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Efteli E, Çömez S. Effects of Web-Assisted Education on Nursing Students' Pressure Injury Knowledge Levels. Adv Skin Wound Care 2024; 37:1-5. [PMID: 38506585 DOI: 10.1097/asw.0000000000000116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To investigate the effect of web-assisted education on the pressure injury knowledge levels of nursing students. METHODS The study was conducted with 106 first-year students in the Nursing Department. Those who received both web-assisted education and conventional education were assigned to the experimental group, and those who received only conventional education were assigned to the control group. The authors used arithmetic mean, percentages, Student t test, and χ2 test to analyze the data. RESULTS The rate of the correct responses given to the questions by the students was 97.55% in the experimental group and 85.15% in the control group. The comparison of the mean number of correct answers revealed a statistically significant difference between the two groups. CONCLUSIONS The authors conclude that the web-supported education given to nursing students in addition to the conventional education positively contributed to their learning level.
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Affiliation(s)
- Elçin Efteli
- In the Faculty of Health Sciences, Mehmet Akif Ersoy University, Burdur, Turkey, Elçin Efteli, PhD, RN, and Saadet Çömez, PhD, RN, are Assistant Professors
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2
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Cavalcante-Silva J, Koh TJ. Targeting the NOD-Like Receptor Pyrin Domain Containing 3 Inflammasome to Improve Healing of Diabetic Wounds. Adv Wound Care (New Rochelle) 2023; 12:644-656. [PMID: 34841901 PMCID: PMC10701516 DOI: 10.1089/wound.2021.0148] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/08/2021] [Indexed: 12/21/2022] Open
Abstract
Significance: Chronic skin wounds are a significant health problem around the world, often leading to amputation and even death. Although persistent inflammation is a hallmark of these poorly healing wounds, few available therapies have been designed to target inflammation. In this review, we summarize available evidence of the role of the NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome in impaired wound healing and describe strategies to inhibit the inflammasome to improve wound healing. Recent Advances: The NLRP3 inflammasome plays an important physiological role in skin wound healing, during which transient inflammasome activity contributes to both epidermal and dermal healing. In contrast, sustained activity of the NLRP3 inflammasome leads to impaired epidermal and dermal healing associated with diabetes. Of importance, preclinical studies have demonstrated that inhibiting the NLRP3 inflammasome-induced resolution of inflammation, increased granulation tissue formation and collagen deposition, and accelerated reepithelialization and wound closure. Critical Issues: NLRP3 inflammasome inhibitors have appealing potential for translation into therapies for chronic wounds. Although preclinical studies have shown promising results, there is a need for human/clinical studies to evaluate dosing formulations, potential therapeutic effects, dose-response relationships, and possible side effects. Future Directions: Among strategies to inhibit the NLRP3 inflammasome, glyburide, metformin, peroxisome proliferator-activated receptor agonists, and the dipeptidyl peptidase 4 inhibitor saxagliptin appear to be closest to clinical translation, as these drugs are already Food and Drug Administration approved for other indications. Future clinical studies are needed to develop topical formulations of these drugs, and to assess the safety and efficacy of these inhibitors, to improve healing of chronic wounds.
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Affiliation(s)
- Jacqueline Cavalcante-Silva
- Center for Wound Healing and Tissue Regeneration; University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Kinesiology and Nutrition; University of Illinois at Chicago, Chicago, Illinois, USA
| | - Timothy J. Koh
- Center for Wound Healing and Tissue Regeneration; University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Kinesiology and Nutrition; University of Illinois at Chicago, Chicago, Illinois, USA
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3
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Han L, Pei J, Tao H, Guo X, Wei Y, Yang Z, Zhang H. The potential role of ferroptosis in the physiopathology of deep tissue injuries. Int Wound J 2023; 21:e14466. [PMID: 37905685 PMCID: PMC10828531 DOI: 10.1111/iwj.14466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/15/2023] [Indexed: 11/02/2023] Open
Abstract
Deep tissue injuries (DTIs) are a serious type of pressure injuries that mainly occur at the bony prominences and can develop rapidly, making prevention and treatment more difficult. Although consistent research efforts have been made over the years, the cellular and molecular mechanisms contributing to the development of DTIs remain unclear. More recently, ferroptosis, a novel regulatory cell death (RCD) type, has been identified that is morphological, biochemical and genetic criteria distinct from apoptosis, autophagy and other known cell death pathways. Ferroptosis is characterized by iron overload, iron-dependent lipid peroxidation and shrunken mitochondria. We also note that some of the pathological features of DTI are known to be key features of the ferroptosis pathway. Numerous studies have confirmed that ferroptosis may be involved in chronic wounds, including DTIs. Here, we elaborate on the basic pathological features of ferroptosis. We also present the evidence that ferroptosis is involved in the pathology of DTIs and highlight a future perspective on this emerging field, desiring to provide more possibilities for the prevention and treatment of DTIs.
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Affiliation(s)
- Lin Han
- Department of NursingGansu Provincial HospitalLanzhouChina
- School of NursingLanzhou UniversityLanzhouChina
| | - Juhong Pei
- The First Clinical Medical CollegeLanzhou UniversityLanzhouChina
| | - Hongxia Tao
- The First Clinical Medical CollegeLanzhou UniversityLanzhouChina
| | | | - Yuting Wei
- School of NursingLanzhou UniversityLanzhouChina
| | - Zhuang Yang
- School of NursingLanzhou UniversityLanzhouChina
| | - Hongyan Zhang
- Department of NursingGansu Provincial HospitalLanzhouChina
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4
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Bourkas AN, Zaman M, Sibbald RG. COVID-19 and Hospital-Acquired Pressure Injuries: A Systematic Review. Adv Skin Wound Care 2023; 36:421-434. [PMID: 37471447 DOI: 10.1097/asw.0000000000000005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To investigate the relationship between COVID-19-related variables and hospital-acquired pressure injury (HAPI) incidence. DATA SOURCES The authors searched four databases: Cochrane, MEDLINE, EMBASE, and CINAHL. The literature search contained key terms such as "COVID-19," "hospital-acquired pressure injuries," "pressure ulcer," "pressure injury," "decubitus ulcer," and "hospitalization." STUDY SELECTION The systematic search of the literature identified 489 publications that matched the inclusion criteria. Articles were included in the review if they were peer-reviewed publications that reported HAPI incidence for patients who were hospitalized and COVID-19 positive. Two reviewers performed the screen simultaneously, and 19 publications were included. DATA EXTRACTION Two reviewers followed a standardized extraction form that included study and patient characteristics, COVID-19 status, HAPI characteristics, prone positioning, length of hospitalization, and HAPI prevention and treatment strategies. DATA SYNTHESIS The authors carried out a narrative synthesis of the extracted data because the data obtained were too heterogeneous for meta-analysis. The primary outcome was HAPI incidence. CONCLUSIONS This review identified that HAPI incidence was high among men who were COVID-19 positive, had longer hospital stays, experienced prone positioning, and had care teams without a skin and wound care expert. Future research should use more robust methodology and focus on quantitative modeling to iteratively improve inpatient HAPI guidelines.
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Affiliation(s)
- Adrienn N Bourkas
- At Queen's University School of Medicine, Kingston, Ontario, Canada, Adrienn N. Bourkas, MSc, and Michele Zaman, MScPH, are Medical Students. R. Gary Sibbald, MD, MEd, FRCPC, FAAD, MAPWCA, JM is Professor, Dalla Lana School of Public Health and Division of Dermatology, Department of Medicine, University of Toronto, Ontario. Acknowledgment: The authors thank the project ECHO Ontario Skin and Wound Team members Andrew Mohan, Reneeka Jaimangal, and Laurie Goodman for their support throughout the project. They also specially thank Queen's University Health Sciences Medical Librarian Abdul K. Pullattayil for his hard work and support during the electronic search process. The authors have disclosed no financial relationships related to this article. Submitted August 3, 2022; accepted in revised form October 4, 2022; published ahead of print January 27, 2023. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website ( www.ASWCjournal.com )
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5
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Xu Z, Dong M, Yin S, Dong J, Zhang M, Tian R, Min W, Zeng L, Qiao H, Chen J. Why traditional herbal medicine promotes wound healing: Research from immune response, wound microbiome to controlled delivery. Adv Drug Deliv Rev 2023; 195:114764. [PMID: 36841332 DOI: 10.1016/j.addr.2023.114764] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/16/2022] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
Impaired wound healing in chronic wounds has been a significant challenge for clinicians and researchers for decades. Traditional herbal medicine (THM) has a long history of promoting wound healing, making them culturally accepted and trusted by a great number of people in the world. However, for a long time, the understanding of herbal medicine has been limited and incomplete, particularly in the allopathic medicine-dominated research system. The therapeutic effects of individual components isolated from THM are found less pronounced compared to synthetic chemical medicine, and the clinical efficacy is always inferior to herbs. In the present article, we review and discuss underlying mechanisms of the skin microbiome involved in the wound healing process; THM in regulating immune responses and commensal microbiome. We additionally propose few pioneer ideas and studies in the development of therapeutic strategies for controlled delivery of herbal medicine. This review aims to promote wound care with a focus on wound microbiome, immune response, and topical drug delivery systems. Finally, future development trends, challenges, and research directions are discussed.
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Affiliation(s)
- Zeyu Xu
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Mei Dong
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Shaoping Yin
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Jie Dong
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Ming Zhang
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Rong Tian
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Wen Min
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; Department of Bone Injury of Traditional Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210004, PR China
| | - Li Zeng
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China
| | - Hongzhi Qiao
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China.
| | - Jun Chen
- Jiangsu Provincial Engineering Research Center of TCM External Medication Development and Application, Nanjing University of Chinese Medicine, Nanjing 210023, PR China; School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, PR China.
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Bourkas AN, Zaman M, Sibbald RG. COVID-19 and Hospital-Acquired Pressure Injuries: A Systematic Review. Adv Skin Wound Care 2023; Publish Ahead of Print:00129334-990000000-00021. [PMID: 36705972 DOI: 10.1097/01.asw.0000919408.20614.61] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To investigate the relationship between COVID-19 related variables and hospital-acquired pressure injuries (HAPI) incidence. DATA SOURCES The authors searched four databases: Cochrane, MEDLINE, EMBASE, and CINAHL. The literature search contained key terms such as COVID-19, hospital-acquired pressure injuries, pressure ulcer, pressure injury, decubitus ulcer, and hospitalization. STUDY SELECTION The systematic search of the literature identified 489 publications that matched the inclusion criteria. This included peer-reviewed publications that reported HAPI incidence for patients who were hospitalized and COVID-19 positive. Two reviewers performed the screen simultaneously and 19 publications were included. DATA EXTRACTION Two reviewers followed a standardized extraction form that included study and patient characteristics, COVID-19 status, HAPI characteristics, prone positioning, length of hospitalization, and HAPI prevention and treatment strategies. DATA SYNTHESIS A narrative synthesis of the extracted data was carried out because the data obtained were too heterogeneous for meta-analysis. The primary outcome was HAPI incidence. CONCLUSIONS This review identified that HAPI incidence was high among men who were COVID-19 positive, had longer hospital stays, experienced prone positioning, and had care teams without a skin and wound care expert. Future research should employ more robust methodology and focus on quantitative modeling to iteratively improve in-patient HAPI guidelines.
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Affiliation(s)
- Adrienn N Bourkas
- At Queen's University School of Medicine, Kingston, Ontario, Canada, Adrienn N. Bourkas, MSc, and Michele Zaman, MScPH, are Medical Students. R. Gary Sibbald, MD, MEd, FRCPC, FAAD is Professor, Dalla Lana School of Public Health and Division of Dermatology, Department of Medicine, University of Toronto, Ontario. Acknowledgment: The authors thank the project ECHO Ontario Skin and Wound Team members Andrew Mohan, Reneeka Jaimangal, and Laurie Goodman for their support throughout the project. They also specially thank Queen's University Health Sciences Medical Librarian Abdul K. Pullattayil for his hard work and support during the electronic search process. The authors have disclosed no financial relationships related to this article. Submitted August 3, 2022; accepted in revised form October 4, 2022
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7
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Lazarus HM, Pitts K, Wang T, Lee E, Buchbinder E, Dougan M, Armstrong DG, Paine R, Ragsdale CE, Boyd T, Rock EP, Gale RP. Recombinant GM-CSF for diseases of GM-CSF insufficiency: Correcting dysfunctional mononuclear phagocyte disorders. Front Immunol 2023; 13:1069444. [PMID: 36685591 PMCID: PMC9850113 DOI: 10.3389/fimmu.2022.1069444] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Endogenous granulocyte-macrophage colony-stimulating factor (GM-CSF), identified by its ability to support differentiation of hematopoietic cells into several types of myeloid cells, is now known to support maturation and maintain the metabolic capacity of mononuclear phagocytes including monocytes, macrophages, and dendritic cells. These cells sense and attack potential pathogens, present antigens to adaptive immune cells, and recruit other immune cells. Recombinant human (rhu) GM-CSF (e.g., sargramostim [glycosylated, yeast-derived rhu GM-CSF]) has immune modulating properties and can restore the normal function of mononuclear phagocytes rendered dysfunctional by deficient or insufficient endogenous GM-CSF. Methods We reviewed the emerging biologic and cellular effects of GM-CSF. Experts in clinical disease areas caused by deficient or insufficient endogenous GM-CSF examined the role of GM-CSF in mononuclear phagocyte disorders including autoimmune pulmonary alveolar proteinosis (aPAP), diverse infections (including COVID-19), wound healing, and anti-cancer immune checkpoint inhibitor therapy. Results We discuss emerging data for GM-CSF biology including the positive effects on mitochondrial function and cell metabolism, augmentation of phagocytosis and efferocytosis, and immune cell modulation. We further address how giving exogenous rhu GM-CSF may control or treat mononuclear phagocyte dysfunction disorders caused or exacerbated by GM-CSF deficiency or insufficiency. We discuss how rhu GM-CSF may augment the anti-cancer effects of immune checkpoint inhibitor immunotherapy as well as ameliorate immune-related adverse events. Discussion We identify research gaps, opportunities, and the concept that rhu GM-CSF, by supporting and restoring the metabolic capacity and function of mononuclear phagocytes, can have significant therapeutic effects. rhu GM-CSF (e.g., sargramostim) might ameliorate multiple diseases of GM-CSF deficiency or insufficiency and address a high unmet medical need.
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Affiliation(s)
- Hillard M. Lazarus
- Department of Medicine, Division of Hematology and Oncology, Case Western Reserve University, Cleveland, OH, United States
| | - Katherine Pitts
- Medical Affairs, Partner Therapeutics, Inc., Lexington, MA, United States
| | - Tisha Wang
- Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Elinor Lee
- Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Elizabeth Buchbinder
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Michael Dougan
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - David G. Armstrong
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Robert Paine
- Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, Salt Lake City, UT, United States
| | | | - Timothy Boyd
- Clinical Development, Partner Therapeutics, Inc., Lexington, MA, United States
| | - Edwin P. Rock
- Clinical Development, Partner Therapeutics, Inc., Lexington, MA, United States
| | - Robert Peter Gale
- Hematology Centre, Department of Immunology and Inflammation, Imperial College, London, United Kingdom
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Raja M, Lopes IC, Vadgama P. A preliminary electrochemical study of crosslinked albumin and collagen membranes as diffusion barriers for potentially degradable chronic wound biosensors. ELECTROCHEMICAL SCIENCE ADVANCES 2022. [DOI: 10.1002/elsa.202100132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Mohammad Raja
- School of Engineering and Materials Science Queen Mary University of London London UK
| | - Ilanna Campelo Lopes
- School of Engineering and Materials Science Queen Mary University of London London UK
- Departamento de Tecnologia Química Centro de Ciências Exatas e Tecnologia Universidade Federal do Maranhão Sao Luis Brazil
| | - Pankaj Vadgama
- School of Engineering and Materials Science Queen Mary University of London London UK
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9
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Zarrintaj P, Ghorbani S, Barani M, Singh Chauhan NP, Khodadadi Yazdi M, Saeb MR, Ramsey JD, Hamblin MR, Mozafari M, Mostafavi E. Polylysine for skin regeneration: A review of recent advances and future perspectives. Bioeng Transl Med 2022; 7:e10261. [PMID: 35111953 PMCID: PMC8780928 DOI: 10.1002/btm2.10261] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/28/2021] [Accepted: 10/03/2021] [Indexed: 12/19/2022] Open
Abstract
There have been several attempts to find promising biomaterials for skin regeneration, among which polylysine (a homopolypeptide) has shown benefits in the regeneration and treatment of skin disorders. This class of biomaterials has shown exceptional abilities due to their macromolecular structure. Polylysine-based biomaterials can be used as tissue engineering scaffolds for skin regeneration, and as drug carriers or even gene delivery vectors for the treatment of skin diseases. In addition, polylysine can play a preservative role in extending the lifetime of skin tissue by minimizing the appearance of photodamaged skin. Research on polylysine is growing today, opening new scenarios that expand the potential of these biomaterials from traditional treatments to a new era of tissue regeneration. This review aims to address the basic concepts, recent trends, and prospects of polylysine-based biomaterials for skin regeneration. Undoubtedly, this class of biomaterials needs further evaluations and explorations, and many critical questions have yet to be answered.
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Affiliation(s)
- Payam Zarrintaj
- School of Chemical EngineeringOklahoma State UniversityStillwaterOklahomaUSA
| | - Sadegh Ghorbani
- Interdisciplinary Nanoscience Center (iNANO)Aarhus UniversityAarhusDenmark
| | - Mahmood Barani
- Medical Mycology and Bacteriology Research CenterKerman University of Medical SciencesKermanIran
| | | | | | - Mohammad Reza Saeb
- Department of Polymer Technology, Faculty of ChemistryGdańsk University of TechnologyGdańskPoland
| | - Joshua D. Ramsey
- School of Chemical EngineeringOklahoma State UniversityStillwaterOklahomaUSA
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health ScienceUniversity of JohannesburgSouth Africa
| | - Masoud Mozafari
- Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in MedicineIran University of Medical SciencesTehranIran
- Present address:
Lunenfeld‐Tanenbaum Research InstituteMount Sinai Hospital, University of TorontoTorontoONCanada.
| | - Ebrahim Mostafavi
- Stanford Cardiovascular InstituteStanford University School of MedicineStanfordCaliforniaUSA
- Department of MedicineStanford University School of MedicineStanfordCaliforniaUSA
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10
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Gomes F, Furtado GE, Henriques M, Sousa LB, Santos-Costa P, Bernardes R, Apóstolo J, Parreira P, Salgueiro-Oliveira A. The skin microbiome of infected pressure ulcers: A review and implications for health professionals. Eur J Clin Invest 2022; 52:e13688. [PMID: 34601718 DOI: 10.1111/eci.13688] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pressure ulcers (PUs) are injuries resulting from ischaemia caused by prolonged compression or shear forces on the skin, adjacent tissues and bones. Advanced stages of PUs are associated with infectious complications and constitute a major clinical challenge, with high social and economic impacts in health care. GOALS This study aims to identify and describe the relationship between PU risk factors, stages and anatomical locations, and the relevance of microbial cohabitation and biofilm growth. METHODS The narrative review method to advocating a critical and objective analysis of the current knowledge on the topic was performed. Indexed databases and direct consultation to specialized and high-impact journals on the subject were used to extract relevant information, guided by co-authors. The Medical Subject Headings of pressure ulcer (or injury), biofilms, infection and other analogues terms were used. RESULTS Development of PUs and consequent infection depends on several direct and indirect risk factors, including cutaneous/PU microbiome, microclimate and behavioural factors. Infected PUs are polymicrobial and characterized by biofilm-associated infection, phenotypic hypervariability of species and inherent resistance to antimicrobials. The different stages and anatomical locations also play an important role in their colonization. The prevention and monitoring of PUs remain crucial for avoiding the emergence of systemic infections and reducing health care-associated costs, improve the quality of life of patients and reduce the mortality-associated infected PUs.
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Affiliation(s)
- Fernanda Gomes
- LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, CEB, Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Guilherme Eustáquio Furtado
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.,Polytechnic Institute of Guarda, Research Unit for Inland Development (UDI), Guarda, Portugal
| | - Mariana Henriques
- LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, CEB, Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Liliana Baptista Sousa
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Paulo Santos-Costa
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Rafael Bernardes
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - João Apóstolo
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Pedro Parreira
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Anabela Salgueiro-Oliveira
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
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11
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Potekaev NN, Borzykh OB, Medvedev GV, Pushkin DV, Petrova MM, Petrov AV, Dmitrenko DV, Karpova EI, Demina OM, Shnayder NA. The Role of Extracellular Matrix in Skin Wound Healing. J Clin Med 2021; 10:jcm10245947. [PMID: 34945243 PMCID: PMC8706213 DOI: 10.3390/jcm10245947] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/30/2022] Open
Abstract
Impaired wound healing is one of the unsolved problems of modern medicine, affecting patients’ quality of life and causing serious economic losses. Impaired wound healing can manifest itself in the form of chronic skin wounds or hypertrophic scars. Research on the biology and physiology of skin wound healing disorders is actively continuing, but, unfortunately, a single understanding has not been developed. The attention of clinicians to the biological and physiological aspects of wound healing in the skin is necessary for the search for new and effective methods of prevention and treatment of its consequences. In addition, it is important to update knowledge about genetic and non-genetic factors predisposing to impaired wound healing in order to identify risk levels and develop personalized strategies for managing such patients. Wound healing is a very complex process involving several overlapping stages and involving many factors. This thematic review focuses on the extracellular matrix of the skin, in particular its role in wound healing. The authors analyzed the results of fundamental research in recent years, finding promising potential for their transition into real clinical practice.
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Affiliation(s)
- Nikolai N. Potekaev
- Department of Skin Disease and Cosmetology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia; (N.N.P.); (E.I.K.); (O.M.D.)
| | - Olga B. Borzykh
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
- Correspondence: (O.B.B.); (N.A.S.); Tel.: +7-(812)-670-02-20-78-14 (N.A.S.)
| | - German V. Medvedev
- Department of Hand Surgery with Microsurgical Equipment, R. R. Vreden National Medical Research Centre for Traumatology and Orthopedics, 195427 Saint Petersburg, Russia;
| | - Denis V. Pushkin
- Medical Faculty, Saint Petersburg State University, 199034 Saint Petersburg, Russia;
| | - Marina M. Petrova
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
| | - Artem V. Petrov
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
| | - Diana V. Dmitrenko
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
| | - Elena I. Karpova
- Department of Skin Disease and Cosmetology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia; (N.N.P.); (E.I.K.); (O.M.D.)
| | - Olga M. Demina
- Department of Skin Disease and Cosmetology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia; (N.N.P.); (E.I.K.); (O.M.D.)
| | - Natalia A. Shnayder
- Shared Core Facilities “Molecular and Cell Technologies”, V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (A.V.P.); (D.V.D.)
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V. M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
- Correspondence: (O.B.B.); (N.A.S.); Tel.: +7-(812)-670-02-20-78-14 (N.A.S.)
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Sianes-Gallén M, Pujol-García AM, Rus García M, Partera Luque C, López Postigo M, Call Mañosa S, Camposo Montesino MC, Ibáñez Touriño B, Ribas Obon E, Segura Rodríguez T, Cores Fuentes P, Tamame Sanantonio M, Jornet-Gibert M. Pressure injuries during the SARS-CoV-2 pandemic: A retrospective, case-control study. J Tissue Viability 2021; 30:478-483. [PMID: 34389188 PMCID: PMC8328527 DOI: 10.1016/j.jtv.2021.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/22/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023]
Abstract
AIM OF STUDY The main objective of this study was to ascertain whether severe alterations in hypoxemic, inflammatory, and nutritional parameters in patients diagnosed with SARS-CoV-2 infection were associated with the occurrence and severity of developed dependency-related injuries. The secondary objective was to determine whether there were prognostic factors associated with the occurrence and severity of developed dependency-related injuries during the SARS-CoV-2 pandemic. MATERIAL AND METHODS A retrospective, single-centre, case-control study was conducted to compare SARS-CoV-2 patients who developed dependency-related injuries after the first 48 h after admission with a control group made up of SARS-CoV-2 patients without dependency-related injuries. The cases of the 1987 patients diagnosed with SARS-CoV-2 infection during the study period were reviewed. Data from 94 patients who developed dependency-related injuries and from 190 patients who did not develop them during hospital admission were analysed. RESULTS High baseline dependency levels, prolonged hospital stays, and low oxygen saturation levels on arrival in emergency department triage were associated with the occurrence of dependency-related injuries among patients diagnosed with SARS-CoV-2 infection. CONCLUSIONS SARS-CoV-2 infection can lead to complications such as dependency-related injuries. Although there are several non-modifiable variables associated with the occurrence of dependency-related injuries in these patients, it is essential to conduct further research and introduce consensus guidelines to reduce their incidence and prevalence.
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Affiliation(s)
- Mònica Sianes-Gallén
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Anna María Pujol-García
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montserrat Rus García
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Carmen Partera Luque
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montserrat López Postigo
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Silvia Call Mañosa
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - María Carmen Camposo Montesino
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Belén Ibáñez Touriño
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Eulalia Ribas Obon
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Tania Segura Rodríguez
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Pilar Cores Fuentes
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Marta Tamame Sanantonio
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montsant Jornet-Gibert
- Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
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Ge S, Khachemoune A. The Importance of Cutaneous Innervation in Wound Healing: From Animal Studies to Clinical Applications. INT J LOW EXTR WOUND 2021:15347346211045022. [PMID: 34533075 DOI: 10.1177/15347346211045022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The skin is a neuroimmunoendocrine organ that regularly undergoes injury and repair. The complex process of wound healing relies heavily on the cutaneous nervous system. Despite the observation that wound healing deficiencies cause significant morbidity and mortality for patients with nervous dysfunction across many disciplinaries, the role of cutaneous innervation in wound repair has not been well elucidated. In a previous article, we learned the basics of cutaneous neuroanatomy and the important neuropeptides involved in the wound healing process. Currently, we aim to synthesize the basics with observations from animal models and human studies for a more comprehensive understanding of nervous system involvement in cutaneous wound healing. We have demonstrated in this review, the importance of the cutaneous nervous system in each phase of wound healing through basic science research, animal experiments, and human studies.
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Affiliation(s)
| | - Amor Khachemoune
- Veterans Affairs Medical Center, Brooklyn, NY, USA.,SUNY Downstate, Brooklyn, NY, USA
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Goswami AG, Basu S, Shukla VK. Wound Healing in the Golden Agers: What We Know and the Possible Way Ahead. INT J LOW EXTR WOUND 2021; 21:264-271. [PMID: 34382451 DOI: 10.1177/15347346211037841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
While "population aging" is an accomplishment that deserves acclamation, it is in itself a tremendous challenge. Age-related skin changes, impaired wound healing, and concurrent comorbidities are the deadly triad that contribute most to the development of nonhealing chronic wounds in the elderly. This imposes enormous medical, social, and financial burden. With the rising trend in the aging population, this problem is likely to exacerbate unless multidisciplinary, rapt wound care strategies are developed. The last decade was dedicated to understand the basic biology underlying the wound healing process but most in vitro and animal model studies translated poorly to human conditions. Forthcoming, the focus is on the development of diagnostic and therapeutic strategies to improve healing in this vulnerable age group. Further, understanding the complex pathobiology of cellular senescence and wound healing process is required to develop focused therapy for these "problem wounds" in the elderly.
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Affiliation(s)
| | - Somprakas Basu
- 442339All India Institute of Medical Sciences, Rishikesh, India
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15
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Rodrigues JB, Garrett C, Norris SL, Albuquerque F, Queijo L, Cooke F, Judge A. Collar pressure mapping: An evaluation of seven collar types used on working donkeys in Europe. Vet Rec 2021; 189:e772. [PMID: 34352122 DOI: 10.1002/vetr.772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/03/2021] [Accepted: 07/19/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Working donkeys represent an important source of energy worldwide. Poor working conditions and equipment affect their ability to work. Poorly designed, ill-fitted harness causes inefficient transfer of power and leads to health and welfare issues. Using technology to assess different types of collars provides a better understanding of those that are most efficient for working donkeys. MATERIALS AND METHODS Seven different collars were tested using pressure pads. Contact area, median, maximum and peak pressures were obtained for the whole collar and critical points. Eight donkeys pulled 20% and 40% of their body weight, using each collar, under controlled conditions. RESULTS Contact area and pressures vary between collars and effort, with design and expansion capacity of the collars playing a major role. Simple collars designed specifically for donkeys performed well, with full collars designed for horses also having good results. Due to reduced expansion capacity and contact in the critical points, the breast collars were the least effective. CONCLUSION Design, appropriate padding and manufacturing materials and adjustment capacity are key features for good collars, and such parameters are of paramount importance in terms of health and welfare for working donkeys.
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Affiliation(s)
- João B Rodrigues
- The Donkey Sanctuary, Research and Operational Support, Sidmouth, UK
| | - Chris Garrett
- The Donkey Sanctuary, Research and Operational Support, Sidmouth, UK
| | - Stuart L Norris
- The Donkey Sanctuary, Research and Operational Support, Sidmouth, UK
| | - Francisco Albuquerque
- Polytechnic Institute of Bragança, School of Technology and Management, Bragança, Portugal
| | - Luis Queijo
- Polytechnic Institute of Bragança, School of Technology and Management, Bragança, Portugal
| | - Fiona Cooke
- The Donkey Sanctuary, Research and Operational Support, Sidmouth, UK
| | - Andrew Judge
- The Donkey Sanctuary, Research and Operational Support, Sidmouth, UK
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16
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Shinge SAU, Zhang D, Achu Muluh T, Nie Y, Yu F. Mechanosensitive Piezo1 Channel Evoked-Mechanical Signals in Atherosclerosis. J Inflamm Res 2021; 14:3621-3636. [PMID: 34349540 PMCID: PMC8328000 DOI: 10.2147/jir.s319789] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/03/2021] [Indexed: 12/18/2022] Open
Abstract
Recently, more and more works have focused and used extensive resources on atherosclerosis research, which is one of the major causes of death globally. Alongside traditional risk factors, such as hyperlipidemia, smoking, hypertension, obesity, and diabetes, mechanical forces, including shear stress, pressure and stretches exerted on endothelial cells by flow, is proved to be crucial in atherosclerosis development. Studies have recognized the mechanosensitive Piezo1 channel as a special sensor and transducer of various mechanical forces into biochemical signals, and recent studies report its role in atherosclerosis through different mechanical forces in pressure, stretching and turbulent shear stress. Based on our expertise in this field and considering the recent advancement of atherosclerosis research, we will be focusing on the function of Piezo1 and its involvement in various cellular mechanisms and consequent involvement in the development of atherosclerosis in this review. Also, we will discuss various functions of Piezo1 involvement in atherosclerosis and come up with new mechanistic insight for future research. Based on the recent findings, we suggest Piezo1 as a valid candidate for novel therapeutic innovations, in which deep exploration and translating its findings into the clinic will be a new therapeutic strategy for cardiovascular diseases, particularly atherosclerosis.
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Affiliation(s)
- Shafiu A Umar Shinge
- Cardiovascular Surgery Department, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Daifang Zhang
- Cardiovascular Surgery Department, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Clinical Research Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Tobias Achu Muluh
- Oncology Department, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Yongmei Nie
- Cardiovascular Surgery Department, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Collaborative Innovation Center for Prevention and Treatment of Cardiovascular Disease of Sichuan Province, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
| | - Fengxu Yu
- Cardiovascular Surgery Department, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
- Collaborative Innovation Center for Prevention and Treatment of Cardiovascular Disease of Sichuan Province, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China
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Diosa JG, Moreno R, Chica EL, Villarraga JA, Tepole AB. Changes in the three-dimensional microscale topography of human skin with aging impact its mechanical and tribological behavior. PLoS One 2021; 16:e0241533. [PMID: 34242217 PMCID: PMC8270165 DOI: 10.1371/journal.pone.0241533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/11/2021] [Indexed: 11/19/2022] Open
Abstract
Human skin enables interaction with diverse materials every day and at all times. The ability to grasp objects, feel textures, and perceive the environment depends on the mechanical behavior, complex structure, and microscale topography of human skin. At the same time, abrasive interactions, such as sometimes occur with prostheses or textiles, can damage the skin and impair its function. Previous theoretical and computational efforts have shown that skin’s surface topography or microrelief is crucial for its tribological behavior. However, current understanding is limited to adult surface profiles and simplified two-dimensional simulations. Yet, the skin has a rich set of features in three dimensions, and the geometry of skin is known to change with aging. Here we create a numerical model of a dynamic indentation test to elucidate the effect of changes in microscale topography with aging on the skin’s response under indentation and sliding contact with a spherical indenter. We create three different microrelief geometries representative of different ages based on experimental reports from the literature. We perform the indentation and sliding steps, and calculate the normal and tangential forces on the indenter as it moves in three distinct directions based on the characteristic skin lines. The model also evaluates the effect of varying the material parameters. Our results show that the microscale topography of the skin in three dimensions, together with the mechanical behavior of the skin layers, lead to distinctive trends on the stress and strain distribution. The major finding is the increasing role of anisotropy which emerges from the geometric changes seen with aging.
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Affiliation(s)
- Juan G. Diosa
- Mechanical Engineering Department, Universidad de Antioquia, Medellín, Colombia
| | - Ricardo Moreno
- Mechanical Engineering Department, Universidad de Antioquia, Medellín, Colombia
| | - Edwin L. Chica
- Mechanical Engineering Department, Universidad de Antioquia, Medellín, Colombia
| | - Junes A. Villarraga
- Mechanical Engineering Department, Universidad de Antioquia, Medellín, Colombia
| | - Adrian B. Tepole
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana, United States of America
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, United States of America
- * E-mail:
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Techanivate A, Athibai N, Siripongsaporn S, Singhatanadgige W. Risk Factors for Facial Pressure Ulcers in Patients Who Underwent Prolonged Prone Orthopedic Spine Surgery. Spine (Phila Pa 1976) 2021; 46:744-750. [PMID: 33337680 DOI: 10.1097/brs.0000000000003892] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
MINI This study evaluated incidence and risk factors associated with the development of facial pressure ulcers (FPU) in patients who underwent spine surgery in prone position. A total of 300 cases were studied. The incidence of FPU after prone spine surgery using head padded device >3 hours was 27.3%. Hypotension, higher temperature, prolonged operation time, and much crystalloid therapy were the independent risk factors.
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Affiliation(s)
- Anchalee Techanivate
- Department of Anesthesiology, Faculty of medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nutwara Athibai
- Department of Anesthesiology, Faculty of medicine, Chulalongkorn University, Bangkok, Thailand
| | - Suvimol Siripongsaporn
- Department of Anesthesiology, Faculty of medicine, Chulalongkorn University, Bangkok, Thailand
| | - Weerasak Singhatanadgige
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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19
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Kesarwani A, Nagpal PS, Chhabra H. Experimental animal modelling for pressure injury: A systematic review. J Clin Orthop Trauma 2021; 17:273-279. [PMID: 33987077 PMCID: PMC8082114 DOI: 10.1016/j.jcot.2021.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/23/2021] [Accepted: 04/02/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Pressure injury (PI) is a potentially serious condition that is often a consequence of other medical illnesses. It remains a challenge for the clinicians and the researcher to fully understand and develop a technique for comprehending pathogenicity, prevention and treatment. Several animal models have been created to understand the multifaceted cellular and biochemical processes of PI. There are numerous known intrinsic and extrinsic factors influencing the recovery of PI. Some of the important factors are friction, spinal cord injury, diabetes, nutrition, aging, infection, medication, obesity and vascular diseases. The dearth of optimal, pre-clinical animal models capable of mimicking the human PI remains a major challenge for its cure. An ideal animal model must endeavour the reproducibility, clinical significance, and most importantly effective translation into clinical use. METHODS In this current systematic review, a methodological literature review was conducted on the PRISMA guidelines. PubMed/Medline, Research Scholar and Science Direct databases were searched. We conferred the animal models like mice, rats, pigs and dogs used in the PI experiments between January 1980 to January 2021. Typically, methods like Ischemia-reperfusion (IR), monoplegia pressure sore and mechanical non-invasive have been discussed. These were used to generate pressure injuries in small and large animal models. RESULTS AND CONCLUSION Different animal models (mouse, rat, pig, dog) were evaluated based on ease of handling, availability for research, their size, skin type and the technical skills required. Studies suggest that mice and rats are the best-suited animals as their skin healing by contraction resembles the skin healing in humans. In most of the studies with mice and rats, the time taken for the recovery was between 1 and 3 weeks. Further, various techniques discussed in the current systematics review, supports the statement that the Ischemia-reperfusion (IR) method is the most suited method to study pressure injury. It is a controlled method that can develop different stages of PI and does not require any specialized setup for the application.
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Affiliation(s)
- Ashwani Kesarwani
- Department of Basic Research, Indian Spinal Injuries Centre, New Delhi, India
| | - Puja S. Nagpal
- Department of Basic Research, Indian Spinal Injuries Centre, New Delhi, India
| | - H.S. Chhabra
- Medical Director and Chief of Spine Unit, Indian Spinal Injuries Centre, New Delhi, India
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An Experimental Intervention Study Assessing the Impact of a Thin Silicone Gel Surface Overlay on Interface Pressure. Radiol Res Pract 2020; 2020:3246531. [PMID: 33299607 PMCID: PMC7710438 DOI: 10.1155/2020/3246531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/23/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction The incidence of pressure ulcers (PUs) presents a substantial threat to patients, especially geriatric patients, those with restricted mobility, and patients suffering from chronic diseases such as cancer. PUs creates a huge financial burden on healthcare authorities and patients, costing billions to treat and manage. Radiography and radiotherapy patients may experience medical device related (MDR) PUs and studies have shown that high interface pressure (IP) values exist for the head when placed on an X-ray table without a mattress. These high IP values pose a PU risk to patients, especially those accessing prolonged radiography/radiology and radiotherapy procedures. The current study assessed the impact on IP values for the head from using a thin silicone gel surface overlay during radiographic procedures and identified whether this reduced the risk of PUs. Materials and Methods A calibrated XSENSOR pressure mat was used to measure IP for the head on an X-ray table with and without a thin silicone gel surface overlay. Prior to pressure mapping, the silicone gel surface overlay was assessed for its impact on radiation attenuation and image quality. Results Study participants were 14 males (70%) and six females (30%), with an age range of 25-53 years (mean = 34.4 ± 7.0). Paired-samples t-test results indicated that there was a statistically significant decrease in the mean IP for the head on the X-ray table without the silicone gel surface overlay (mean = 83.9 ± 8.2 in mmHg) and the X-ray table with the gel surface overlay (mean = 62.4 ± 6.1 in mmHg), p ≤ 0.001. Paired-samples t-test results indicated that there was a statistically significant decrease in the mean peak pressure index (PPI) for the head on the X-ray table without the silicone gel surface overlay (mean = 205.1 ± 28.2 in mmHg) and the X-ray table with the gel surface overlay (mean = 159.8 ± 26.8 in mmHg), p ≤ 0.001. Conclusions The use of a thin silicone gel surface overlay could reduce IP risk for the head by approximately 25%. The reduction in IP risk could have a significant impact in reducing the risk of developing a PU. To ensure maximum benefit, the silicone gel surface overlay should be evaluated to address the specific needs within radiography and radiotherapy planning and treatment settings.
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21
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Nazarko L. Eczema and the older person. Br J Community Nurs 2020; 25:451-459. [PMID: 32881612 DOI: 10.12968/bjcn.2020.25.9.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Age-related changes lead to an increase in skin problems, and around 70% of older people have a treatable skin condition. However, ageing and poor physical health can make it difficult for older people to care for their skin. Eczema, a chronic inflammatory skin condition, where the skin becomes red, inflamed, itchy and scaly, can develop easily in older adults. This can, in turn, become infected and cause discomfort and health problems. This article explains how ageing affects the skin, how eczema can develop and how it can be treated, also touching upon the different types of eczema. It aims to equip community nurses with knowledge about this common condition and how to recognise and manage it.
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Affiliation(s)
- Linda Nazarko
- Nurse Consultant, West London Mental Health NHS Trust
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22
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Angmorterh SK, England A, Anaman-Torgbor J, Kortei NK, Alidu H, Yarfi C, Webb J, Ofori EK, Hogg P. A narrative review on pressure ulcer (PU) studies relevant to medical imaging. Pan Afr Med J 2020; 36:66. [PMID: 32754293 PMCID: PMC7380868 DOI: 10.11604/pamj.2020.36.66.19431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 04/27/2020] [Indexed: 11/24/2022] Open
Abstract
Pressure ulcers (PUs) are defined as localised injuries to the skin and/or underlying tissue as a result of pressure or pressure together with shear. PUs present significant health implications to patients; costing billions to manage and/or treat. The burden of PU prevention in hospitals must be the concern of all healthcare professionals, including radiographers. The purpose of this narrative review article was to identify and critically evaluate relevant literature and research conducted into pressure ulcers (PUs) relevant to medical imaging. It is expected that this review article will increase the level of awareness about PUs amongst radiographers and help to develop appropriate interventions to minimise the risk of PUs. A literature search was conducted in PubMed/Medline, Scopus, CINAHL, and Google Scholar to retrieve relevant articles. Also, books, professional body guidelines, magazines, grey and unpublished literatures were also searched. The search was limited to English Language articles. Only five articles were retrieved and reviewed. There are limited studies on PUs relevant to medical imaging. Available studies provide some evidence that radiographic procedures and settings subject patients attending for radiographic procedures to the risk of PUs. Further studies are needed into PU risk assessment, minimisation and management in medical imaging to help raise awareness and address the problem of the potential for PU development.
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Affiliation(s)
- Seth Kwadjo Angmorterh
- Department of Medical Imaging, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana
| | - Andrew England
- Directorate of Radiography, School of Healthcare Sciences, Allerton Building, University of Salford, Salford, Greater Manchester, United Kingdom
| | - Judith Anaman-Torgbor
- School of Nursing and Midwifery, University of Health and Allied Sciences (UHAS), Ho, Ghana
| | - Nii Korley Kortei
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana
| | - Huseini Alidu
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana
| | - Cosmos Yarfi
- Department of Physiotherapy and Rehabilitation Sciences, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana
| | - Jo Webb
- Directorate of Occupational Therapy, School of Health Sciences, University of Salford, Salford, Greater Manchester, United Kingdom
| | - Eric Kwasi Ofori
- Department of Medical Imaging, School of Allied Health Sciences, University of Health and Allied Sciences (UHAS), Ho, Ghana
| | - Peter Hogg
- Directorate of Radiography, School of Healthcare Sciences, Allerton Building, University of Salford, Salford, Greater Manchester, United Kingdom
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Alresheedi N, Walton LA, Tootell A, Webb JA, Hogg P. A Phantom-Based Method to Assess X-Ray Table Mattress Interface Pressures. J Med Imaging Radiat Sci 2020; 51:417-424. [PMID: 32505598 DOI: 10.1016/j.jmir.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pressure redistribution performance of x-ray table mattresses can influence the development of pressure ulcers in at-risk populations. Interface pressure analysis, with human participants, is a common method to assess mattresses. This approach has limitations that relate to the lack of standardisation between and within humans. AIM This study aimed to develop and validate an anthropomorphic phantom-based method to assess x-ray table mattress interface pressures as an index of mattress performance. METHODS A three dimensional phantom simulating an adult's head, pelvis, and heels was printed from x-ray computed tomography image data and attached to a metal frame 175 cm in length. Dry sand was added to the phantom head, pelvis, and heels to represent a range of human weights. Pressure distribution was assessed using XSensor. Phantom validation was achieved by comparing phantom mattress interface pressure characteristics, for five human equivalent weights, against 27 sets of human mattress interface pressure data. RESULTS Using the correlation coefficient R, phantom and human pressure data showed good correlation for the five phantom weights (R values: head = 0.993, pelvis = 0.997, and heels = 0.996). CONCLUSION A novel method to test x-ray mattresses for interface pressure was developed and validated. The method could have utility in the testing of x-ray mattresses that are in routine use and for new mattress development. Phantom interface pressure data could be provided by manufacturers to help inform procurement decisions when matching mattress characteristics to medical imaging demands and the underlying patient populations.
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Affiliation(s)
- Nadi Alresheedi
- Department of Radiography, School of Health & Society, University of Salford, Salford, UK.
| | - Lucy Anne Walton
- Department of Radiography, School of Health & Society, University of Salford, Salford, UK
| | - Andrew Tootell
- Department of Radiography, School of Health & Society, University of Salford, Salford, UK
| | - Jo-Anne Webb
- Department of Radiography, School of Health & Society, University of Salford, Salford, UK
| | - Peter Hogg
- Department of Radiography, School of Health & Society, University of Salford, Salford, UK
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Moda Vitoriano Budri A, Moore Z, Patton D, O’Connor T, Nugent L, Mc Cann A, Avsar P. Impaired mobility and pressure ulcer development in older adults: Excess movement and too little movement—Two sides of the one coin? J Clin Nurs 2020; 29:2927-2944. [DOI: 10.1111/jocn.15316] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Aglecia Moda Vitoriano Budri
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
| | - Zena Moore
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
- Cardiff University Cardiff UK
- Fakeeh College for Medical Sciences Jeddah Saudi Arabia
- Monash University Melbourne Vic. Australia
- UGent Ghent University Ghent Belgium
| | - Declan Patton
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
- Fakeeh College for Medical Sciences Jeddah Saudi Arabia
- University of Wollongong Wollongong NSW Australia
| | - Tom O’Connor
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
- Fakeeh College for Medical Sciences Jeddah Saudi Arabia
- Lida Institute Shanghai China
| | - Linda Nugent
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
| | - Aisling Mc Cann
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
| | - Pinar Avsar
- School of Nursing and Midwifery Skin Wounds and Trauma – SWaT Research Centre Royal College of Surgeons in Ireland Dublin Ireland
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25
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Ultrasound imaging of tissue overlying the ischial tuberosity: Does patient position matter? J Tissue Viability 2019; 28:179-185. [DOI: 10.1016/j.jtv.2019.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 11/22/2022]
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26
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Wang Q, Zhu L, Xing F, Zhao P, Wang F. The comparison of the effects of local cooling and heating on apoptosis and pyroptosis of early-stage pressure ulcers in rats. J Cell Biochem 2019; 121:1649-1663. [PMID: 31560409 DOI: 10.1002/jcb.29399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/13/2019] [Indexed: 12/26/2022]
Abstract
The exploration of an effective method for preventing and treating pressure ulcers (PUs) is a hot topic in medical research. Recently, disputes about the choice of heat and cold therapies have emerged for the prevention and treatment of clinical PUs. The present study was designed to compare the effect of cool and heat therapies on pyroptosis and apoptosis of early-stage PUs in rats. Sixty SD rats of SPF grade were randomly divided into the sham group, model group, heating group, and cooling group. We established a rat model of early-stage PUs by using an ischemia-reperfusion method. At the end of the experiment, the tissue underneath the compressed region was collected for hematoxylin and eosin staining, transmission electron microscopy, immunohistochemistry, immunofluorescence staining, a TdT-mediated dUTP nick-end labeling assay, a Western blot analysis, and a mitochondrial swelling experiment. Our results suggested that the mitochondrial apoptotic pathway and pyroptosis were involved in the formation of early-stage PUs, and local heating increased the PU injury in rats, while local cooling reduced the PU injury in rats. This study showed that heat therapy might not be suitable for the clinical treatment and care of early-stage PUs, while cold therapy may be more appropriate.
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Affiliation(s)
- Qing Wang
- Department of Nursing, Institute of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China
| | - Liang Zhu
- Department of Nursing, Institute of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China
| | - Fengmei Xing
- Department of Nursing, Institute of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China
| | - Ping Zhao
- Department of Nursing, Institute of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China
| | - Fenglan Wang
- Department of Nursing, Institute of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China
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27
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Thomé Lima AMC, da Silva Sergio LP, da Silva Neto Trajano LA, de Souza BP, da Motta Mendes JP, Cardoso AFR, Figueira CP, dos Anjos Tavares B, Figueira DS, Mencalha AL, Trajano ETL, de Souza da Fonseca A. Photobiomodulation by dual-wavelength low-power laser effects on infected pressure ulcers. Lasers Med Sci 2019; 35:651-660. [DOI: 10.1007/s10103-019-02862-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/16/2019] [Indexed: 12/12/2022]
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28
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Gould LJ, Bohn G, Bryant R, Paine T, Couch K, Cowan L, McFarland F, Simman R. Pressure ulcer summit 2018: An interdisciplinary approach to improve our understanding of the risk of pressure‐induced tissue damage. Wound Repair Regen 2019; 27:497-508. [DOI: 10.1111/wrr.12730] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/12/2019] [Accepted: 05/07/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Lisa J. Gould
- South Shore Hospital Center for Wound Healing Weymouth Massachusetts
| | | | - Ruth Bryant
- Abbott Northwestern Hospital Minneapolis Minnesota
| | - Tim Paine
- Department of RehabilitationLitchfield Hills Orthopedic Torrington Connecticut
| | - Kara Couch
- Wound Healing and Limb Preservation CenterGeorge Washington University Hospital Washington District of Columbia
| | - Linda Cowan
- Center of Innovation on Disability and Rehabilitation ResearchVirginia Health Care Richmond Virginia
| | | | - Richard Simman
- Jobst Vascular InstituteUniversity of Toledo College of Medicine Toledo Ohio
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29
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Sharp CA, Schulz Moore JS, McLaws ML. Two-Hourly Repositioning for Prevention of Pressure Ulcers in the Elderly: Patient Safety or Elder Abuse? JOURNAL OF BIOETHICAL INQUIRY 2019; 16:17-34. [PMID: 30671872 PMCID: PMC6474851 DOI: 10.1007/s11673-018-9892-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
For decades, aged care facility residents at risk of pressure ulcers (PUs) have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week (24/7). Yet, PUs still develop. We used a cross-sectional survey of eighty randomly selected medical records of residents aged ≥ 65 years from eight Australian Residential Aged Care Facilities (RACFs) to determine the number of residents at risk of PUs, the use of two-hourly repositioning, and the presence of PUs in the last week of life. Despite 91 per cent (73/80) of residents identified as being at risk of PUs and repositioned two-hourly 24/7, 34 per cent (25/73) died with one or more PUs. Behaviours of concern were noted in 72 per cent (58/80) of residents of whom 38 per cent (22/58) were restrained. Dementia was diagnosed in 70 per cent (56/80) of residents. The prevalence of behaviours of concern displayed by residents with dementia was significantly greater than by residents without dementia (82 per cent v 50 per cent, p = 0.028). The rate of restraining residents with dementia was similar to the rate in residents without dementia. Two-hourly repositioning failed to prevent PUs in a third of at-risk residents and may breach the rights of all residents who were repositioned two-hourly. Repositioning and restraining may be unlawful. Rather than only repositioning residents two-hourly, we recommend every resident be provided with an alternating pressure air mattress.
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Affiliation(s)
- Catherine A Sharp
- School of Public Health and Community Medicine, University of New South Wales, 3rd Floor Samuels Building, Sydney, NSW, 2052, Australia
| | | | - Mary-Louise McLaws
- School of Public Health and Community Medicine, University of New South Wales, 3rd Floor Samuels Building, Sydney, NSW, 2052, Australia.
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30
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Maruyama K, Nemoto E, Yamada S. Mechanical regulation of macrophage function - cyclic tensile force inhibits NLRP3 inflammasome-dependent IL-1β secretion in murine macrophages. Inflamm Regen 2019; 39:3. [PMID: 30774738 PMCID: PMC6367847 DOI: 10.1186/s41232-019-0092-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/22/2019] [Indexed: 02/07/2023] Open
Abstract
Mechanical stress maintains tissue homeostasis by regulating many cellular functions including cell proliferation, differentiation, and inflammation and immune responses. In inflammatory microenvironments, macrophages in mechanosensitive tissues receive mechanical signals that regulate various cellular functions and inflammatory responses. Macrophage function is affected by several types of mechanical stress, but the mechanisms by which mechanical signals influence macrophage function in inflammation, such as the regulation of interleukin-1β by inflammasomes, remain unclear. In this review, we describe the role of mechanical stress in macrophage and monocyte cell function.
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Affiliation(s)
- Kentaro Maruyama
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Eiji Nemoto
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Satoru Yamada
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
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31
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Mejias NH, Martinez CC, Stephens ME, de Rivero Vaccari JP. Contribution of the inflammasome to inflammaging. JOURNAL OF INFLAMMATION-LONDON 2018; 15:23. [PMID: 30473634 PMCID: PMC6240324 DOI: 10.1186/s12950-018-0198-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/05/2018] [Indexed: 01/14/2023]
Abstract
Background Inflammation is a natural part of the aging process. This process is referred to as inflammaging. Inflammaging has been associated with deleterious outcomes in the aging brain in diseases such as Alzheimer’s disease and Parkinson’s disease. The inflammasome is a multi-protein complex of the innate immune response involved in the activation of caspase-1 and the processing of the inflammatory cytokines interleukin (IL)-1β and IL-18. We have previously shown that the inflammasome plays a role in the aging process in the brain. In this study, we analyzed the brain of young (3 months old) and aged (18 months old) mice for the expression of inflammasome proteins. Results Our findings indicate that the inflammasome proteins NLRC4, caspase-1, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), and IL-18 are elevated in the cytosol of cortical lysates in aged mice when compared to young. In addition, in the cytosolic fraction of hippocampal lysates in aged mice, we found an increase in NLRC4, caspase-1, caspase-11, ASC and IL-1β. Moreover, we found higher levels of ASC in the mitochondrial fraction of aged mice when compared to young, consistent with higher levels of the substrate of pyroptosis gasdermin-D (GSDM-D) and increased pyroptosome formation (ASC oligomerization). Importantly, in this study we obtained fibroblasts from a subject that donated his cells at three different ages (49, 52 and 64 years old (y/o)) and found that the protein levels of caspase-1 and ASC were higher at 64 than at 52 y/o. In addition, the 52 y/o cells were more susceptible to oxidative stress as determined by lactose dehydrogenase (LDH) release levels. However, this response was ameliorated by inhibition of the inflammasome with Ac-Tyr-Val-Ala-Asp-Chloromethylketone (Ac-YVAD-CMK). In addition, we found that the protein levels of ASC and IL-18 are elevated in the serum of subjects over the age of 45 y/o when compared to younger subjects, and that ASC was higher in Caucasians than Blacks and Hispanics, whereas IL-18 was higher in Caucasians than in blacks, regardless of age. Conclusions Taken together, our data indicate that the inflammasome contributes to inflammaging and that the inflammasome-mediated cell death mechanism of pyroptosis contributes to cell demise in the aging brain.
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Affiliation(s)
- Nancy H Mejias
- Department of Neurological Surgery, Lois Pope LIFE Center, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, 1095 NW 14th Terrace, 3-25, Miami, FL 33136-1060 USA
| | - Camila C Martinez
- Department of Neurological Surgery, Lois Pope LIFE Center, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, 1095 NW 14th Terrace, 3-25, Miami, FL 33136-1060 USA
| | - Marisa E Stephens
- Department of Neurological Surgery, Lois Pope LIFE Center, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, 1095 NW 14th Terrace, 3-25, Miami, FL 33136-1060 USA
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery, Lois Pope LIFE Center, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, 1095 NW 14th Terrace, 3-25, Miami, FL 33136-1060 USA
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32
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Wilkinson HN, Iveson S, Catherall P, Hardman MJ. A Novel Silver Bioactive Glass Elicits Antimicrobial Efficacy Against Pseudomonas aeruginosa and Staphylococcus aureus in an ex Vivo Skin Wound Biofilm Model. Front Microbiol 2018; 9:1450. [PMID: 30018606 PMCID: PMC6037725 DOI: 10.3389/fmicb.2018.01450] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/11/2018] [Indexed: 11/28/2022] Open
Abstract
Biofilm infection is now understood to be a potent contributor to the recalcitrant nature of chronic wounds. Bacterial biofilms evade the host immune response and show increased resistance to antibiotics. Along with improvements in antibiotic stewardship, effective new anti-biofilm therapies are urgently needed for effective wound management. Previous studies have shown that bioactive glass (Bg) is able to promote healing with moderate bactericidal activity. Here we tested the antimicrobial efficacy of a novel BG incorporating silver (BgAg), against both planktonic and biofilm forms of the wound-relevant bacteria Pseudomonas aeruginosa and Staphylococcus aureus. BgAg was stable, long lasting, and potently effective against planktonic bacteria in time-kill assays (6-log reduction in bacterial viability within 2 h) and in agar diffusion assays. BgAg reduced bacterial load in a physiologically relevant ex vivo porcine wound biofilm model; P. aeruginosa (2-log reduction) and S. aureus (3-log reduction). BgAg also conferred strong effects against P. aeruginosa biofilm virulence, reducing both protease activity and virulence gene expression. Co-culture biofilms appeared more resistant to BgAg, where a selective reduction in S. aureus was observed. Finally, BgAg was shown to benefit the host response to biofilm infection, directly reducing host tissue cell death. Taken together, the findings provide evidence that BgAg elicits potent antimicrobial effects against planktonic and single-species biofilms, with beneficial effects on the host tissue response. Further investigations are required to elucidate the specific consequences of BG administration on polymicrobial biofilms, and further explore the effects on host-microbe interactions.
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Affiliation(s)
| | - Sammi Iveson
- School of Life Sciences, University of Hull, Hull, United Kingdom
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33
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Tam BT, Yu AP, Tam EW, Monks DA, Wang XP, Pei XM, Koh SP, Sin TK, Law HKW, Ugwu FN, Supriya R, Yung BY, Yip SP, Wong SC, Chan LW, Lai CW, Ouyang P, Siu PM. Ablation of Bax and Bak protects skeletal muscle against pressure-induced injury. Sci Rep 2018; 8:3689. [PMID: 29487339 PMCID: PMC5829134 DOI: 10.1038/s41598-018-21853-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/06/2017] [Indexed: 01/23/2023] Open
Abstract
Pressure-induced injury (PI), such as a pressure ulcer, in patients with limited mobility is a healthcare issue worldwide. PI is an injury to skin and its underlying tissue such as skeletal muscle. Muscle compression, composed of mechanical deformation of muscle and external load, leads to localized ischemia and subsequent unloading reperfusion and, hence, a pressure ulcer in bed-bound patients. Although the gross factors involved in PI have been identified, little is known about the exact disease mechanism or its links to apoptosis, autophagy and inflammation. Here, we report that PI is mediated by intrinsic apoptosis and exacerbated by autophagy. Conditional ablation of Bax and Bak activates the Akt-mTOR pathway and Bnip3-mediated mitophagy and preserves mitochondrial contents in compressed muscle. Moreover, we find that the presence/absence of Bax and Bak alters the roles and functions of autophagy in PI. Our results suggest that manipulating apoptosis and autophagy are potential therapeutic targets for treatment and prevention of PI.
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Affiliation(s)
- Bjorn T Tam
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Angus P Yu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Eric W Tam
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Douglas A Monks
- Department of Cell and Systems Biology & Department of Psychology, University of Toronto, Toronto, Canada
| | - Xu P Wang
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Xiao M Pei
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Su P Koh
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Thomas K Sin
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Department of Integrative Biology and Pharmacology, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Helen K W Law
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Felix N Ugwu
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Rashmi Supriya
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Benjamin Y Yung
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shea P Yip
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - S C Wong
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Lawrence W Chan
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Christopher W Lai
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Pin Ouyang
- Department of Anatomy & Transgenic Mouse Core Laboratory, Chang Gung University, Taoyuan, Taiwan
| | - Parco M Siu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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34
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Hu JL, Todhunter ME, LaBarge MA, Gartner ZJ. Opportunities for organoids as new models of aging. J Cell Biol 2017; 217:39-50. [PMID: 29263081 PMCID: PMC5748992 DOI: 10.1083/jcb.201709054] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/13/2017] [Accepted: 11/27/2017] [Indexed: 01/02/2023] Open
Abstract
The biology of aging is challenging to study, particularly in humans. As a result, model organisms are used to approximate the physiological context of aging in humans. However, the best model organisms remain expensive and time-consuming to use. More importantly, they may not reflect directly on the process of aging in people. Human cell culture provides an alternative, but many functional signs of aging occur at the level of tissues rather than cells and are therefore not readily apparent in traditional cell culture models. Organoids have the potential to effectively balance between the strengths and weaknesses of traditional models of aging. They have sufficient complexity to capture relevant signs of aging at the molecular, cellular, and tissue levels, while presenting an experimentally tractable alternative to animal studies. Organoid systems have been developed to model many human tissues and diseases. Here we provide a perspective on the potential for organoids to serve as models for aging and describe how current organoid techniques could be applied to aging research.
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Affiliation(s)
- Jennifer L Hu
- University of California Berkeley-University of California San Francisco Graduate Program in Bioengineering, San Francisco, CA
| | - Michael E Todhunter
- Center for Cancer and Aging, Beckman Research Institute at City of Hope, Duarte, CA
| | - Mark A LaBarge
- Center for Cancer and Aging, Beckman Research Institute at City of Hope, Duarte, CA
| | - Zev J Gartner
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, CA .,National Science Foundation Center for Cellular Construction, University of California San Francisco, San Francisco, CA.,Chan Zuckerberg Biohub, San Francisco, CA
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35
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Makrantonaki E, Wlaschek M, Scharffetter-Kochanek K. Pathogenesis of wound healing disorders in the elderly. J Dtsch Dermatol Ges 2017; 15:255-275. [PMID: 28252848 DOI: 10.1111/ddg.13199] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/21/2016] [Indexed: 12/25/2022]
Abstract
The elderly constitute the age group most susceptible to wound healing disorders and chronic wounds, the most prevalent being venous leg ulcers, pressure ulcers, and diabetic foot ulcers. However, other age-associated diseases should also be taken into consideration in the diagnostic workup of chronic wounds, and not be underestimated. A better understanding of the pathomechanisms involved in the wound healing process is of key importance in combatting the difficulties associated with the treatment of chronic wounds. In recent decades, considerable progress has been made in the development of pioneering therapeutic strategies for chronic wounds. In this context, the use of growth factors and cytokines, tissue engineering, and cell therapy - including stem cells - have proven very promising. Nevertheless, prior to their introduction into routine clinical practice, large controlled clinical trials are required to assess the safety of these techniques.
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Affiliation(s)
| | - Meinhard Wlaschek
- Department of Dermatology and Allergic Diseases, University Medical Center Ulm
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36
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Rathore A, Wilcox M, Ramirez DZM, Loureiro R, Carlson T. Quantifying the human-robot interaction forces between a lower limb exoskeleton and healthy users. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:586-589. [PMID: 28268398 DOI: 10.1109/embc.2016.7590770] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To counter the many disadvantages of prolonged wheelchair use, patients with spinal cord injuries (SCI) are beginning to turn towards robotic exoskeletons. However, we are currently unaware of the magnitude and distribution of forces acting between the user and the exoskeleton. This is a critical issue, as SCI patients have an increased susceptibility to skin lesions and pressure ulcer development. Therefore, we developed a real-time force measuring apparatus, which was placed at the physical human-robot interface (pHRI) of a lower limb robotic exoskeleton. Experiments captured the dynamics of these interaction forces whilst the participants performed a range of typical stepping actions. Our results indicate that peak forces occurred at the anterior aspect of both the left and right legs, areas that are particularly prone to pressure ulcer development. A significant difference was also found between the average force experienced at the anterior and posterior sensors of the right thigh during the swing phase for different movement primitives. These results call for the integration of instrumented straps as standard in lower limb exoskeletons. They also highlight the potential of such straps to be used as an alternative/complementary interface for the high-level control of lower limb exoskeletons in some patient groups.
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37
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Abstract
Inflammasomes are intracellular multiprotein complexes that comprise part of the
innate immune response. Since their definition, inflammasome disorders have been
linked to an increasing number of diseases. Autoinflammatory diseases refer to
disorders in which local factors lead to the activation of innate immune cells,
causing tissue damage when in the absence of autoantigens and autoantibodies.
Skin symptoms include the main features of monogenic inflammasomopathies, such
as Cryopyrin-Associated Periodic Syndromes (CAPS), Familial Mediterranean Fever
(FMF), Schnitzler Syndrome, Hyper-IgD Syndrome (HIDS), PAPA Syndrome, and
Deficiency of IL-1 Receptor Antagonist (DIRA). Concepts from other pathologies
have also been reviewed in recent years, such as psoriasis, after the
recognition of a combined contribution of innate and adaptive immunity in its
pathogenesis. Inflammasomes are also involved in the response to various
infections, malignancies, such as melanoma, autoimmune diseases, including
vitiligo and lupus erythematosus, atopic and contact dermatitis, acne,
hidradenitis suppurativa, among others. Inhibition of the inflammasome pathway
may be a target for future therapies, as already occurs in the handling of CAPS,
through the introduction of IL-1 inhibitors. This study presents a literature
review focusing on the participation of inflammasomes in skin diseases.
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Affiliation(s)
| | - Cyro Festa
- Universidade de São Paulo (USP) - São Paulo (SP), Brazil
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38
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Effects of two different fabrics on skin barrier function under real pressure conditions. J Tissue Viability 2017; 26:150-155. [DOI: 10.1016/j.jtv.2016.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 10/15/2016] [Accepted: 10/18/2016] [Indexed: 12/21/2022]
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39
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Makrantonaki E, Wlaschek M, Scharffetter-Kochanek K. Pathogenese von Wundheilungsstörungen bei älteren Patienten. J Dtsch Dermatol Ges 2017; 15:255-278. [DOI: 10.1111/ddg.13199_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/21/2016] [Indexed: 01/13/2023]
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40
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Yeung CYC, Holmes DF, Thomason HA, Stephenson C, Derby B, Hardman MJ. An ex vivo porcine skin model to evaluate pressure-reducing devices of different mechanical properties used for pressure ulcer prevention. Wound Repair Regen 2016; 24:1089-1096. [PMID: 27717144 DOI: 10.1111/wrr.12481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/13/2016] [Indexed: 12/01/2022]
Abstract
Pressure ulcers are complex wounds caused by pressure- and shear-induced trauma to skin and underlying tissues. Pressure-reducing devices, such as dressings, have been shown to successfully reduce pressure ulcer incidence, when used in adjunct to pressure ulcer preventative care. While pressure-reducing devices are available in a range of materials, with differing mechanical properties, understanding of how a material's mechanical properties will influence clinical efficacy remains limited. The aim of this study was to establish a standardized ex vivo model to allow comparison of the cell protection potential of two gel-like pressure-reducing devices with differing mechanical properties (elastic moduli of 77 vs. 35 kPa). The devices also displayed differing energy dissipation under compressive loading, and resisted strain differently under constant load in compressive creep tests. To evaluate biological efficacy we employed a new ex vivo porcine skin model, with a confirmed elastic moduli closely matching that of human skin (113 vs. 119 kPa, respectively). Static loads up to 20 kPa were applied to porcine skin ex vivo with subsequent evaluation of pressure-induced cell death and cytokine release. Pressure application alone increased the percentage of epidermal apoptotic cells from less than 2% to over 40%, and increased cellular secretion of the pro-inflammatory cytokine TNF-alpha. Co-application of a pressure-reducing device significantly reduced both cellular apoptosis and cytokine production, protecting against cellular damage. These data reveal new insight into the relationship between mechanical properties of pressure-reducing devices and their biological effects. After appropriate validation of these results in clinical pressure ulcer prevention with all tissue layers present between the bony prominence and external surface, this ex vivo porcine skin model could be widely employed to optimize design and evaluation of devices aimed at reducing pressure-induced skin damage.
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Affiliation(s)
| | - David F Holmes
- Wellcome Trust Centre for Cell-Matrix Research, Faculty of Life Sciences, University of Manchester, Oxford Road, Manchester, United Kingdom
| | | | | | - Brian Derby
- School of Materials, University of Manchester, Manchester, United Kingdom
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Brand FJ, Forouzandeh M, Kaur H, Travascio F, de Rivero Vaccari JP. Acidification changes affect the inflammasome in human nucleus pulposus cells. JOURNAL OF INFLAMMATION-LONDON 2016; 13:29. [PMID: 27563282 PMCID: PMC4997758 DOI: 10.1186/s12950-016-0137-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/17/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Interleukin (IL)-1β is involved in the pathology of intervertebral disc degeneration. Under normal conditions, IL-1β is present in cells in an inactive form (pro-IL-1β). However, under pathological conditions, pro-IL-1β is turned into its active form (IL-1β) by the inflammasome, a multi-protein complex of the innate immune response that activates caspase-1. Under conditions of degeneration, the disc experiences an environment of increased acidification. However, the implications of acidification on the innate immune response remain poorly explored. METHODS Here we have studied how pH changes in human nucleus pulposus cells affect inflammasome activation by immunoblot analysis of protein lysates obtained from nucleus pulposus cells that were exposed to different pH levels in culture. RESULTS In this study, we have found that in nucleus pulposus cells, with increased acidification, there was a decrease in inflammasome activation consistent with lower levels of active IL-1β. However, this effect at a pH of 6.5, the lowest pH level tested, was abrogated when cells were treated with IL-1β. CONCLUSIONS Taken together, these findings suggest that the inflammatory response through IL-1β experienced by the human disc is not initiated in nucleus pulposus cells when the stimulus is acidification.
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Affiliation(s)
- Frank J Brand
- Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL 33136 USA
| | - Mahtab Forouzandeh
- Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL 33136 USA
| | - Harmanpreet Kaur
- Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL 33136 USA
| | - Francesco Travascio
- Biomechanics Research Laboratory, Department of Industrial Engineering, University of Miami, Coral Gables, FL 33146 USA
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL 33136 USA ; Department of Neurological Surgery, Lois Pope LIFE Center, 1095 NW 14th Terrace, 3-25JJ, Miami, FL 33136-1060 USA
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Schäfer G, Dobos G, Lünnemann L, Blume-Peytavi U, Fischer T, Kottner J. Using ultrasound elastography to monitor human soft tissue behaviour during prolonged loading: A clinical explorative study. J Tissue Viability 2015; 24:165-72. [DOI: 10.1016/j.jtv.2015.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 06/14/2015] [Accepted: 06/18/2015] [Indexed: 01/25/2023]
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Kurose T, Hashimoto M, Ozawa J, Kawamata S. Analysis of Gene Expression in Experimental Pressure Ulcers in the Rat with Special Reference to Inflammatory Cytokines. PLoS One 2015; 10:e0132622. [PMID: 26177082 PMCID: PMC4503587 DOI: 10.1371/journal.pone.0132622] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 06/16/2015] [Indexed: 11/24/2022] Open
Abstract
Pressure ulcers have been investigated in a few animal models, but the molecular mechanisms of pressure ulcers are not well understood. We hypothesized that pressure results in up-regulation of inflammatory cytokines and those cytokines contribute to the formation of pressure ulcers. We measured genome-wide changes in transcript levels after compression, and focused especially on inflammatory cytokines. The abdominal wall of rats was compressed at 100 mmHg for 4 hours by two magnets. Specimens were obtained 12 hours, 1, or 3 days after compression, and analyzed by light microscopy, microarray, Real-Time PCR, and ELISA. The skin and subcutaneous tissue in the compressed area were markedly thickened. The microarray showed that numerous genes were up-regulated after the compression. Up-regulated genes were involved in apoptosis, inflammation, oxidative stress, proteolysis, hypoxia, and so on. Real-Time PCR showed the up-regulation of granulocyte-macrophage colony stimulating factor (GM-CSF), interferon γ (IFN-γ), interleukin 1β (IL-1β), interleukin 1 receptor antagonist gene (IL1Ra), interleukin 6 (IL-6), interleukin 10 (IL-10), matrix metalloproteinase 3 (MMP-3), tissue inhibitor of metalloproteinase 1 (TIMP-1), and tumor necrosis factor α (TNF-α) at 12 hours, IFN-γ, IL-6, IL-10, MMP-3, and TIMP-1 at 1 day, and IFN-γ, IL-6, and MMP-3 at 3 days. Some genes from subcutaneous tissue were up-regulated temporarily, and others were kept at high levels of expression. ELISA data showed that the concentrations of IL-1β and IL-6 proteins were most notably increased following compression. Prolonged up-regulation of IL-1β, and IL-6 might enhance local inflammation, and continuous local inflammation may contribute to the pressure ulcer formation. In addition, GM-CSF, IFN-γ, MMP-3, and TIMP-1 were not reported previously in the wound healing process, and those genes may have a role in development of the pressure ulcers. Expression data from Real-Time PCR were generally in good agreement with those of the microarray. Our microarray data were useful for identifying genes involved in pressure ulcer formation. However, the expression levels of the genes didn’t necessarily correspond with protein production. As such, the functions of these cytokines need to be further investigated.
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Affiliation(s)
- Tomoyuki Kurose
- Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- * E-mail:
| | - Masakazu Hashimoto
- Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junya Ozawa
- Faculty of Health Sciences, Hiroshima International University, Hiroshima, Japan
| | - Seiichi Kawamata
- Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Affiliation(s)
- Catherine A. Sharp
- Pressure Injury Prevention/Wound Care/Infection Control Consultant, Australia
| | | | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Emily Haesler
- PGDipAdvNursing, PhD candidate Canberra, Australia. On behalf of the Guideline Development Group
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The Effectiveness of a Pressure Ulcer Intervention Program on the Prevalence of Hospital Acquired Pressure Ulcers: Controlled Before and After Study. Appl Nurs Res 2015; 28:106-13. [DOI: 10.1016/j.apnr.2014.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 10/25/2022]
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Ogai K, Matsumoto M, Minematsu T, Kitamura K, Kobayashi M, Sugama J, Sanada H. Development of an improved method for quantitative analysis of skin blotting: increasing reliability and applicability for skin assessment. Int J Cosmet Sci 2015; 37:425-32. [DOI: 10.1111/ics.12217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/07/2015] [Indexed: 01/08/2023]
Affiliation(s)
- K. Ogai
- Wellness Promotion Science Center; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Kanazawa Ishikawa Japan
| | - M. Matsumoto
- Division of Health Science; Department of Clinical Nursing; Graduate School of Medicine; Kanazawa University; Kanazawa Ishikawa Japan
| | - T. Minematsu
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Bunkyo-ku Tokyo Japan
| | - K. Kitamura
- Department of Clinical Laboratory Science; Graduate School of Medical Science; Kanazawa University; Kanazawa Ishikawa Japan
| | - M. Kobayashi
- Wellness Promotion Science Center; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Kanazawa Ishikawa Japan
| | - J. Sugama
- Wellness Promotion Science Center; Institute of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Kanazawa Ishikawa Japan
- Division of Health Science; Department of Clinical Nursing; Graduate School of Medicine; Kanazawa University; Kanazawa Ishikawa Japan
| | - H. Sanada
- Department of Gerontological Nursing/Wound Care Management; Graduate School of Medicine; The University of Tokyo; Bunkyo-ku Tokyo Japan
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Abstract
The cellular and molecular mechanisms underpinning tissue repair and its failure to heal are still poorly understood, and current therapies are limited. Poor wound healing after trauma, surgery, acute illness, or chronic disease conditions affects millions of people worldwide each year and is the consequence of poorly regulated elements of the healthy tissue repair response, including inflammation, angiogenesis, matrix deposition, and cell recruitment. Failure of one or several of these cellular processes is generally linked to an underlying clinical condition, such as vascular disease, diabetes, or aging, which are all frequently associated with healing pathologies. The search for clinical strategies that might improve the body's natural repair mechanisms will need to be based on a thorough understanding of the basic biology of repair and regeneration. In this review, we highlight emerging concepts in tissue regeneration and repair, and provide some perspectives on how to translate current knowledge into viable clinical approaches for treating patients with wound-healing pathologies.
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Affiliation(s)
- Sabine A Eming
- Department of Dermatology, University of Cologne, Cologne 50937, Germany. Center for Molecular Medicine Cologne, University of Cologne, Cologne 50931, Germany. Cologne Cluster of Excellence on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne 50931, Germany.
| | - Paul Martin
- Schools of Biochemistry and Physiology and Pharmacology, Faculty of Medical and Veterinary Sciences, University of Bristol, University Walk, Bristol BS8 1TD, UK. School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK.
| | - Marjana Tomic-Canic
- Wound Healing and Regenerative Medicine Research Program, Department of Dermatology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Li CT, Chen YN, Chang CH, Tsai KH. The effects of backward adjustable thoracic support in wheelchair on spinal curvature and back muscle activation for elderly people. PLoS One 2014; 9:e113644. [PMID: 25480152 PMCID: PMC4257911 DOI: 10.1371/journal.pone.0113644] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/27/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the effects of backward adjustable thoracic support on spinal curvature and back muscle activation during wheelchair sitting. METHODS Twenty elderly people were recruited for this study. The backward adjustable thoracic support sitting posture was compared with the slumped, normal, and lumbar support sitting postures. Spinal curvatures (pelvic, lumbar, and thoracic angles) and muscle activations of 4 back muscles on both sides (maximal voluntary isometric contraction of the lumbar multifidus, lumbar erector spinae, iliocostalis lumborum pars thoracis, and thoracic erector spinae at T9) were measured and compared between the different sitting postures using one-way analysis of variance with repeated measures. RESULTS The backward adjustable thoracic support sitting posture showed a relatively neutral pelvic tilt (-0.32±4.80°) when compared with the slumped (22.84±5.27°) and lumbar support (-8.97±3.31°) sitting postures (P<0.001), and showed relatively higher lumbar lordosis (-23.38±6.50°) when compared with the slumped (14.77±7.83°), normal (0.44±7.47°), and lumbar support (-16.76±4.77°) sitting postures (P<0.05). It also showed relatively lower back muscle activity when compared with the normal and lumbar support sitting postures (P<0.05). CONCLUSIONS The backward adjustable thoracic support sitting concept was suggested because it maintains a more neutral pelvic tilt, higher lumbar lordosis, and lower back muscle activation, which may help maintain a better sitting posture and reduce the risk of back pain.
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Affiliation(s)
- Chun-Ting Li
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Nien Chen
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Metal Industries Research & Development Centre, Kaohsiung, Taiwan
| | - Chih-Han Chang
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- * E-mail: (KHT); (CHC)
| | - Kuen-Horng Tsai
- Graduate Institute of Mechatronic System Engineering, National University of Tainan, Tainan, Taiwan
- * E-mail: (KHT); (CHC)
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Neuroprotective effect of erythropoietin against pressure ulcer in a mouse model of small fiber neuropathy. PLoS One 2014; 9:e113454. [PMID: 25422898 PMCID: PMC4244151 DOI: 10.1371/journal.pone.0113454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 10/24/2014] [Indexed: 01/31/2023] Open
Abstract
An increased risk of skin pressure ulcers (PUs) is common in patients with sensory neuropathies, including those caused by diabetes mellitus. Recombinant human erythropoietin (rhEPO) has been shown to protect the skin against PUs developed in animal models of long-term diabetes. The aim of this work was to determine whether rhEPO could prevent PU formation in a mouse model of drug-inducedSFN. Functional SFN was induced by systemic injection of resiniferatoxin (RTX, 50 µg/kg, i.p.). RhEPO (3000 UI/kg, i.p.) was given the day before RTX injection and then every other day. Seven days after RTX administration, PUs were induced by applying two magnetic plates on the dorsal skin. RTX-treated mice expressed thermal and mechanical hypoalgesia and showed calcitonin gene-related peptide (CGRP) and substance P (SP) depletion without nerve degeneration or vascular dysfunction. RTX mice developed significantly larger stage 2 PUs than Vehicle mice. RhEPO prevented thermal and mechanical hypoalgesia and neuropeptide depletion in small nerve fibers. RhEPO increased hematocrit and altered endothelium-dependent vasodilatation without any effect on PU formation in Vehicle mice. The characteristics of PUs in RTX mice treated with rhEPO and Vehicle mice were found similar. In conclusion, RTX appeared to increased PU development through depletion of CGRP and SP in small nerve fibers, whereas systemic rhEPO treatment had beneficial effect on peptidergic nerve fibers and restored skin protective capacities against ischemic pressure. Our findings support the evaluation of rhEPO and/or its non-hematopoietic analogs in preventing to prevent PUs in patients with SFN.
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Butcher M. Martyn Butcher. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2013; 22:S60-S61. [PMID: 24225514 DOI: 10.12968/bjon.2013.22.sup20.s60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Martyn Butcher
- Independent tissue viability and wound care consultant, Associate Lecturer at University of Plymouth, Honorary Tissue Viability Research Nurse and a current student of podiatry
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