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Di Pietro A, Cameron M, Campana V, Leyes L, Zalazar Cinat JAI, Lochala C, Johnson CZ, Hilldebrand A, Loyo M. Efficacy of adding selective electrical muscle stimulation to usual physical therapy for Bell's palsy: immediate and six-month outcomes. Eur J Transl Myol 2023; 33:11630. [PMID: 37877154 PMCID: PMC10811644 DOI: 10.4081/ejtm.2023.11630] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/28/2023] [Indexed: 10/26/2023] Open
Abstract
Bell's palsy is the most common cause of facial paralysis, affecting one in every 60 people in their lifetime. Transcutaneously applied selective electrical muscle stimulation could potentially accelerate recovery from Bell's palsy but this intervention remains controversial. Studies have shown benefit, but concerns for lack of efficacy and potential for worsening synkinesis remain. We performed a prospective controlled trial comparing outcomes at initial recovery and six months later with selective electrical muscle stimulation and usual physical therapy versus usual physical therapy alone in adults with acute Bell's palsy. Outcomes were facial function assessed with the House Brackman and eFACE scales. Outcomes were evaluated at discharge and six months after discharge. Discharge occurred when participants were judged to be fully recovered by their treating therapist and supervisor. 38 adults participated in the study. Participants in the electrical stimulation group achieved maximal recovery twice as fast as the control group (2.5 weeks versus 5.2 weeks) with no significant differences in facial function or synkinesis between groups at any time point. This study is the first human trial of electrical stimulation in Bell's palsy to follow patients 6 months from recovery and supports that selective electrical muscle stimulation accelerates recovery and does not increase synkinesis.
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Affiliation(s)
| | - Michelle Cameron
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; VA Portland Health Care System.
| | - Vilma Campana
- Department of Biomedical Physics, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba.
| | - Laura Leyes
- Department of Kinesiology and Physical Therapy, Universidad Nacional del Nordeste, Corrientes.
| | | | - Carly Lochala
- Department of Rehabilitation, Oregon Health & Science University, Portland, OR, USA; Division of Biokinesiology & Physical Therapy, University of Southern California.
| | - Christopher Z Johnson
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
| | - Andrea Hilldebrand
- Biostatistics and Design Program, Oregon Health & Science University, Portland, OR, USA; Portland State University School of Public Health, Portland, OR.
| | - Myriam Loyo
- Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
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Borges D, Pires R, Ferreira J, Dias-Neto M. The effect of wound electrical stimulation in venous leg ulcer healing-a systematic review. J Vasc Surg Venous Lymphat Disord 2023; 11:1070-1079.e1. [PMID: 37196922 DOI: 10.1016/j.jvsv.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE The benefit of using electric stimulation therapy (EST) to heal venous leg ulcers (VLUs) is not well established. The main aim of this systematic review was to evaluate the effects of ulcer EST in VLU healing. METHODS A systematic search of the literature was conducted using the databases PubMed, Scopus, and Web of Science and included original studies that reported VLU healing after EST. The inclusion criteria were at least two surface electrodes placed on or near the wound or a planar probe covering the ulcer area to be treated. The Cochrane risk of bias tool for randomized control trials (RCTs) and Joanna Briggs Institute critical appraisal checklist for case series were used to evaluate the risk of bias. RESULTS This review included eight RCTs and three case series involving a total of 724 limbs in 716 patients with VLUs. The mean patient age was 64.2 years (95% confidence interval, 62.3-66.2), and 46.2% (95% confidence interval, 41.2%-50.4%) were men. The active electrode was placed on the wound with the passive electrode placed on healthy skin (n = 6), the two electrodes were placed on either side of the wound edges (n = 4), or a planar probe was used (n = 1). The pulsed current was the most used waveform (n = 9). The change in the ulcer size was the main method used to determine ulcer healing (n = 8), followed by the ulcer healing rate (n = 6), exudate levels (n = 4), and the time to healing (n = 3). Five RCTs detected a statistically significant improvement in at least one VLU healing outcome, after EST compared with the control group. In two of these, EST was better than the control but only for patients who had not undergone surgical treatment of VLU. CONCLUSIONS The findings from the present systematic review support the use of EST to accelerate wound healing of VLUs, especially for patients who are not surgical candidates. However, the significant variation in electric stimulation protocols represents an important limitation to its use and should be addressed in future studies.
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Affiliation(s)
- Daniela Borges
- Faculdade de Medicina da Universidade do Porto, University of Porto, Porto, Portugal.
| | - Raquel Pires
- Escola Superior de Biotecnologia, Universidade Católica do Porto, Porto, Portugal
| | - Joana Ferreira
- Department of Angiology and Vascular Surgery, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Marina Dias-Neto
- Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
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Yoo MC, Kim JH, Kim YJ, Jung J, Kim SS, Kim SH, Yeo SG. Effects of Electrical Stimulation on Facial Paralysis Recovery after Facial Nerve Injury: A Review on Preclinical and Clinical Studies. J Clin Med 2023; 12:4133. [PMID: 37373826 DOI: 10.3390/jcm12124133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Various methods have been used to improve function and manage facial nerve injury. Although electrical stimulation therapy is frequently used to treat facial paralysis, its effects have been found to vary and no clear standards have been developed. The current review describes the results of preclinical and clinical studies evaluating the effectiveness of electrical stimulation therapy in promoting the recovery of a peripheral facial nerve injury. Evidence is presented showing the efficacy of electrical stimulation in promoting nerve regeneration after peripheral nerve injuries in both animal models and human patients. The ability of electrical stimulation to promote the recovery of facial paralysis was found to depend on the type of injury (compression or transection), the species of animal tested, the type of disease, the frequency and method of electrical stimulation, and the duration of the follow-up. Electrical stimulation, however, can also have potential negative outcomes, such as reinforcing synkinesis, including mistargeted axonal regrowth via inappropriate routes; excessive collateral axonal branching at the lesion site; and multiple innervations at neuromuscular junctions. Because of the inconsistencies among studies and the low quality of evidence, electrical stimulation therapy is not currently regarded as a primary treatment of facial paralysis in patients. However, understanding the effects of electrical stimulation, as determined in preclinical and clinical studies, is important for the potential validity of future research on electrical stimulation.
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Affiliation(s)
- Myung Chul Yoo
- Department of Physical Medicine & Rehabilitation, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jeong Hee Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Yong Jun Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Pathology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Junyang Jung
- Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sung Soo Kim
- Department of Biochemistry and Molecular Biology, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sang Hoon Kim
- Department of Otorhinolaryngology Head & Neck Surgery, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Seung Geun Yeo
- Department of Otorhinolaryngology Head & Neck Surgery, College of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
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Tsolakidis S, Rosenauer R, Schmidhammer R, Pallua N, Rennekampff HO. Wireless microcurrent stimulation improves blood flow in burn wounds. Burns 2022; 48:1230-1235. [PMID: 34607727 DOI: 10.1016/j.burns.2021.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022]
Abstract
RATIONALE Skin breakdown, as in wounds, leads to an electric potential, defined as current of injury with the intent of wound closure. Burn wounds are defined by different zones of perfusion having a direct influence on further therapy (e.g. conservative management or skin grafting). We studied immediate, quantifiable effects of electric stimulation on skin perfusion in burn wounds. METHOD Wireless Microcurrent Stimulation (WMCS) was utilised as an adjunct therapeutic modality in 10 patients with partial thickness burn wounds. Microcirculation in the skin was quantified with a Laser Doppler (LDI) before and after WMCS treatment. We included a control group of 10 healthy individuals. RESULTS A single application of WMCS significantly increased mean flow, velocity and subsequently, haemoglobin and oxygen saturation in partial thickness burn wounds. In healthy skin these parameters increased, but were far less pronounced than in thermally injured skin. CONCLUSION This study revealed, for the first time that non-contact WMCS improves blood flow in critically perfused partial thickness burn wounds without disturbing the wound or systemically affecting the patient and may represent a promising adjunct tool in burn treatment, with the potential of faster healing by enhanced perfusion of burn wounds and reduction of the zone of stasis. LEVEL OF EVIDENCE III.
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Affiliation(s)
- S Tsolakidis
- Austrian Cluster of Tissue Regeneration and Ludwig Boltzmann Institute for Experimental and Clinical Traumatology at the Research Centre for Traumatology of the Austrian Workers Compensation Board (AUVA), Donaueschingenstraße 13, 1200 Vienna, Austria; Millesi Center for Surgery of Peripheral Nerves, Vienna Private Clinic, Pelikangasse 15, 1090 Vienna, Austria.
| | - R Rosenauer
- Austrian Cluster of Tissue Regeneration and Ludwig Boltzmann Institute for Experimental and Clinical Traumatology at the Research Centre for Traumatology of the Austrian Workers Compensation Board (AUVA), Donaueschingenstraße 13, 1200 Vienna, Austria; Trauma Hospital Lorenz Boehler of the Austrian Workers Compensation Board (AUVA), Donaueschingenstrasse 13, 1200 Vienna, Austria; Millesi Center for Surgery of Peripheral Nerves, Vienna Private Clinic, Pelikangasse 15, 1090 Vienna, Austria.
| | - R Schmidhammer
- Austrian Cluster of Tissue Regeneration and Ludwig Boltzmann Institute for Experimental and Clinical Traumatology at the Research Centre for Traumatology of the Austrian Workers Compensation Board (AUVA), Donaueschingenstraße 13, 1200 Vienna, Austria; Millesi Center for Surgery of Peripheral Nerves, Vienna Private Clinic, Pelikangasse 15, 1090 Vienna, Austria.
| | - N Pallua
- Faculty of Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - H O Rennekampff
- Klinik für Plastische Chirurgie, Hand-und Verbrennungschirurgie, Rhein-Maas Klinikum, Mauerfeldchen 25, 52146 Wuerselen, Germany.
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Elfahl AM, Abd El Baky AM, Yousef MT, Elgohary HM. High Versus Low Frequency Transcutaneous Electric Nerve Stimulation On Chronic Venous Lower Limb Ulceration Randomized Controlled Trial. INT J LOW EXTR WOUND 2022:15347346221093860. [PMID: 35422171 DOI: 10.1177/15347346221093860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
The major objective of the current paper is to trace and investigate which method is more effective whether the high or the low Transcutaneous electric Nerve Stimulations (TENS) on venous ulcers. A single-blinded, randomized, and controlled trial was done successfully. Sixty venous ulcer patients were divided randomly into three groups; Group (A): control group, Group(B): High-TENS group, and Group(C): Low-TENS group. Group (A), contains twenty participants who received routine medical care and dressing. As for group (B), includes twenty participants who obtained high-frequency TENS; Frequency (80-120) HZ, Intensity (15 - 30 amp), Pulse duration 250 Micro sec, 60 min per session with routine medical care and dressing. The third group (c) L-TENS, encompasses twenty participants who received low-frequency TENS (1-5) HZ; Intensity (30 -80 amp), Pulse duration 250 Micro sec, 60 min per session with routine medical care and dressing. All the participants were examined before and after two months of intervention; four weeks (post1), then after eight weeks (post2). Participants were examined by using (image j) to measure the ulcer area. Saline was used for measuring the ulcer volume, and a visual analog scale was adopted to evaluate pain. After drawing a comparison among the three groups after four weeks and after eight weeks of treatment, a statistically significant decrease (P <0.05) in wound surface area, wound volume, and pain in favor of L-TENS was noticed. It has been found that L- TENS is more effective than H -TENS and is highly recommended in the treatment protocol for such debilitating conditions.
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Affiliation(s)
- Ahmed M Elfahl
- Physical Therapy for Burn and Surgery Department, Faculty of Physical Therapy, 110120Modern University for Information and Technology, Cairo, Egypt
| | - Amal M Abd El Baky
- Professor of Physical Therapy for Surgery and Vice Dean for Postgraduate Studies and Scientific Research, Faculty of Physical Therapy, 531226Cairo University, Cairo, Egypt
| | - Mohamed T Yousef
- Assistant professor and chairman of Endo Vascular Surgery Department, Al-Mataria Teaching Hospital, Cairo, Egypt
| | - Hany M Elgohary
- Assistant professor of Physical Therapy for Surgery, Faculty of Physical Therapy, 531226Cairo University, Cairo, Egypt
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Yoshikawa Y, Hiramatsu T, Sugimoto M, Uemura M, Mori Y, Ichibori R. Efficacy of Low-frequency Monophasic Pulsed Microcurrent Stimulation Therapy in Undermining Pressure Injury: A Double-blind Crossover-controlled Study. Prog Rehabil Med 2022; 7:20220045. [PMID: 36160025 PMCID: PMC9470497 DOI: 10.2490/prm.20220045] [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: 01/13/2022] [Accepted: 08/09/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives: This double-blind crossover-controlled trial aimed to verify the effect of electrical
stimulation therapy on pressure injuries with undermining. Methods : In this trial, we compared the healing rates between a sham period and a treatment
period using monophasic pulsed microcurrent therapy. The participants were randomly
assigned to the sham or treatment group and received stimulation for 2 weeks. All the
participants, physical therapists, and researchers were blinded to the allocation. For
the main analysis, data on the effect of the intervention on changes in weekly healing
and contraction rates of the wound areas, including undermining, were analyzed based on
a two-period crossover study design. The intervention effect was estimated by examining
the mean treatment difference for each period using Wilcoxon’s signed-rank test. Results : The reduction of the entire wound area, including the undermining area, resulted in
significantly higher healing and contraction rates in the treatment group (overall wound
area reduction rate: contraction rate, P=0.008; period healing rate, P=0.002). Conclusions : Electrical stimulation therapy for pressure injuries, using conditions based on the
findings of an in vivo culture study, was effective in reducing the wound area.
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Affiliation(s)
| | | | - Masaharu Sugimoto
- Department of Physical therapy, Kobe Gakuin University (Retired), Kobe, Japan
| | - Mikiko Uemura
- Department of Health Science, Kansai University of Welfare Sciences, Kashiwara City, Japan
| | - Yuki Mori
- Department of Rehabilitation, Housenka Hospital, Ibaraki City, Japan
| | - Ryoko Ichibori
- Department of Dermatology, Housenka Hospital, Ibaraki City, Japan
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Bosanquet DC, Harding KG. Wound healing: potential therapeutic options. Br J Dermatol 2021; 187:149-158. [PMID: 34726774 DOI: 10.1111/bjd.20772] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2021] [Indexed: 12/22/2022]
Abstract
This review highlights the range of therapeutic options available to clinicians treating difficult-to-heal wounds. While certain treatments are established in daily clinical practice, most therapeutic interventions lack robust and rigorous data regarding their efficacy, which would help to determine when, and for whom, they should be used. The purpose of this review is to give a broad overview of the available interventions, with a brief summary of the evidence base for each intervention.
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Affiliation(s)
- D C Bosanquet
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Cardiff Road, Newport, NP16 2UB, UK
| | - K G Harding
- Clinical Innovation Hub, Cardiff University, Cardiff, CF14 4XN, UK.,Skin Research Institute Singapore (SRIS), Singapore
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Milne J, Swift A, Smith J, Martin R. Electrical stimulation for pain reduction in hard-to-heal wound healing. J Wound Care 2021; 30:568-580. [PMID: 34256596 DOI: 10.12968/jowc.2021.30.7.568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Despite treatment advances over the past 30 years, the societal impact of hard-to-heal wounds is increasingly burdensome. An unresolved issue is wound pain, which can make many treatments, such as compression in venous leg ulcers, intolerable. The aim of this review is to present the evidence and stimulate thinking on the use of electrical stimulation devices as a treatment technology with the potential to reduce pain, improve adherence and thus hard-to-heal wound outcomes. METHOD A literature search was conducted for clinical studies up to August 2020 reporting the effects of electrical stimulation devices on wound pain. Devices evoking neuromuscular contraction or direct spinal cord stimulation were excluded. RESULTS A total of seven publications (three non-comparative and four randomised trials) were identified with four studies reporting a rapid (within 14 days) reduction in hard-to-heal wound pain. Electrical stimulation is more widely known for accelerated healing and is one of the most evidence-based technologies in wound management, supported by numerous in vitro molecular studies, five meta-analyses, six systematic reviews and 30 randomised controlled trials (RCTs). Despite this wealth of supportive evidence, electrical stimulation has not yet been adopted into everyday practice. Some features of electrical stimulation devices may have hampered adoption in the past. CONCLUSION As new, pocket-sized, portable devices allowing convenient patient treatment and better patient adherence become more widely available and studied in larger RCTs, the evidence to date suggests that electrical stimulation should be considered part of the treatment options to address the challenges of managing and treating painful hard-to-heal wounds.
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Hernández-Bule ML, Toledano-Macías E, Naranjo A, de Andrés-Zamora M, Úbeda A. In vitro stimulation with radiofrequency currents promotes proliferation and migration in human keratinocytes and fibroblasts. Electromagn Biol Med 2021; 40:338-352. [PMID: 34315307 DOI: 10.1080/15368378.2021.1938113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Capacitive-resistive electric transfer (CRET) therapies have been proposed as strategies for regeneration of cutaneous tissue lesions. Previous studies by our group have shown that intermittent stimulation with 448 kHz CRET currents at subthermal densities promotes in vitro proliferation of human stem cells involved in tissue regeneration. The present study investigates the effects of the in vitro exposure to these radiofrequency (RF) currents on the proliferation and migration of keratinocytes and fibroblasts, the main cell types involved in skin regeneration. The effects of the electric stimulation on cell proliferation and migration were studied through XTT and wound closure assays, respectively. The CRET effects on the expression and location of proteins involved in proliferation and migration were assessed by immunoblot and immunofluorescence. The obtained results reveal that electrostimulation promotes proliferation and/or migration in keratinocytes and fibroblasts. These effects would be mediated by changes observed in the expression and location of intercellular adhesion proteins such as β-catenin and E-cadherin, of proteins involved in cell-to-substrate adhesion such as vinculin, p-FAK and the metalloproteinase MMP-9, and of other proteins that control both processes: MAP kinases p-p38, p-JUNK and p-ERK1/2. These responses could represent a mechanism underlying the promotion of normotrophic wound regeneration induced by CRET. Indeed, electric stimulation would favor completion of granulation tissue formation prior to the closure of the outer tissue layers, thus preventing abnormal wound cicatrization or chronification.
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Affiliation(s)
| | - Elena Toledano-Macías
- Servicio de Bioelectromagnetismo, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Aida Naranjo
- Departamento de Ingeniería Eléctrica, Escuela Técnica Superior de Ingeniería y Diseño Industrial, Universidad Politécnica de Madrid, Madrid, Spain
| | - Marina de Andrés-Zamora
- Departamento de Ingeniería Eléctrica, Escuela Técnica Superior de Ingeniería y Diseño Industrial, Universidad Politécnica de Madrid, Madrid, Spain
| | - Alejandro Úbeda
- Servicio de Bioelectromagnetismo, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
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Carraro U, Yablonka-Reuveni Z. Translational research on Myology and Mobility Medicine: 2021 semi-virtual PDM3 from Thermae of Euganean Hills, May 26 - 29, 2021. Eur J Transl Myol 2021; 31:9743. [PMID: 33733717 PMCID: PMC8056169 DOI: 10.4081/ejtm.2021.9743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 02/08/2023] Open
Abstract
On 19-21 November 2020, the meeting of the 30 years of the Padova Muscle Days was virtually held while the SARS-CoV-2 epidemic was hitting the world after a seemingly quiet summer. During the 2020-2021 winter, the epidemic is still active, despite the start of vaccinations. The organizers hope to hold the 2021 Padua Days on Myology and Mobility Medicine in a semi-virtual form (2021 S-V PDM3) from May 26 to May 29 at the Thermae of Euganean Hills, Padova, Italy. Here the program and the Collection of Abstracts are presented. Despite numerous world problems, the number of submitted/selected presentations (lectures and oral presentations) has increased, prompting the organizers to extend the program to four dense days.
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Affiliation(s)
- Ugo Carraro
- Department of Biomedical Sciences of the University of Padova, Italy; CIR-Myo - Myology Centre, University of Padova, Italy; A-C Mioni-Carraro Foundation for Translational Myology, Padova.
| | - Zipora Yablonka-Reuveni
- Department of Biological Structure, University of Washington School of Medicine, Seattle, WA.
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Ferreira CL, Neves Jardini MA, Moretto Nunes CM, Bernardo DV, Viana Casarin RC, Dos Santos Gedraite E, Mathias MA, Liu F, Mendonça G, Silveira Mendonça DB, Santamaria MP. Electrical stimulation enhances early palatal wound healing in mice. Arch Oral Biol 2020; 122:105028. [PMID: 33360374 DOI: 10.1016/j.archoralbio.2020.105028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND/OBJECTIVE Electrical stimulation (ES) has been used to treat chronic wound and other clinical applications, showing favorable results in wound closure. It was hypothesized that ES can present a positive effect on oral mucosa healing. The aim of this study was to investigate the effects of ES during the palatal mucosa early healing process in Swiss mice. METHODS Ninety animals were divided into two groups: Control (C; n = 45), which received Sham ES applications, and Test (ES; n = 45), which received ES (100 μA; 9 kHz; 660 mVpp) once a day for 3 days. A full thickness wound was performed with a 1.5 mm diameter biopsy punch in the hard palate. Histologically, the following parameters were evaluated: palatal wound closure and epithelial and connective wound edge distance (EED and CED). Furthermore, IL-1β, IL-6, IL-10 TNF-α, and VEGF cytokine levels were evaluated by multiplex assay. The percentage of collagen fibers was assessed using the polarization method and the Smad proteins using the immunofluorescence method. RESULTS Palatal wound closure presented a significant reduction on day 5 in the ES group (p = 0.01). Additionally, both EED and CED were shorter for all time points in the ES group (p < 0.05), and the inflammatory markers IL-6, IL-10, TNF-α, and VEGF were reduced (p < 0.05). There were no differences in collagen fibers and phospho-Smad2 between the groups. CONCLUSION ES had a positive effect on early palatal wound closure outcomes, as well as on inflammatory markers.
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Affiliation(s)
- Camila Lopes Ferreira
- Postgraduate Student, Oral Biopathology Program, Periodontics Area, São Paulo State University (UNESP), College of Dentistry, São José dos Campos, Brazil
| | - Maria Aparecida Neves Jardini
- São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Camilla Magnoni Moretto Nunes
- Postgraduate Student, Oral Biopathology Program, Periodontics Area, São Paulo State University (UNESP), College of Dentistry, São José dos Campos, Brazil
| | - Daniella Vicensotto Bernardo
- Postgraduate Student, Oral Biopathology Program, Periodontics Area, São Paulo State University (UNESP), College of Dentistry, São José dos Campos, Brazil
| | - Renato Corrêa Viana Casarin
- University of Campinas (UNICAMP). Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, Piracicaba, São Paulo, Brazil
| | | | | | - Fei Liu
- University of Michigan, School of Dentistry, Department of Biologic and Materials Sciences & Prosthodontics, Ann Arbor, USA
| | - Gustavo Mendonça
- University of Michigan, School of Dentistry, Department of Biologic and Materials Sciences & Prosthodontics, Ann Arbor, USA
| | | | - Mauro Pedrine Santamaria
- São Paulo State University (UNESP), Division of Periodontics, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil.
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Das SK, Dhoonmoon L, Chhabra S. Neuromuscular stimulation of the common peroneal nerve increases arterial and venous velocity in patients with venous leg ulcers. Int Wound J 2020; 18:187-193. [PMID: 33236847 PMCID: PMC8243992 DOI: 10.1111/iwj.13510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 12/21/2022] Open
Abstract
Activation of the venous muscle pumps by neuromuscular stimulation of the common peroneal nerve has been previously shown to increase venous and arterial flow in the legs of healthy subjects. The aim of this study is to determine whether a similar effect is observed in patients with chronic venous leg ulcers. 1 Hz intermittent electrostimulation of the common peroneal nerve was applied to 14 patients with ulcers between 1 and 10 cm in diameter, eliciting a small, painless, regular, muscular twitch of the leg. Flow was measured using Duplex ultrasound in the popliteal vein and the popliteal artery. Peak arterial velocity increased from 57 to 78 cm/s (P = .001) in sitting position, and from 79 to 98 cm/s in recumbent position (P = .001). Peak venous velocity increased from 10 to 33 cm/s (P = .001) sitting, and from 14 to 47 cm/s (P = .001) recumbent. Significant increases were observed in both venous and arterial blood flow in the lower limb. This suggestsed that activation of the venous muscle pump and improvement of arterial flow assisted oxygen delivery at the wound site. Moreover this may be a worthwhile intervention to assist in the healing of venous leg ulcers, and may provide a mechanistic explanation for the increased healing rates previously reported with neuromuscular stimulation of the common peroneal nerve.
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Affiliation(s)
- Saroj K Das
- Consultant Vascular & Endovascular Surgeon, West London Vascular and Intervention Centre (WeLVIC), London North West Health Care NHS Trust, London, UK
| | | | - Swati Chhabra
- London North West University Health care NHS Trust, London, UK
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Miguel MMV, Mathias-Santamaria IF, Rossato A, Ferraz LFF, Figueiredo-Neto AM, de Marco AC, Casarin RCV, Wallet SM, Tatakis DN, Mathias MA, Santamaria MP. Microcurrent electrotherapy improves palatal wound healing: Randomized clinical trial. J Periodontol 2020; 92:244-253. [PMID: 32783220 DOI: 10.1002/jper.20-0122] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/07/2020] [Accepted: 05/31/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study was conducted to assess the clinical, immunological, and patient-centered outcomes of microcurrent electrotherapy on palatal wound healing. METHODS This was a parallel, double-masked randomized clinical trial, in which 53 patients with ridge preservation indications were selected and randomly assigned to one of two groups. In the control (sham) group (n = 27), palatal wounds, after free gingival grafts (FGG) harvest, received sham application of electrotherapy. In the test (electrotherapy treatment [EE]) group (n = 26), palatal wounds, after FGG harvest, received application of microcurrent electrotherapy protocol. Clinical parameters, patient-centered outcomes, and inflammatory markers were evaluated, up to 90 days postoperatively. RESULTS The EE group achieved earlier wound closure (P <0.001) and epithelialization (P <0.05; P = 0.03) at 7 and 14 days after harvest when compared with the sham group. Painful symptomatology was reported less frequently in the EE group than in the sham group at 3-day follow-up (P = 0.008). Likewise, an improvement in Oral Health Impact Profile was reported 2 days after the procedure by the EE group (P = 0.04). In addition, favorable modulation of inflammatory wound healing markers occurred when electrotherapy was applied. CONCLUSION Within the limits of the present study, it can be concluded that the use of a low-intensity electrotherapy protocol may accelerate palatal wound healing and decrease patient discomfort after FGG harvest.
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Affiliation(s)
- Manuela Maria Viana Miguel
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Ingrid Fernandes Mathias-Santamaria
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil.,National Institute of Science and Technology-Complex Fluids, São Paulo, Brazil
| | - Amanda Rossato
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Laís Fernanda Ferreira Ferraz
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | | | - Andrea Carvalho de Marco
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Renato Corrêa Viana Casarin
- Department of Prosthodontics and Periodontics, Division of Periodontics, University of Campinas Piracicaba Dental School Piracicaba, São Paulo, Brazil
| | | | - Dimitris N Tatakis
- College of Dentistry, Division of Periodontology, The Ohio State University, Columbus, OH, USA
| | - Marcio Antonio Mathias
- FEI University, Department of Electrical Engineering, São Bernardo do Campo, São Paulo, Brazil
| | - Mauro Pedrine Santamaria
- Division of Periodontics, Unesp - São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
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Peng Z, Zhou L, Wong JKW, Chan YK. Eye-on-a-chip (EOC) models and their role in the future of ophthalmic drug discovery. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1788388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Zhiting Peng
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, P.R.China
| | - Liangyu Zhou
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Jasper Ka Wai Wong
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Yau Kei Chan
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong SAR
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Chapman-Jones D, Lusher J. Possible implications and clinical value of commercially sponsored evaluations: discussion on research methodology. J Wound Care 2020; 28:501-509. [PMID: 31393802 DOI: 10.12968/jowc.2019.28.8.501] [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
This paper is written in response to a publication in the Journal of Wound Care in 2018 by Guest et al., 'Cost-effectiveness of an electroceutical device in treating non-healing venous leg ulcers: results of an RCT'. The publication and subsequent analysis of the paper provides a vehicle for a wider debate about the care of people with wounds, including who manages the wound, how resources are allocated and the use of supplemental technologies. It also raises a further important issue regarding whether the outcomes from a single randomised controlled trial (RCT) provides a more reliable level of evidence than the findings of previous investigations involving observational trials. This article analyses the results from the cited study, comparing clinical outcomes from previous published studies, and evaluates whether a conclusion may be reached as to the most appropriate and reliable method to assess the efficacy of such medical devices used in wound care. It discusses why the assessment of clinical evidence can be a problem when there is variance of outcomes in studies which use different research methodologies. The hierarchy of evidence lies at the heart of the appraisal process; and within health-care it is common that smaller commercial companies present small-scale observational trials as evidence for the efficacy of the product they are promoting. We question whether this level of data promoted as evidence for clinical efficacy should be dismissed. Guest et al. reported that, in the UK within wound care, clinical practice is inconsistent with significant regional variations; therefore, unless clinical practice guidelines are strictly enforced in a study, which then may be unrepresentative of clinical practice, does it mean that any results produced could not be transferred to the clinical environment? We discuss the conundrum.
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Affiliation(s)
- David Chapman-Jones
- The Institute for Research in Healthcare, The University of the West of Scotland, Glasgow, Scotland
| | - Joanne Lusher
- The University of the West of Scotland, London Campus, London, England
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Arora M, Harvey LA, Glinsky JV, Nier L, Lavrencic L, Kifley A, Cameron ID. Electrical stimulation for treating pressure ulcers. Cochrane Database Syst Rev 2020; 1:CD012196. [PMID: 31962369 PMCID: PMC6984413 DOI: 10.1002/14651858.cd012196.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Pressure ulcers (also known as pressure sores, decubitus ulcers or bedsores) are localised injuries to the skin or underlying tissue, or both. Pressure ulcers are a disabling consequence of immobility. Electrical stimulation (ES) is widely used for the treatment of pressure ulcers. However, it is not clear whether ES is effective. OBJECTIVES To determine the effects (benefits and harms) of electrical stimulation (ES) for treating pressure ulcers. SEARCH METHODS In July 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. We did not impose any restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA We included published and unpublished randomised controlled trials (RCTs) comparing ES (plus standard care) with sham/no ES (plus standard care) for treating pressure ulcers. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted data, and assessed risk of bias. We assessed the certainty of evidence using GRADE. MAIN RESULTS We included 20 studies with 913 participants. The mean age of participants ranged from 26 to 83 years; 50% were male. ES was administered for a median (interquartile range (IQR)) duration of five (4 to 8) hours per week. The chronicity of the pressure ulcers was variable, ranging from a mean of four days to more than 12 months. Most of the pressure ulcers were on the sacral and coccygeal region (30%), and most were stage III (45%). Half the studies were at risk of performance and detection bias, and 25% were at risk of attrition and selective reporting bias. Overall, the GRADE assessment of the certainty of evidence for outcomes was moderate to very low. Nineteen studies were conducted in four different settings, including rehabilitation and geriatric hospitals, medical centres, a residential care centre, and a community-based centre. ES probably increases the proportion of pressure ulcers healed compared with no ES (risk ratio (RR) 1.99, 95% confidence interval (CI) 1.39 to 2.85; I2 = 0%; 11 studies, 501 participants (512 pressure ulcers)). We downgraded the evidence to moderate certainty due to risk of bias. It is uncertain whether ES decreases pressure ulcer severity on a composite measure compared with no ES (mean difference (MD) -2.43, 95% CI -6.14 to 1.28; 1 study, 15 participants (15 pressure ulcers) and whether ES decreases the surface area of pressure ulcers when compared with no ES (12 studies; 494 participants (505 pressure ulcers)). Data for the surface area of pressure ulcers were not pooled because there was considerable statistical heterogeneity between studies (I2 = 96%) but the point estimates for the MD of each study ranged from -0.90 cm2 to 10.37 cm2. We downgraded the evidence to very low certainty due to risk of bias, inconsistency and imprecision. It is uncertain whether ES decreases the time to complete healing of pressure ulcers compared with no ES (hazard ratio (HR) 1.06, 95% CI 0.47 to 2.41; I2 = 0%; 2 studies, 55 participants (55 pressure ulcers)). We downgraded the evidence to very low certainty due to risk of bias, indirectness and imprecision. ES may be associated with an excess of, or difference in, adverse events (13 studies; 586 participants (602 pressure ulcers)). Data for adverse events were not pooled but the types of reported adverse events included skin redness, itchy skin, dizziness and delusions, deterioration of the pressure ulcer, limb amputation, and occasionally death. We downgraded the evidence to low certainty due to risk of selection and attrition bias and imprecision. ES probably increases the rate of pressure ulcer healing compared with no ES (MD 4.59% per week, 95% CI 3.49 to 5.69; I2 = 25%; 12 studies, 561 participants (613 pressure ulcers)). We downgraded the evidence to moderate certainty due to risk of bias. We did not find any studies that looked at quality of life, depression, or consumers' perception of treatment effectiveness. AUTHORS' CONCLUSIONS ES probably increases the proportion of pressure ulcers healed and the rate of pressure ulcer healing (moderate certainty evidence), but its effect on time to complete healing is uncertain compared with no ES (very low certainty evidence). It is also uncertain whether ES decreases the surface area of pressure ulcers. The evidence to date is insufficient to support the widespread use of ES for pressure ulcers outside of research. Future research needs to focus on large-scale trials to determine the effect of ES on all key outcomes.
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Affiliation(s)
- Mohit Arora
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Lisa A Harvey
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Joanne V Glinsky
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Lianne Nier
- Royal North Shore HospitalSpinal Cord Injury UnitWard 7E, Royal North Shore Hospital, Reserve Road, St LeonardsSydneyNSWAustralia2065
| | - Lucija Lavrencic
- Royal North Shore HospitalSpinal Cord Injury UnitWard 7E, Royal North Shore Hospital, Reserve Road, St LeonardsSydneyNSWAustralia2065
| | - Annette Kifley
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
| | - Ian D Cameron
- Northern Sydney Local Health DistrictKolling Institute of Medical ResearchReserve RoadSt LeonardsNSWAustralia2065
- The University of SydneyJohn Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical SchoolReserve RoadSt LeonardsNSWAustralia2065
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Loyo M, McReynold M, Mace JC, Cameron M. Protocol for randomized controlled trial of electric stimulation with high-volt twin peak versus placebo for facial functional recovery from acute Bell's palsy in patients with poor prognostic factors. J Rehabil Assist Technol Eng 2020; 7:2055668320964142. [PMID: 33354350 PMCID: PMC7734495 DOI: 10.1177/2055668320964142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/26/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Electric stimulation (ES) can prevent muscle atrophy and promote tissue healing and therefore may help prevent sequelae of Bell's palsy but due to lack of high-quality studies, the effectiveness of ES in Bell's palsy remains controversial. Here we describe a protocol to evaluate the effects of monophasic high volt ES in patients with Bell's palsy and poor prognosis for recovery. RESULTS This is a protocol for a prospective, double-blinded, randomized, placebo-controlled study. Participants include adults with acute Bell's palsy with poor prognosis for full recovery due to complete paralysis or being over age 60. ES will be a monophasic, high-volt pulsed waveform, 100μsec pulse duration, 35 hertz, motor-level intensity. Follow up will be at months 1, 2, 3 and 6. The primary outcome will be the proportion of patients with complete recovery using the eFACES tool. Secondary outcomes include patient reported quality of life measured by FaCE and the synkinesis assessment questionnaires, objective photographs, time to complete recovery, adverse effects, and tolerability. CONCLUSION This protocol has the potential to provide high quality evidence regarding the effects, up to 6 months after onset, of pulsed monophasic high-volt ES for patients with acute Bell's palsy and poor prognosis for complete recovery.
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Affiliation(s)
- Myriam Loyo
- Department of Otolaryngology – Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Margaret McReynold
- Department of Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Jess C Mace
- Department of Otolaryngology – Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Michelle Cameron
- Department of Neurology, Oregon Health & Science University, Oregon Health & Science University, Portland, OR, USA
- VA Portland Health Care System, Oregon Health & Science University, Portland, OR, USA
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Aline de Oliveira Kaizer U, Hauany Silva Costa M, Aparecida Rocha Domingues E, Roana Ferreira de Carvalho M. High-frequency generator in the treatment of necrotizing fasciitis in a person
with diabetes. ESTIMA 2019. [DOI: 10.30886/estima.v17.688_in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: A case report on the treatment of necrotizing fasciitis with the use of high frequency (HF) generator in a person with diabetes. Methods: This is descriptive study of applied nature developed in an outpatient clinic in Minas Gerais. The patient underwent dressing sessions three times a week for high frequency application. Healing was weekly evaluated using the Pressure Ulcer Scale Healing (PUSH) instrument and Image J software. Results: The area was significantly reduced, which was measured during six weekly evaluations. In the first four evaluations, a progressive reduction of the lesion was obtained in 11.78 cm², that is, 90% of the area. Conclusion: The use of the AF generator was effective in the treatment of necrotizing fasciitis, reducing the lesion area.
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19
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Aline de Oliveira Kaizer U, Hauany Silva Costa M, Aparecida Rocha Domingues E, Roana Ferreira de Carvalho M. Gerador de alta frequência no tratamento de fasciíte necrotizante em pessoa com diabetes. ESTIMA 2019. [DOI: 10.30886/estima.v17.688_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo: Relato de caso sobre o tratamento da fasciíte necrotizante com a utilização do gerador de alta frequência (AF) em uma pessoa com diabetes. Métodos: Trata-se de um estudo descritivo de natureza aplicada, desenvolvido em um ambulatório no interior de Minas Gerais. A paciente foi submetida a sessões de curativo durante três vezes na semana para aplicação de alta frequência. A cicatrização foi avaliada semanalmente por meio do instrumento Pressure Ulcer Scale Healing (PUSH) e pelo software Image J. Resultados: Houve redução significativa da área da lesão, que foi mensurada durante seis avaliações semanais. Nas quatro primeiras avaliações, foi obtida redução progressiva da lesão em 11,78 cm², ou seja, 90% da área. Conclusão: O uso do gerador de AF foi efetivo no tratamento da fasciíte necrotizante, com redução da área da lesã
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20
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Yu Y, Shen J, Fang G, Wang L, Lei S, Cai D, Shi Y, Jin S, Lu Q, Wang S, Sun Y, Yao J, Hu P, Wu X, He X. Use of autologous platelet rich fibrin-based bioactive membrane in pressure ulcer healing in rats. J Wound Care 2019; 28:S23-S30. [PMID: 30975063 DOI: 10.12968/jowc.2019.28.sup4.s23] [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
OBJECTIVE To verify the feasibility of treating pressure ulcers (PUs) with autologous platelet-rich fibrin-based (PRF) bioactive membrane, both in vitro and in vivo. METHOD An animal model using adult male Sprague-Dawley rats was used. Pressure was periodically exerted on the skin to induce localised ischaemia by using an external magnet and transplanted metal disc. After a PU developed, the rats were divided into two groups: a treatment group and a control group. Rats in the treatment group were then treated with PRF bioactive membrane every three days. RESULTS A total of 20 rats were used in this study. At days three and seven, the PU area in the PRF bioactive membrane-treated group was significantly smaller than that in the control group, and after 14 days of treatment, the PUs in the PRF bioactive membrane treatment group had healed. Haemotoxylin and eosin staining, immunohistochemistry and Western blot results indicated that PRF bioactive membrane induced wound healing by increasing the thickness of the regenerated epidermis and by upregulating vascular endothelial growth factor expression. Further, we found that different concentrations of rat autologous PRF soluble factors extraction components could significantly promote rat aortic endothelial cell proliferation, wound healing and migration ability in vitro. CONCLUSION Overall, results indicate that PRF bioactive membrane promotes PU healing in rats. Thus, it may represent a natural and effective wound-healing tool for use in the treatment of clinical skin PUs in humans in the future.
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Affiliation(s)
- Yajuan Yu
- ICU Specialty Nurse, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Jian Shen
- Technologist-in-charge, Department of Blood Transfusion, Zhejiang Provincial People's Hospital; People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Guizhen Fang
- Lead Nurse Advanced Nurse Practitioner, Nursing Department of Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Lingcong Wang
- Chief Physician, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Shu Lei
- Chief Physician, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Danli Cai
- Associate Chief Physician, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Ying Shi
- Physician, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Shuifang Jin
- Physician, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Qiaoli Lu
- Nurse, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Sisi Wang
- Nurse, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Yunlei Sun
- Nurse, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Jinmei Yao
- Associate Senior Technician, Department of Laboratory Medicine, Key Laboratory of Clinical In vitro Diagnostic Techniques of Zhejiang Province First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Peiya Hu
- ICU Specialty Nurse, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
| | - Xiaofei Wu
- Senior Nurse; Department of Central Vein Maintenance Center, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hubin Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310006, Zhejiang, China
| | - Xujun He
- Physician, Department of Intensive Care Units, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Xiasha Campus; The First Affiliated Hospital and First Clinical College of Zhejiang Chinese Medical University, Hangzhou, 310018, Zhejiang, China
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Najafian Y, Khorasani ZM, Najafi MN, Hamedi SS, Mahjour M, Feyzabadi Z. Efficacy of Aloe vera/ Plantago Major Gel in Diabetic Foot Ulcer: A Randomized Double-Blind Clinical Trial. Curr Drug Discov Technol 2019; 16:223-231. [PMID: 29336265 DOI: 10.2174/1570163815666180115093007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 06/07/2023]
Abstract
BACKGROUND Diabetic foot ulcer (DFU) is one of the most common complications of diabetic patients. Mostly, non-healing DFU leads to infection, gangrene, amputation and even death. High costs and poor healing of the wounds need a new treatment such as alternative medicine. So, the aim of this study was to evaluate the efficacy of Aloe vera/ Plantago major gel (Plantavera gel) in healing of DFU. METHODS Forty patients with DFU enrolled in a double-blind randomized clinical trial. The patients who were randomly assigned into the intervention group (n = 20), received topical Plantavera gel in addition to the routine cares, whereas the patients in the control group (n = 20), received topical Placebo gel in addition to the routine cares. Intervention was done twice a day for 4 weeks in the both groups. Photography and an evaluation of DFU healing were conducted by a checklist and then were scored at baseline and at the end of each week. The collected data was analyzed by SPSS software. RESULTS At the end of the study, there was a significant difference between the two groups in terms of total ulcer score (P<0.001) and Plantavera gel significantly reduced the ulcer surface comparing with the control group (P=0.039). However, there was not a significant difference between the two groups (P=0.263) in terms of the ulcer depth. During this study, no side effect was observed for Plantavera gel in the intervention group. CONCLUSION Topical Plantavera gel seems to be an effective, cheap and safe treatment. Of course, further studies are required to confirm the properties of the wound healing of this gel.
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Affiliation(s)
- Younes Najafian
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra M Khorasani
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona N Najafi
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shokouh S Hamedi
- Department of Persian Pharmacy, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marjan Mahjour
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zohre Feyzabadi
- Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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22
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Guest JF, Singh H, Rana K, Vowden P. Cost-effectiveness of an electroceutical device in treating non-healing venous leg ulcers: results of an RCT. J Wound Care 2018; 27:230-243. [DOI: 10.12968/jowc.2018.27.4.230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Julian F Guest
- Catalyst Health Economics Consultants, Rickmansworth, Hertfordshire, UK, Faculty of Life Sciences and Medicine, King's College, London, UK
| | - Heenal Singh
- Catalyst Health Economics Consultants, Rickmansworth, Hertfordshire
| | - Karan Rana
- Catalyst Health Economics Consultants, Rickmansworth, Hertfordshire
| | - Peter Vowden
- Bradford Teaching Hospitals NHS Foundation Trust and University of Bradford, UK
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Prina E, Mistry P, Sidney LE, Yang J, Wildman RD, Bertolin M, Breda C, Ferrari B, Barbaro V, Hopkinson A, Dua HS, Ferrari S, Rose FRAJ. 3D Microfabricated Scaffolds and Microfluidic Devices for Ocular Surface Replacement: a Review. Stem Cell Rev Rep 2018; 13:430-441. [PMID: 28573367 DOI: 10.1007/s12015-017-9740-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In recent years, there has been increased research interest in generating corneal substitutes, either for use in the clinic or as in vitro corneal models. The advancement of 3D microfabrication technologies has allowed the reconstruction of the native microarchitecture that controls epithelial cell adhesion, migration and differentiation. In addition, such technology has allowed the inclusion of a dynamic fluid flow that better mimics the physiology of the native cornea. We review the latest innovative products in development in this field, from 3D microfabricated hydrogels to microfluidic devices.
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Affiliation(s)
- Elisabetta Prina
- Division of Regenerative Medicine and Cellular Therapies, School of Pharmacy, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Pritesh Mistry
- Division of Regenerative Medicine and Cellular Therapies, School of Pharmacy, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Laura E Sidney
- Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Jing Yang
- Division of Regenerative Medicine and Cellular Therapies, School of Pharmacy, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Ricky D Wildman
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Marina Bertolin
- Fondazione Banca degli Occhi del Veneto, c/o Padiglione G. Rama - Via Paccagnella 11, 30174 Zelarino, Venice, Italy
| | - Claudia Breda
- Fondazione Banca degli Occhi del Veneto, c/o Padiglione G. Rama - Via Paccagnella 11, 30174 Zelarino, Venice, Italy
| | - Barbara Ferrari
- Fondazione Banca degli Occhi del Veneto, c/o Padiglione G. Rama - Via Paccagnella 11, 30174 Zelarino, Venice, Italy
| | - Vanessa Barbaro
- Fondazione Banca degli Occhi del Veneto, c/o Padiglione G. Rama - Via Paccagnella 11, 30174 Zelarino, Venice, Italy
| | - Andrew Hopkinson
- Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Harminder S Dua
- Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Stefano Ferrari
- Fondazione Banca degli Occhi del Veneto, c/o Padiglione G. Rama - Via Paccagnella 11, 30174 Zelarino, Venice, Italy.
| | - Felicity R A J Rose
- Division of Regenerative Medicine and Cellular Therapies, School of Pharmacy, Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
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Khouri C, Kotzki S, Roustit M, Blaise S, Gueyffier F, Cracowski JL. Hierarchical evaluation of electrical stimulation protocols for chronic wound healing: An effect size meta-analysis. Wound Repair Regen 2017; 25:883-891. [DOI: 10.1111/wrr.12594] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 09/07/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Charles Khouri
- Pharmacovigilance Unit, Grenoble Alps University Hospital; Grenoble France
- Clinical Pharmacology Department, INSERM CIC1406; Grenoble Alps University Hospital; Grenoble France
| | - Sylvain Kotzki
- UMR 1042-HP2, INSERM, University of Grenoble Alpes; Grenoble France
| | - Matthieu Roustit
- Clinical Pharmacology Department, INSERM CIC1406; Grenoble Alps University Hospital; Grenoble France
- UMR 1042-HP2, INSERM, University of Grenoble Alpes; Grenoble France
| | - Sophie Blaise
- UMR 1042-HP2, INSERM, University of Grenoble Alpes; Grenoble France
- Department of Vascular Medicine; Grenoble Alps University Hospital; Grenoble France
| | - Francois Gueyffier
- Department of Clinical Pharmacology; Lyon University Hospital; Lyon France
- UMR 5558, Biometry and Evolutionary Biology Laboratory; Claude-Bernard Lyon 1 University, CNRS; Lyon France
| | - Jean-Luc Cracowski
- Clinical Pharmacology Department, INSERM CIC1406; Grenoble Alps University Hospital; Grenoble France
- UMR 1042-HP2, INSERM, University of Grenoble Alpes; Grenoble France
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Messinger-Rapport BJ, Little MO, Morley JE, Gammack JK. Clinical Update on Nursing Home Medicine: 2017. J Am Med Dir Assoc 2017; 18:928-940. [PMID: 29080572 DOI: 10.1016/j.jamda.2017.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 01/09/2023]
Abstract
This is the 11th annual Clinical Update from the AMDA meeting article. This year the topics covered are hypertension after the Systolic Blood Pressure Intervention Trial; chronic obstructive pulmonary disease risk factors, diagnosis and management including end-of-life planning, and the difficulties with exacerbations such as breathlessness; diagnosis and treatment of cognitive impairment and dementia; and wound care and pressure ulcer management.
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Affiliation(s)
| | - Milta O Little
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO.
| | - Julie K Gammack
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
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Environmental Factors That Influence Stem Cell Migration: An "Electric Field". Stem Cells Int 2017; 2017:4276927. [PMID: 28588621 PMCID: PMC5447312 DOI: 10.1155/2017/4276927] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/21/2017] [Accepted: 04/11/2017] [Indexed: 01/14/2023] Open
Abstract
Environmental Stimulus of Electric Fields on Stem Cell Migration. The movement of cells in response to electric potential gradients is called galvanotaxis. In vivo galvanotaxis, powered by endogenous electric fields (EFs), plays a critical role during development and wound healing. This review aims to provide a perspective on how stem cells transduce EFs into directed migration and an understanding of the current literature relating to the mechanisms by which cells sense and transduce EFs. We will comment on potential EF-based regenerative medicine therapeutics.
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Zhou K, Schenk R, Brogan MS. The wound healing trajectory and predictors with combined electric stimulation and conventional care: one outpatient wound care clinic's experience. Eur J Clin Invest 2016; 46:1017-1023. [PMID: 27709618 DOI: 10.1111/eci.12685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/02/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Electric stimulation (E-stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure (CWC) have not been reported with E-stim treatment. MATERIALS AND METHODS This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E-stim and conventional care were included. The Kaplan-Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time. RESULTS With 100, 112 and 140 days of treatment, the percentages of patients with CWC were 59·12%, 61·01% and 65·41%, respectively. Linear regression models predicted that all patients would achieve CWC by 21·55, 22·26 and 24·80 weeks, respectively. The speed for the increase in the number and percentage of patients with CWC peaked between 50-75 days of treatment. To optimize timely healing, referral to other treatment facilities or change of treatment protocol is warranted around the peak time. With the combined intervention of E-stim and conventional care, positive predictors for CWC included a shorter wound duration at initial evaluation (P = 0·005, OR = 3·10), better compliance with appointments (P = 0·007, OR = 3·38) and the diagnosis of venous leg ulcer (P = 0·001, OR = 3·88). CONCLUSIONS This study provided preliminary data on wound healing trajectory and predictors with combined E-stim and conventional care. E-stim seemed to expedite wound healing; however, further research studies are needed.
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Affiliation(s)
- Kehua Zhou
- Physical Therapy Wound Care Clinic, Daemen College, Amherst, NY, USA.,Department of Health Promotion, Daemen College, Amherst, NY, USA
| | - Ronald Schenk
- Department of Physical Therapy, Daemen College, Amherst, NY, USA
| | - Michael S Brogan
- Department of Physical Therapy, Daemen College, Amherst, NY, USA
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Lala D, Spaulding SJ, Burke SM, Houghton PE. Electrical stimulation therapy for the treatment of pressure ulcers in individuals with spinal cord injury: a systematic review and meta-analysis. Int Wound J 2016; 13:1214-1226. [PMID: 25869151 PMCID: PMC7949516 DOI: 10.1111/iwj.12446] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 03/10/2015] [Accepted: 03/13/2015] [Indexed: 01/16/2023] Open
Abstract
To conduct a systematic review and meta-analysis on the effects of electrical stimulation therapy (EST) on healing pressure ulcers in individuals with spinal cord injury (SCI). CINAHL, The Cochrane Library, PubMed, SCOPUS, EMBASE, Nursing & Allied Health and Dissertation & Theses databases were searched for relevant English language articles from the date of inception to 31 January 2014. Separate searches were conducted in Google Scholar and academic journals specialised in wound care. Two reviewers independently assessed study eligibility. Studies were included if EST was used to treat pressure ulcers in individuals with SCI. A total of 599 articles were screened, and 15 studies met the inclusion criteria. A meta-analysis with five studies demonstrated that EST significantly decreased the ulcer size by 1·32%/day [95% confidence interval (CI): 0·58-2·05, P < 0·001] compared to standard wound care (SWC) or sham EST. Another meta-analysis conducted with four studies showed that EST increased the risk of wound healing by 1·55 times compared with standard wound care or sham EST (95% CI: 1·12 to 2·15, P < 0·0001). Because of the wide array of outcome measures across studies, a single meta-analysis could not be conducted. EST appears to be an effective adjunctive therapy to accelerate and increase pressure ulcer closure in individuals with SCI.
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Affiliation(s)
- Deena Lala
- Health and Rehabilitation SciencesWestern UniversityLondonONCanada
| | - Sandi J Spaulding
- Health and Rehabilitation SciencesWestern UniversityLondonONCanada
- School of Occupational TherapyWestern UniversityLondonONCanada
| | - Shauna M Burke
- School of Health StudiesWestern UniversityLondonONCanada
| | - Pamela E Houghton
- Health and Rehabilitation SciencesWestern UniversityLondonONCanada
- School of Physical TherapyWestern UniversityLondonONCanada
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30
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Arora M, Harvey LA, Glinsky JV, Nier L, Lavrencic L, Kifley A, Cameron ID. Electrical stimulation for treating pressure ulcers. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Mohit Arora
- Kolling Institute, Northern Sydney Local Health District; John Walsh Centre for Rehabilitation Research; St Leonards NSW Australia 2065
- Sydney Medical School Northern; University of Sydney Australia
| | - Lisa A Harvey
- Kolling Institute, Northern Sydney Local Health District; John Walsh Centre for Rehabilitation Research; St Leonards NSW Australia 2065
- Sydney Medical School Northern; University of Sydney Australia
| | - Joanne V Glinsky
- Kolling Institute, Northern Sydney Local Health District; John Walsh Centre for Rehabilitation Research; St Leonards NSW Australia 2065
- Sydney Medical School Northern; University of Sydney Australia
| | - Lianne Nier
- Royal North Shore Hospital; Spinal Cord Injury Unit; Ward 7E, Royal North Shore Hospital, Reserve Road, St Leonards Sydney NSW Australia 2065
| | - Lucija Lavrencic
- Royal North Shore Hospital; Spinal Cord Injury Unit; Ward 7E, Royal North Shore Hospital, Reserve Road, St Leonards Sydney NSW Australia 2065
| | - Annette Kifley
- Kolling Institute, Northern Sydney Local Health District; John Walsh Centre for Rehabilitation Research; St Leonards NSW Australia 2065
- Sydney Medical School Northern; University of Sydney Australia
| | - Ian D Cameron
- Kolling Institute, Northern Sydney Local Health District; John Walsh Centre for Rehabilitation Research; St Leonards NSW Australia 2065
- Sydney Medical School Northern; University of Sydney Australia
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Rouabhia M, Park HJ, Zhang Z. Electrically Activated Primary Human Fibroblasts Improve In Vitro and In Vivo Skin Regeneration. J Cell Physiol 2016; 231:1814-21. [PMID: 26661681 DOI: 10.1002/jcp.25289] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/10/2015] [Indexed: 12/14/2022]
Abstract
Electrical stimulation (ES) changes cellular behaviors and thus constitutes a potential strategy to promote wound healing. However, well-controlled in vitro findings have yet to be translated to in vivo trials. This study was to demonstrate the feasibility and advantages of transplanting electrically activated cells (E-Cells) to help wound healing. Primary human skin fibroblasts were activated through well defined ES and cultured with keratinocytes to generate engineered human skin (EHS), which were transplanted to nu/nu mice. The electrically activated EHS grafts were analyzed at 20 and 30 days post-grafting, showing faster wound closure, thick epidermis, vasculature, and functional basement membrane containing laminin and type IV collagen that were totally produced by the implanted human cells. Because a variety of cells can be electrically activated, E-Cells may become a new cell source and the transplantation of E-Cells may represent a new strategy in wound healing and tissue engineering. J. Cell. Physiol. 231: 1814-1821, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Mahmoud Rouabhia
- Groupe de Recherche en Écologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, Canada
| | - Hyun Jin Park
- Groupe de Recherche en Écologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, Canada.,Département de Chirurgie, Faculté de Médecine, Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
| | - Ze Zhang
- Département de Chirurgie, Faculté de Médecine, Axe Médecine Régénératrice, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
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32
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Harvey LA. Physiotherapy rehabilitation for people with spinal cord injuries. J Physiother 2016; 62:4-11. [PMID: 26701156 DOI: 10.1016/j.jphys.2015.11.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/11/2015] [Accepted: 11/13/2015] [Indexed: 01/13/2023] Open
Affiliation(s)
- Lisa A Harvey
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, Australia
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Abstract
Management of chronic wounds remains unsatisfactory in terms of treatment cost and time required for complete wound closure (CWC).This study aimed to calculate the healing rates, estimated cost, and time required for CWC in wounds; compare estimated wound care costs between healing and nonhealing wounds; and compare cost effectiveness between venous leg ulcer (VLU) and non-VLU.This was a retrospective cohort study performed at a physical therapy (PT) wound care clinic. Deidentified patient data in the electronic medical database from September 10, 2012 to January 23, 2015 were extracted.Among 159 included patients with wounds, 119 (74.84%) patients were healed with CWC. The included patients were treated for 109.70 ± 95.70 days, 29.71 ± 25.66 visits, and at the costs per treatment episode of $1629.65 ± 1378.82 per reimbursement rate and $2711.42 ± 2356.81 per breakeven rate. For patients with CWC (healing group), the treatment duration was 98.01 ± 76.12 days with the time for CWC as 72.45 ± 64.21 days; the cost per treatment episode was $1327.24 ± 1143.53 for reimbursement rate and $2492.58 ± 2106.88 for breakeven cost. For patients with nonhealing wounds, treatment duration was found to be longer with costs significantly higher (P < 0.01 for all). In the healing group, no differences were found between VLU and non-VLU in treatment duration (95.46 days vs. 100.88 days, P = 0.698), time for CWC (68.06 days vs. 77.38 days, P = 0.431), and cost ($2756.78 vs. 2397.84 for breakeven rate, P = 0.640) with the exception of wound dressing costs ($329.19 vs. 146.47, P = 0.001).Healing rates may be affected with patient exclusions. Costs at physicians' offices were not included.Incorporation of PT in wound care appeared to be cost effective. PT may thus be a good referral option for patients with wounds. However, the results should be interpreted cautiously and further studies are warranted.
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Affiliation(s)
- Kehua Zhou
- From the Daemen College Physical Therapy Wound Care Clinic, Daemen College, Amherst, New York, USA (KK, KZ); Department of Health Care Studies, Daemen College, Amherst, New York, USA (KZ); and Department of Physical Therapy, Daemen College, Amherst, New York, USA (MSB)
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Altman IA, Kleinfelder RE, Quigley JG, Ennis WJ, Minniti CP. A treatment algorithm to identify therapeutic approaches for leg ulcers in patients with sickle cell disease. Int Wound J 2015; 13:1315-1324. [PMID: 26537664 DOI: 10.1111/iwj.12522] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/20/2015] [Indexed: 12/31/2022] Open
Abstract
Sickle cell leg ulcers (SCLUs) are a common complication of sickle cell disease (SCD). Patients who develop ulcers appear to have a more severe haemolysis-associated vasculopathy than individuals who do not develop them, and manifest other complications such as priapism and pulmonary hypertension. SCLUs are slow to heal and often recur, affecting both the emotional and physical well-being of patients. Here we summarise what is known about the pathophysiology of SCLUs, describe available treatment options and propose a treatment algorithm.
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Affiliation(s)
- Igor A Altman
- Department of Surgery, Section of Wound Healing and Tissue Repair, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - Raymond E Kleinfelder
- Traditional Rotating Internship, Genesys Regional Medical Center, Grand Blanc, MI, USA
| | - John G Quigley
- Department of Hematology and Medical Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - William J Ennis
- Department of Surgery, Section of Wound Healing and Tissue Repair, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - Caterina P Minniti
- Department of Oncology, Division of Hematology, Sickle Cell Center, Montefiore Medical Center, Bronx, NY, USA
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Gomes RC, Brandino HE, de Sousa NTA, Santos MF, Martinez R, Guirro RRDJ. Polarized currents inhibit in vitro growth of bacteria colonizing cutaneous ulcers. Wound Repair Regen 2015; 23:403-11. [PMID: 25845400 DOI: 10.1111/wrr.12296] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 03/31/2015] [Indexed: 12/01/2022]
Abstract
Infections caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli are among the microorganisms that often lead to infection in pressure ulcers. Polarized current has emerged as a possible intervention to limit bacterial proliferation. We analyzed the effect of fixed diphasic - Bernard (FD-B) and high voltage monophasic pulsed (HVMP) currents on bacteria S. aureus ATCC 25923 (Gram +), P. aeruginosa ATCC 27853 (Gram -), and E. coli ATCC 25922 (Gram -). After the bacterial strains were activated the bacteria were suspended in physiological solution (0.9%) and the concentration adjusted to 1.5 × 10(3) CFU/mL. The cultures were stimulated with FD-B current at (3, 6, and 9 mA, 100 Hz, 15 and 30 minutes) and HVMP (32, 64, and 95 V, 100 Hz, 30 and 60 min) while monitoring the pH and temperature. After the stimulation, the suspensions were plated and incubated for 24 hours at 37°C. Then the counts were made of colony forming units (CFU). Data were submitted to normality Shapiro-Wilk test followed by nonparametric ANOVA test and post hoc Tukey test with p < 0.05. There was a decrease in the CFU for the two currents, but the most effective reduction was in FD-B. The temperature remained constant and the pH measured alkaline at the negative pole and acid at the positive pole during stimulation. The application of FD-B and HVMP currents promoted inhibition of bacterial proliferation when stimulated in vitro, acting as an adjuvant resource in the healing process.
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Affiliation(s)
- Rosana Caetano Gomes
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine
| | - Hugo Evangelista Brandino
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine
| | - Natanael Teixeira Alves de Sousa
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine
| | - Marcos Ferracioli Santos
- Graduation Course in Physiotherapy, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine
| | - Roberto Martinez
- Infectious Diseases Division of the Internal Medicine Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rinaldo Roberto de Jesus Guirro
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine.,Graduation Course in Physiotherapy, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine
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Nasiri M, Fayazi S, Jahani S, Yazdanpanah L, Haghighizadeh MH. The effect of topical olive oil on the healing of foot ulcer in patients with type 2 diabetes: a double-blind randomized clinical trial study in Iran. J Diabetes Metab Disord 2015; 14:38. [PMID: 25969821 PMCID: PMC4428202 DOI: 10.1186/s40200-015-0167-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 04/23/2015] [Indexed: 12/24/2022]
Abstract
Background Diabetic Foot Ulcer (DFU) is the most costly and devastating complication of diabetes mellitus which can lead to infection, gangrene, amputation, and even death if the necessary care is not provided. Nowadays, some herbal products have shown therapeutic effects on healing of DFU. So, this study aimed to assess the effects of topical olive oil on the healing of DFU. Methods This double-blind randomized clinical trial study was conducted in Diabetes Clinic of Ahvaz Golestan hospital, Iran, in 2014. Thirty-four patients with DFU of Wagner’s ulcer grade 1 or 2 were enrolled in this study. Patients who were randomly assigned to intervention group (n = 17) received topical olive oil in addition to routine cares, whereas patients in control group (n = 17) just received routine cares. Intervention was done once a day for 4 weeks in both groups, and in the end of each week; the ulcers were assessed and scored. Data was collected by demographic and clinical characteristics checklists as well as diabetic foot ulcer healing checklist, and was analyzed by SPSS version 19 software using descriptive (mean and standard deviation) and analytic (student’s sample t-test, chi-square and repeated-measures analysis of variance) statistics. Results At the end of 4th week, there was a significant differences between two groups regarding to 3 parameters of ulcer including degree (P = 0.03), color (P = 0.04) and surrounding tissues (P < 0.001) as well as total status of ulcer (P = 0.001), while related to ulcer drainages no significant difference was seen between the two groups (P = 0.072). At the end of the follow up, olive oil significantly decreased ulcer area (P = 0.01) and depth (P = 0.02) compared with control group. Complete ulcer healing in the intervention group was significantly greater than control group (73.3% vs. 13.3%, P = 0.003) at the end of follow up. Also, there were no adverse effects to report during the study in intervention group. Conclusions Our results indicated that olive oil in combination with routine cares is more effective than routine cares alone, and is without any side effect. However, further studies are required in the future to confirm these results. Trial registration IRCT2014083014251N2. Electronic supplementary material The online version of this article (doi:10.1186/s40200-015-0167-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Morteza Nasiri
- Department of Nursing and Midwifery, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sadigheh Fayazi
- Department of Nursing and Midwifery, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Simin Jahani
- Department of Nursing and Midwifery, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Yazdanpanah
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Affiliation(s)
- Richard White
- Professor of Tissue Viability, Institute of Health and Society, University of Worcerster, St. John's Campus, Worcester, UK
| | - Rose Cooper
- Professor of Microbiology, Centre for Biomedical Sciences, Cardiff Metropolitan University, Llandaff Campus, Western Avenue, Cardiff, UK
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Yu C, Hu ZQ, Peng RY. Effects and mechanisms of a microcurrent dressing on skin wound healing: a review. Mil Med Res 2014; 1:24. [PMID: 26000170 PMCID: PMC4440595 DOI: 10.1186/2054-9369-1-24] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 10/10/2014] [Indexed: 12/28/2022] Open
Abstract
The variety of wound types has resulted in a wide range of wound dressings, with new products frequently being introduced to target different aspects of the wound healing process. The ideal wound dressing should achieve rapid healing at a reasonable cost, with minimal inconvenience to the patient. Microcurrent dressing, a novel wound dressing with inherent electric activity, can generate low-level microcurrents at the device-wound contact surface in the presence of moisture and can provide an advanced wound healing solution for managing wounds. This article offers a review of the effects and mechanisms of the microcurrent dressing on the healing of skin wounds.
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Affiliation(s)
- Chao Yu
- Beijing Institute of Radiation Medicine, Beijing, 100850 China
| | - Zong-Qian Hu
- Beijing Institute of Radiation Medicine, Beijing, 100850 China
| | - Rui-Yun Peng
- Beijing Institute of Radiation Medicine, Beijing, 100850 China
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