skin-care-1.matches: skin care
Dermatological findings following acute traumatic spinal cord injury.

Rubin-Asher D, Zeilig G, Klieger M, Adunsky A, Weingarden H.

The Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Israel.

STUDY DESIGN: Prospective study. OBJECTIVE: To identify and define dermatological conditions following acute traumatic spinal cord injury (ATSCI) during inpatient rehabilitation. SETTING: Spinal Cord Injury Unit, The Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Israel. METHODS: During a 1-year study, all patients following ATSCI were prospectively studied for new dermatological findings during their inpatient rehabilitation. Every new dermatological finding was defined concerning its location with regard to the patient's neurological level, the time from injury to appearance and the exact dermatological diagnosis. RESULTS: During the study year, 46 ATSCI patients were hospitalized in our department, of whom were 38 (82.6%) males and eight (17.4%) females (mean age 30.2 years). A total of 21 (45.6%) patients were tetraplegic and 25 (54.3%) paraplegic. Of the patients, 28 (60.9%) had complete neurological injuries and 18 (39.1%) incomplete. In all, 14 (30.4%) patients developed a dermatological condition. There was no significant age or sex correlation to the development of these complications. There was a greater likelihood of paraplegia (48 versus 9.5%, P=0.005) and being neurologically complete (42.9 versus 11.1%, P=0.02). The dermatological findings appeared on an average of 80.3 days after the initial neurological insult. There were a total of 22 different dermatological findings: 11 (50%) were local fungal infections, two (9.1%) psoriatic lesions, two (9.1%) hyperkeratotic lesions, two (9.1%) bacterial infections (one folliculitis, one impetigo) and single cases of seborrheic dermatitis, acne, alopecia, scabies and allergic reaction. Of the findings, 14 (63.6%) were below the neurological level, including all of the fungal infections. CONCLUSIONS: Dermatological findings are common during rehabilitation of ATSCI. The clinical impact of these findings is low, but nevertheless, they are troublesome to the patient. The most common dermatological disorder was a local fungal infection below the neurological level. Paraplegic patients are more susceptible to the development of this condition. Patient and staff education regarding proper skin care may reduce these infections.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15570320&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
The non-operative care of the vascular surgical patient.

Bradham GB.

It is as important to recognize that some patients will not improve by operative surgery for vascular disease. When a decision is made for nonoperative management, responsibility dictates that the patient be given a regimen of measures designed for stabilization of his present condition and reversal of lifestyle trends which caused it. These include cessation of smoking, appropriate exercise and nutrition, excellent skin care, attention to clothing and shoes, management of prostheses, control of pain, and control of stress. A careful analysis of the patient's medications and his work environment must be made and tailored to his needs. Finally, the patient should be studiously educated as to his disease process and its relationship to his lifestyle. Only through understanding of the reasons for taking good care of himself can patients be effective in following their physician's advice.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2724932&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Total knee arthroplasty in patients with psoriasis.

Stern SH, Insall JN, Windsor RE, Inglis AE, Dines DM.

Hospital for Special Surgery, New York, NY 10021.

Patients with progressive psoriasis have an increased infection rate when having total joint arthroplasty. Therefore, maximum precautions should be taken in the perioperative period as well as with long-term follow-up care to prevent joint sepsis in these patients. In particular, skin care should be meticulous. Special attention should be given to use of a topical corticosteroid or other dermatologic treatment when total joint arthroplasty is considered.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2805466&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Prevalence of cytomegalovirus antibodies in obstetric nurses. A study in a specialist metropolitan teaching hospital.

Hatherley LI.

The prevalence of antibodies to cytomegaloviruses (CMV) in applicants for nursing staff appointments was shown to be significantly lower than that reported earlier in obstetric patients of the same metropolitan area. Age and previous nursing experience with midwifery patients or neonates were found to be significant factors associated with the prevalence of antibodies to CMV in staff applicants. Student midwives younger than 25 years were the group most susceptible to primary CMV infection. The duties that seronegative pregnant staff members or those planning pregnancy at an early date should be allowed to carry out are discussed. The importance of hygiene in the prevention of nosocomial infections, and of the skin care of hands subjected to frequent washing, is stressed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2982081&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Impact of staff education on pressure sore development in elderly hospitalized patients.

Moody BL, Fanale JE, Thompson M, Vaillancourt D, Symonds G, Bonasoro C.

Department of Internal Medicine, Worcester Memorial Hospital, MA 01605.

To test the hypothesis that an educational program alone without the introduction of new technology could result in both higher quality care and cost savings, the incidence of development of pressure sores among patients over the age of 65 years was concurrently reviewed before and after an education program developed and disseminated by a skin care team composed of physicians and nurses. Before the education program, 18 (14.6%) of 123 patients with no pressure sores developed pressure sores during their hospital admission. After the education program, only six (5.4%) of 105 patients who entered the hospital with intact skin developed a pressure sore during their hospital stay. The data show that an educational program was effective in decreasing by 63% the development of pressure sores in an elderly hospitalized population. Furthermore, a cost savings of $74,372 in the use of special care beds was realized.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3178381&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
In vitro and in vivo evaluation of the genotoxic potential of 2-ethyl-1,3-hexanediol.

Slesinski RS, Guzzie PJ, Putman DL, Ballantyne B.

Bushy Run Research Center, Export, PA 15632.

2-Ethyl-1,3-hexanediol (EHD) has intentional human exposure because of its application to skin as an insect repellent and its use in various skin care products. Genotoxicity studies on EHD were conducted to determine mutagenic and clastogenic potential using in vitro and in vivo test systems. In vitro tests were conducted both with and without an Aroclor-induced, rat-liver S9 metabolic activation system and within a range of cytotoxic to non-cytotoxic doses. EHD did not produce dose-related positive increases in gene mutations in the Salmonella (Ames) test or in the CHO/HGPRT forward mutation test. No statistically significant or dose-related increases in sister chromatid exchanges indicative of DNA damage were produced by EHD in CHO cells. Small but statistically significant increases in chromosome aberrations were produced in CHO cells only in tests with S9 activation. However, no evidence of clastogenicity of EHD was obtained in vivo in a mouse peripheral blood micronucleus test or in 2 rat bone marrow chromosome aberration studies using single or repeated dosing procedures. The overall negative pattern of mutagenic and clastogenic results in the majority of tests conducted suggests that EHD is unlikely to pose significant hazard as a genotoxic agent or to possess carcinogenic initiating activity in animals.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3212782&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Pressure sores in the elderly. A systematic approach to management.

Melcher RE, Longe RL, Gelbart AO.

Department of Family Medicine, Medical College of Georgia School of Medicine, Augusta 30912-5470.

Pressure sores are a serious but often avoidable problem. The best management plan focuses on early identification of high-risk patients, appropriate allocation of resources, and adequate techniques of pressure relief. A standardized treatment plan that is familiar to care givers should be followed. The clinician must correct all conditions that retard the healing process, including nutritional deficits and underlying medical problems. Multiple-drug therapy must be eliminated, and only established skin care protocols should be followed. Use of systemic antibiotics is reserved for complications, such as osteomyelitis, cellulitis, and sepsis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3336611&dopt=Abstract skin, skin care, skin care medicine