Search

On March 11, 2020, the WHO has declared the coronavirus disease 2019 (COVID-19) a global pandemic. As the last few months have profoundly changed the delivery of health care in the world, we should recognize the effort of numerous comprehensive cancer centers to share experiences and knowledge to develop best practices to care for oncological patients during the COVID-19 pandemic. Patients as well as physicians must be aware of all these constraints and profound social, personal, and medical challenges posed by the tackling of this deadly disease in everyday life in order to adjust to such a completely novel scenario. This review will discuss facing the challenges and the current approaches that cancer centers in Italy and United States are adopting in order to cope with clinical and research activities. [ABSTRACT FROM AUTHOR]

Aim: To report the case of a 49-year-old female patient diagnosed with systemic scleroderma, with healing of bilateral plantar ulcerations by the use of negative pressure therapy. Methods: The anamnesis and clinical examination revealed chronic bilateral, intensely painful plantar ulcerations, with local signs of infection, progressing for 9 months, with a recent rapid extension in size and depth. The presence of Raynaud's phenomenon, sclerodactyly, and post-ulcerative digital cicatricial lesions on the hands, Mauskopf facies, positivity of anti-SCL70+ antibodies, and histopathological examination established the diagnosis of systemic scleroderma. Arterial and venous Doppler ultrasound examination of the lower limbs revealed femoral vascular axes stenosis and the presence of distal popliteal and interdigital flows. Wound bacteriological examination was positive for Staphylococcus aureus and Streptococcus agalactiae. Results/ Discussion: Therapeutic management was complex by systemic treatment (antibiotics, alprostadil as vasodilator) and local therapy (surgical debridement, topical antiseptics, modern dressings, negative pressure wound therapy). The evolution was favorable with complete wound healing within 3 weeks. Conclusion: Negative pressure therapy has proven to be beneficial in healing plantar chronic ulcers in a systemic sclerosis patient by: diminishing pain, removing the exudate, stimulating the development of granulation tissue, and maintaining a sterile optimal local environment throughout the whole healing process. There is little information in the scientific literature about the usefulness of negative pressure therapy in healing skin ulcers in patients with systemic scleroderma. This work was supported by a grant of the Ministry of Research, Innovation and Digitization, CNCS/CCCDI -- UEFISCDI, project number PN-III-P1-1.1-PD-2019-1225, within PNCDI III. [ABSTRACT FROM AUTHOR]