skin-care-5.matches: skin care
[Rehabilitative methods for the laryngectomized patient - new orientation for the practice]

[Article in German]

Schultz-Coulon HJ.

The rehabilitation of the laryngectomee has not only a functional aspect, i.e. restoration of voice and treatment of physical complaints, but also requires social readjustment and mastering of psychological problems. The most important part of functional rehabilitation is the acquisition of an effective substitute voice. A critical review of the various methods of voice restoration reveals that esophageal speech is still to be preferred, because it is independent of any aids. The Singer-Blom voice prosthesis appears to be superior to the vocal fistula of Staffieri because of its smaller aspiration risk and less complications. Regarding electromechanical speech aids some recent publications by several authors have outlined probable improvements in this field. For the treatment of physical complaints a suction pump, an inhalor and a humidifier are necessary in every case as well as gauze aprons for the protection of the tracheostoma, an ointment for skin care and (for patients wearing a tracheostomy tube) a set-up for cleaning the tube. This indispensable basic equipment may be complemented by a shower shield, a swimming tube, an alarm bell and a respiration tube for emergencies. Efforts at social rehabilitation have two directions: (1) Support of social reintegration by eliminating ignorance, prejudices and anxieties of relatives and friends; (2) preservation of employment or procurement of a new job. The task of psychological rehabilitation is to cope with the abnormal depressive reaction which is to be expected in about half of the patients; psychological rehabilitation begins with intensive counselling before surgery and goes hand in hand with a quick and complete functional and social rehabilitation; its main goal is the restoration of selfconfidence in the patient. These multiple rehabilitation tasks can only be accomplished by close cooperation with the speech therapist, the social services, the employment office and the employer, the insurance companies and possibly with the psychotherapist. The laryngectomee associations and special rehabilitation centers offer valuable help, but the ENT-specialist does have a key position as an advisor and coordinator within the rehabilitation process.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6706696&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Long term pressure recordings under the ischial tuberosities of tetraplegics.

Fisher SV, Patterson P.

Five ulcer free tetraplegic subjects who are unable to do lift-offs were studied on four separate days on two types of wheelchair cushions to measure the pressures underneath the ischial tuberosities. Small electrical pressure transducers and a tape-recorder were utilised. The average pressures on the ROHO and foam cushions were 71.5 and 105.4 mmHg respectively. The average time between push-ups greater than 1 second and greater than 5 seconds was 72.1 and 96.2 minutes. The average pressures and the time between push-ups was greatly in excess of the usually suggested skin care regime. The data would suggest that the relative importance of pressure and pressure relief in the aetiology of decubitus ulcers should be re-examined.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6866561&dopt=Abstract skin, skin care, skin care medicine skin-care-1.matches: skin care
Skin care of the healthy newborn.

Lin RL, Tinkle LL, Janniger CK.

UMDNJ-New Jersey Medical School, Newark NJ 07103-2714, USA.

Routine care of a newborn may be an intimidating task for new parents. This routine care includes tending to the skin of the infant. Maintaining a healthy, intact cutaneous barrier is important psychologically for the parent and medically for the child. Clinicians should be able to offer guidance concerning the basics of skin care, to dispel any misconceptions concerning baby products, and to optimize cutaneous integrity for the comfort and well being of the infant.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15732431&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Pressure ulcerations.

Elliott TM.

Pressure sore are caused by multiple mechanisms. Preventive management requires relief of pressure, skin care, control of spasms, release of contractures and treatment of infection. Conservative treatment succeeds only when pressure on the ulcer site is relieved. Surgical treatment involves primary, secondary and tertiary procedures. Benefits of surgical closure include avoidance of protein loss, prevention of osteomyelitis and other infections, improved appearance and prevention of carcinoma and amyloidosis. A coordinated team approach, incorporating patient education, is effective.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7058730&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Prospective study of cosmetic reactions: 1977-1980. North American Contact Dermatitis Group.

Eiermann HJ, Larsen W, Maibach HI, Taylor JS.

This prospective study (1977-1980) of cosmetic adverse reactions by eleven dermatologists identified 487 cases of cosmetic-induced dermatitis. Approximately half of the cases were covert in nature. Eight percent were due to allergic contact dermatitis; the face, eye, and upper arm were the most involved sites. Skin care products, hair preparations (including colors), and facial makeup products were the most commonly involved product categories. Fragrances, preservatives, lanolin and lanolin derivatives, p-phenylenediamine, and propylene glycol were most commonly identified causative agents. The data may not be representative of the country at large because of the special interests of the dermatologists involved.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7096650&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Skin care in childhood.

Agache P, Makki S, Blanc D, Constans S, Michalet D.

Childhood (3 to 9 years) is a calm period of constant growth throughout which social contacts are discovered and intelligence and discretion take place. Consequently, most diseases are infectious. Microrelief was found twice shallower and skin (epidermis + dermis) twice thinner than in adults. Intervals between furrows were reduced parallel to total body surface, thus ruling out the possible existence of special shelters favouring bacterial growth. Sweating is lower, as are skin surface lipid levels, in contrast to the post-natal period, inducing dryness of skin. Although total skin stiffness in vivo was found to be identical to young adult skin, skin chapping is much more frequent. Since detergents as well as extended hot baths may reduce the stratum corneum water binding capacity, they should be used with discretion. Hence, skin care in this period of age should be based upon different criteria than in adults.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7105804&dopt=Abstract skin, skin care, skin care medicine skin-care-1.matches: skin care
A randomised controlled trial in the north of England examining the effects of skin-to-skin care on breast feeding.

Carfoot S, Williamson P, Dickson R.

Women's Health Directorate, North Cheshire Hospitals NHS Trust, Warrington, UK.

OBJECTIVE: to examine the effect of early skin-to-skin contact between mothers and their healthy full-term babies on initiation and duration of breast feeding. DESIGN: a randomised controlled trial comparing skin-to-skin with routine care. SETTING: Warrington Hospital, Cheshire, UK. PARTICIPANTS: 204 mother and baby pairs; 102 randomised to each group. OUTCOME MEASURES: success of first breast feed, maternal satisfaction with skin-to-skin care and preference for future post-delivery care, baby-body temperature 1 hr after birth, partial or exclusive breast feeding at 4 months. FINDINGS: in the skin-to-skin group, 89 out of 98 (91%) babies had a successful first feed compared with 82 out of 89 (83%) in the routine care group. The difference in the success rate was 8%, 95% confidence interval (CI) (-1.6%, 17.6%); chi(2)=2.7; df=1; P=0.10. Forty-two out of 97 (43%) babies given skin-to-skin were partially or exclusively breast feeding at 4 months compared with 40 out of 100 (40%) of babies in the routine care group. The difference in breast-feeding rate at 4 months was 3.3%, 95% CI (-10.3%, 16.7% ); chi(2)=0.22; df=1; P=0.64. The mean temperature 1 hr after birth was higher with skin-to-skin than routine care. The difference in means was 0.15 degrees C; 95% CI (0.03, 0.28); P=0.02. A larger proportion of mothers (87/97 [90%]) were very satisfied with skin-to-skin care, compared with 60 out of 102 (59%) in the control group; 83 out of 97 (86%) of the mothers in the intervention group said that they would prefer to receive the same care in the future compared with 31 out of 102 (30%) mothers in the control group. CONCLUSIONS: the difference between the groups in the success rate for the first breast feed and rates at 4 months was not statistically significant. However, mothers who had skin-to-skin contact enjoyed the experience, and most reported that they would choose to have skin-to skin care in the future. In this, the largest trial to date, previous concerns about baby-body temperature after skin-to-skin care were dispelled.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15740818&dopt=Abstract skin, skin care, skin care medicine