articles relating to AMS, and the use of wound dressings in the prevention and treatment of wound infections. The evidence supporting alternative wound dressings that can reduce bioburden and prevent wound infection in a way that does not kill or damage the microorganisms were reviewed. Results: The evidence demonstrated that using bacterial-binding wound dressings that act in a physical manner (eg, DACC-coated dressings) to preventing infection in both acute and hard-to-heal wounds does not exacerbate AMR and supports AMS. Conclusion: Some wound dressings work via a mechanism that promotes the binding and physical sequestration and removal of intact microorganisms from the wound bed (eg, a wound dressing that uses DACC technology to prevent/reduce infection). They provide a valuable tool that aligns with the requirements of AMS by effectively reducing wound bioburden without inducing/selecting for resistant bacteria. CONFLICT OF INTEREST This study was funded by an Educational Grant from ABIGO Medical AB, Sweden. The authors have no other conflicts of interest to declare.

Background: Traditionally, infections are treated with antimicrobials (for example, antibiotics, antiseptics, etc), but antimicrobial resistance (AMR) has become one of the most serious health threats of the 21st century (before the emergence of COVID-19). Wounds can be a source of infection by allowing unconstrained entry of microorganisms into the body, including antimicrobial-resistant bacteria. The development of new antimicrobials (particularly antibiotics) is not keeping pace with the evolution of resistant microorganisms and novel ways of addressing this problem are urgently required. One such initiative has been the development of antimicrobial stewardship (AMS) programmes, which educate healthcare workers, and control the prescribing and targeting of antimicrobials to reduce the likelihood of AMR. Of great importance has been the European Wound Management Association (EWMA) in supporting AMS by providing practical recommendations for optimising antimicrobial therapy for the treatment of wound infection. The use of wound dressings that use a physical sequestration and retention approach rather than antimicrobial agents to reduce bacterial burden offers a novel approach that supports AMS. Bacterial-binding by dressings and their physical removal, rather than active killing, minimises their damage and hence prevents the release of damaging endotoxins. Aim: Our objective is to highlight AMS for the promotion of the judicious use of antimicrobials and to investigate how dialkylcarbamoyl chloride (DACC)-coated dressings can support AMS goals. Method: MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar were searched to identify published articles describing data relating to AMS, and the use of a variety of wound dressings in the prevention and/or treatment of wound infections. The evidence supporting alternative wound dressings that can reduce bioburden and prevent and/or treat wound infection in a manner that does not kill or damage the microo

44 p. -- Bibliogr.: p. 24-28, Introducción: Las heridas crónicas suponen un problema de salud importante a nivel global, por la repercusión psicosocial que tienen a nivel del individuo que la padece, así como por el gran gasto sanitario asociado. El Plasma Rico en Plaquetas (PRP), es un compuesto rico en factores de crecimiento, que podría ser una terapia eficaz en aquellas heridas crónicas que no se resuelven con el tratamiento convencional. Objetivo: Analizar la efectividad del PRP autólogo como tratamiento local de heridas crónicas. Metodología: Se realizó una revisión crítica de la literatura. En primer lugar, se extrajeron palabras clave como Platelet Rich Plasma”; “Platelet Derived Growth factor”; “Wound chronic”;” Diabetic Foot”; “Foot Ulcer”; “Varicose Ulcer”;” Venous ulcer”; “Pressure Ulcer”;” Ulcer”; “Skin Ulcer”. Posteriormente, se revisaron las bases de datos de Medline, Cinhal, Cuiden, Lillacs y Cochrane y se realizó una búsqueda manual en science direct, springer link. Resultados: Para dar respuesta al objetivo se seleccionaron 17 artículos: 8 ECAS, 5 estudios cuasi-experimentales, 3 ensayos observacionales y 1 revisión sistemática. De dichos estudios se analizaron las siguientes categorías: reducción de área de la herida crónica, tasa de cicatrización completa, tiempo de cicatrización y dolor. Conclusiones: El uso de PRP en la cura de heridas crónicas parece tener un efecto positivo en la reducción del área de la herida crónica y el tiempo de cicatrización. Aun así, la gran variabilidad en cuanto al tamaño de la lesión y metodología de obtención y aplicación del PRP, entre otros, dificulta la extracción de conclusiones firmes, haciendo necesario la realización de nuevos estudios clínicos de mayor consistencia para determinar la efectividad del PRP

56 p. -- Bibliogr.: p. 23-25, Nuestro sistema sanitario debe hacer frente, desde las últimas décadas, a los problemas de salud derivados del aumento de la esperanza de vida, como, por ejemplo, la diabetes y sus complicaciones. En concreto, el pie diabético supone una gran cantidad de recursos al sistema sanitario, y por ello, se buscan nuevas vías de tratamiento, entre ellas, la oxigenoterapia hiperbárica. Este tratamiento pretende favorecer la revascularización, reduciendo la hipoxia de los tejidos, y por tanto, favorecer la curación de la úlcera. Por medio de mi TFG (trabajo de fin de grado) trato de analizar la eficacia de la terapia de oxigenación hiperbárica en la curación de las úlceras del pie diabético. Para ello, realicé una búsqueda bibliográfica, de los últimos 10 años, en diversas fuentes: Medline Ovid, Cinahl, Dialnet, CoChrane, Cuiden y ResearchGate. Utilicé palabras clave como “Diabetic Foot”, “Ulcer” “Hyperbaric oxygenation”, “Wound Healing” … Tras la revisión, procedí a realizar una lectura crítica de 15 artículos para esclarecer los beneficios de la terapia de oxigenación hiperbárica sobre las úlceras del pie diabético. Una vez realizada la lectura crítica y analizar los resultados, se puede determinar que la terapia de oxigenación hiperbárica mejora la tasa de curación del pie diabético, reduciendo el tamaño y profundidad de la úlcera. Además, reduce la tasa de amputación y mejora la glucemia y el estado inflamatorio, lo que repercute en una mejora subjetiva de la calidad de vida de los pacientes.

Introduktion: Antimikrobiell resistens är en av de stora utmaningarna för folkhälsan i världen. Enligt synsättet One Health är kunskap viktig för att antibiotikaresistens ska kunna bromsas. I Sverige finns en låg men dock tilltagande förekomst av multiresistenta bakterier. Tidigare studier visa att personer som är bärare av multiresistenta bakterier upplever okunskap och otillräckligt och inadekvat bemötande, främst bland hälso- och sjukvårdspersonal. Sår är en riskfaktor för Meticillinresistenta Staphylococcus aureus MRSA, Extended spectrum betalactamase ESBL, Extended spectrum beta-lactamase ESBL-CARBA och Vancomycinresistenta enterokocker VRE. Syfte: Att beskriva hur personer som har sår och som har smittats av någon typ av multiresistent bakterie upplever bemötandet från sin omgivning på grund av smitta. Metod: En kvalitativ intervjustudie med induktiv ansats. Åtta semistrukturerade intervjuer genomfördes med studiedeltagare som hade svårläkta sår och som var bärare av en eller flera multiresistenta bakterier. Resultat: Den kvalitativa innehållsanalysen visade två övergripande teman: Bemötande från omgivningen och Bärarskap av multiresistenta bakterier påverkar omgivningen. Kategorierna för temat Bemötande från omgivningen var: Bemötande av hälso- och sjukvård; Bemötande från familj och vänner och Bemötande från övriga i samhället. Kategorierna till Bärarskap av multiresistenta bakterier påverkar omgivningen var: Överkonsumtion av skyddsutrustning; Personer som är bärare av multiresistenta bakterier har ett eget ansvar mot sin omgivningoch Samhällets ansvar för information om multiresistenta bakterier. Slutsats: De flesta av studiedeltagarna upplever att de blev bra bemötta eller att reaktion saknades från omgivningen, dock förekom det enstaka situationer där multiresistensen påverkade bemötandet. Det fanns en kunskapsbrist, både hos de personer som är bärare av multiresistenta bakterier och från omgivningen., Introduction: Antimicrobial resistance is a major challenge for public health globally. Out of a One Health approach, knowledge is important for slowing down spread of antibiotic resistance. In Sweden, the prevalence of multi-resistant bacteria is low but, however, is increasing. Previous studies show that people who are carrier of multi-resistant bacteria perceive lack of knowledge and incompetent and inadequate encountering mainly with health care professionals. Ulcer is risk factor for Methicillin-resistant Staphylococcus aureus, Extended-Spectrum-Beta-Lactamase, Extended-Spectrum-Beta-Lactamase- Carba and Vancomycin-resistant Enterococcus. Aim: To describe how people who have been infected by some type of multi-resistant bacteria experience the treatment from their surroundings due to infection. Method: A qualitative content analysis with inductive approach. Eight semistructured interviews were conducted with patients who had ulcer and were carriers of one och more multi-resistant bacteria. Results: The qualitative content analysis showed two overarching themes: Treatment from the enviroment and Carrier of multi-resistant bacteriaaffect the enviroment. The categories for the theme Treatment from the enviroment were: Treatment from health care; Treatment from family and friends and Treatment from others in the community. The categories for Carrier of multi-resistant bacteria affect the enviroment were Overconsumption of protective equipment; People who are carrier of multi-resistant bacteria have a responsibility for the environment and Society’s responsibility for information on multi-resistant bacteria. Conclusion: Most of the study participants felt that they were treated well or that there was no reaction from the environment, however, there were occasional situations when the multi-resistance affected the treatment. There was at lack of knowledge, both among the people who are carriers of multi-resistant bacteria and from the enviroment.

Introduktion: Antimikrobiell resistens är en av de stora utmaningarna för folkhälsan i världen. Enligt synsättet One Health är kunskap viktig för att antibiotikaresistens ska kunna bromsas. I Sverige finns en låg men dock tilltagande förekomst av multiresistenta bakterier. Tidigare studier visa att personer som är bärare av multiresistenta bakterier upplever okunskap och otillräckligt och inadekvat bemötande, främst bland hälso- och sjukvårdspersonal. Sår är en riskfaktor för Meticillinresistenta Staphylococcus aureus MRSA, Extended spectrum betalactamase ESBL, Extended spectrum beta-lactamase ESBL-CARBA och Vancomycinresistenta enterokocker VRE. Syfte: Att beskriva hur personer som har sår och som har smittats av någon typ av multiresistent bakterie upplever bemötandet från sin omgivning på grund av smitta. Metod: En kvalitativ intervjustudie med induktiv ansats. Åtta semistrukturerade intervjuer genomfördes med studiedeltagare som hade svårläkta sår och som var bärare av en eller flera multiresistenta bakterier. Resultat: Den kvalitativa innehållsanalysen visade två övergripande teman: Bemötande från omgivningen och Bärarskap av multiresistenta bakterier påverkar omgivningen. Kategorierna för temat Bemötande från omgivningen var: Bemötande av hälso- och sjukvård; Bemötande från familj och vänner och Bemötande från övriga i samhället. Kategorierna till Bärarskap av multiresistenta bakterier påverkar omgivningen var: Överkonsumtion av skyddsutrustning; Personer som är bärare av multiresistenta bakterier har ett eget ansvar mot sin omgivningoch Samhällets ansvar för information om multiresistenta bakterier. Slutsats: De flesta av studiedeltagarna upplever att de blev bra bemötta eller att reaktion saknades från omgivningen, dock förekom det enstaka situationer där multiresistensen påverkade bemötandet. Det fanns en kunskapsbrist, både hos de personer som är bärare av multiresistenta bakterier och från omgivningen., Introduction: Antimicrobial resistance is a major challenge for public health globally. Out of a One Health approach, knowledge is important for slowing down spread of antibiotic resistance. In Sweden, the prevalence of multi-resistant bacteria is low but, however, is increasing. Previous studies show that people who are carrier of multi-resistant bacteria perceive lack of knowledge and incompetent and inadequate encountering mainly with health care professionals. Ulcer is risk factor for Methicillin-resistant Staphylococcus aureus, Extended-Spectrum-Beta-Lactamase, Extended-Spectrum-Beta-Lactamase- Carba and Vancomycin-resistant Enterococcus. Aim: To describe how people who have been infected by some type of multi-resistant bacteria experience the treatment from their surroundings due to infection. Method: A qualitative content analysis with inductive approach. Eight semistructured interviews were conducted with patients who had ulcer and were carriers of one och more multi-resistant bacteria. Results: The qualitative content analysis showed two overarching themes: Treatment from the enviroment and Carrier of multi-resistant bacteriaaffect the enviroment. The categories for the theme Treatment from the enviroment were: Treatment from health care; Treatment from family and friends and Treatment from others in the community. The categories for Carrier of multi-resistant bacteria affect the enviroment were Overconsumption of protective equipment; People who are carrier of multi-resistant bacteria have a responsibility for the environment and Society’s responsibility for information on multi-resistant bacteria. Conclusion: Most of the study participants felt that they were treated well or that there was no reaction from the environment, however, there were occasional situations when the multi-resistance affected the treatment. There was at lack of knowledge, both among the people who are carriers of multi-resistant bacteria and from the enviroment.

Background: Tamoxifen is selective estrogen receptor modulators, used in treatment of breast cancer; some literatures reported its impact on the process of peroxidation. Aim: This study was aimed to evaluate the effect of tamoxifen on ethanol induced gastric ulcer in rats. Method: Gastric ulcers were induced in Wistar albino rats by oral administration of absolute alcohol (1 ml/200 gm). Antiulcer activity of tamoxifen (0.5 and 10 mg/kg, p.o.) was observed and compared to standard drug (omeprazole 20mg/kg, p.o.), the ulcer index, ulcers numbers, lengths, gastric volume and total gastric acidity were evaluated. Histopathology is performed for confirmation. Results: tamoxifen in 10mg/kg dose produced a highly significant (P<0.001) decrease in ulcer parameters studied compared to ulcer control. While 0.5mg/kg of tamoxifen produced less significant (P<0.01) effect on gastric volume when compared to ulcer group. The anti-ulcer effects of the drug of interest is highly comparable to omeprazole was very, surprisingly; the higher dose of tamoxifen produced even a much significant reduction in gastric volume and ulcers length compared to standard drug. Conclusion: Tamoxifen shows significant antiulcer activity against ethanol induced gastric ulcers, and this could possibly related to its antioxidant properties.

Background: Tamoxifen is selective estrogen receptor modulators, used in treatment of breast cancer; some literatures reported its impact on the process of peroxidation. Aim: This study was aimed to evaluate the effect of tamoxifen on ethanol induced gastric ulcer in rats. Method: Gastric ulcers were induced in Wistar albino rats by oral administration of absolute alcohol (1 ml/200 gm). Antiulcer activity of tamoxifen (0.5 and 10 mg/kg, p.o.) was observed and compared to standard drug (omeprazole 20mg/kg, p.o.), the ulcer index, ulcers numbers, lengths, gastric volume and total gastric acidity were evaluated. Histopathology is performed for confirmation. Results: tamoxifen in 10mg/kg dose produced a highly significant (P<0.001) decrease in ulcer parameters studied compared to ulcer control. While 0.5mg/kg of tamoxifen produced less significant (P<0.01) effect on gastric volume when compared to ulcer group. The anti-ulcer effects of the drug of interest is highly comparable to omeprazole was very, surprisingly; the higher dose of tamoxifen produced even a much significant reduction in gastric volume and ulcers length compared to standard drug. Conclusion: Tamoxifen shows significant antiulcer activity against ethanol induced gastric ulcers, and this could possibly related to its antioxidant properties.

Introduction:Traumatic ulcerative granuloma with stromal eosinophilia is an uncommon condition of the oral mucosa with a chronic course, usually affecting the tongue. Case Report: Clinically it presents as a chronic ulcer, with raised and indurated borders, rarely presented as a tumor. Histologically it shows a diffuse mixed inflammatory infiltrate, rich in eosinophils. The etiology of this lesion is still unclear; however, chronic irritation from traumatic agents is considered a major initiating factor. In some cases, the presence of CD30+ mononuclear cells within the lesions suggest the possibility of a CD30+ lymphoproliferative disorder. This article presents a case of a traumatic ulcerative granuloma with stromal eosinophilia manifested in a 56-year-old female with a solitary ulcerated tumor inside the right cheek. Conclusion: It was diagnosed based on clinical data and histopathological features. In a brief literature review, the entity has been characterized, analyzing its etiology and nature., Introducción: El granuloma ulcerativo traumático con eosinofilia estromal es una afección infrecuente de la mucosa oral de curso crónico, que suele afectar a la lengua. Reporte del Caso: Clínicamente se presenta como una úlcera crónica, con bordes elevados e indurados, rara vez se presenta como un tumor. Histológicamente muestra un infiltrado inflamatorio mixto difuso, rico en eosinófilos. La etiología de esta lesión aún no está clara; sin embargo, la irritación crónica por agentes traumáticos se considera un factor de iniciación importante. En algunos casos, la presencia de células mononucleares CD30+ dentro de las lesiones sugiere la posibilidad de un trastorno linfoproliferativo CD30+. En este artículo se presenta el caso de un granuloma ulcerativo traumático con eosinofilia estromal que se manifiesta en una mujer de 56 años con un tumor ulcerado solitario en el interior de la mejilla derecha. Conclusión: Se diagnosticó con base en datos clínicos y características histopatológicas. En una breve revisión de la literatura se ha caracterizado la entidad, analizando su etiología y naturaleza.

Malignant changes arising on the previously traumatized or chronically inflamed skin are defined as Marjolin ulcers. They can develop on many different lesions but frequently they are detected on burn scars. Histopathologically, Marjolin ulcers are mostly diagnosed as squamous cell carcinoma and they need special attention when especially located on the lower extremities. In this study, 63 patients treated for Marjolin ulcers between January 2000 and March 2015 were evaluated according to etiology, histological differentiation, primary tumor size, patient age and anatomical localization. Medical records of these patients were reviewed retrospectively. Mean age was 49.7 years. Average interval between the first injury and carcinoma development was 37.9 years. Most frequent etiologic factor was burn scars with 82.5%. Foot was the most frequently affected site with 28.6% and scalp was the second most frequent localization with 25.4%. Squamous cell carcinomas were detected in 88.9% of the patients and basal cell carcinomas were detected in 11.1% of the patients. For treatment, excision and grafting was performed for 48 patients (76.2%), excision and local flaps were used for 10 patients (15.9%) and excision and free flaps were used for five patients (7.9%). Regional lymph node dissection was performed for 12 patients (19%). Average follow up period was 46.5 months. Local recurrences were detected in nine patients (14.3%). In conclusion, Marjolin ulcers are aggressive tumors that require special care. In order to prevent life threatening sequelas of this entity, it is important to know basic aspects of clinical progress, prognostic factors and treatment modalities. Copyright (C) 2017, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.

Malignant changes arising on the previously traumatized or chronically inflamed skin are defined as Marjolin ulcers. They can develop on many different lesions but frequently they are detected on burn scars. Histopathologically, Marjolin ulcers are mostly diagnosed as squamous cell carcinoma and they need special attention when especially located on the lower extremities. In this study, 63 patients treated for Marjolin ulcers between January 2000 and March 2015 were evaluated according to etiology, histological differentiation, primary tumor size, patient age and anatomical localization. Medical records of these patients were reviewed retrospectively. Mean age was 49.7 years. Average interval between the first injury and carcinoma development was 37.9 years. Most frequent etiologic factor was burn scars with 82.5%. Foot was the most frequently affected site with 28.6% and scalp was the second most frequent localization with 25.4%. Squamous cell carcinomas were detected in 88.9% of the patients and basal cell carcinomas were detected in 11.1% of the patients. For treatment, excision and grafting was performed for 48 patients (76.2%), excision and local flaps were used for 10 patients (15.9%) and excision and free flaps were used for five patients (7.9%). Regional lymph node dissection was performed for 12 patients (19%). Average follow up period was 46.5 months. Local recurrences were detected in nine patients (14.3%). In conclusion, Marjolin ulcers are aggressive tumors that require special care. In order to prevent life threatening sequelas of this entity, it is important to know basic aspects of clinical progress, prognostic factors and treatment modalities. Copyright (C) 2017, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.