Combined resection and multi-agent adjuvant chemotherapy for desmoplastic small round cell tumor arising in the abdominal cavity:Report of a case

促结缔织增生的小圆房间肿瘤(DSRCT ) 是有特殊组织学的特征的稀罕、高度好攻击的恶意：在稠密的促结缔织增生基质以内的细胞的生长的一个嵌套的模式，与男优势发生在年轻人口。吝啬的幸存时期仅仅关于 1.5-2.5 年。肿瘤共同表示上皮，在免疫的肌肉，和神经标记组织化学的研究。这个工作报导与吐血和长期的便秘介绍的一个 27 岁的人。包括内视镜检查法，上面的胃肠的系列，腹的计算断层摄影术和钡灌肠的连续研究学习内脏的机关的显示出的传播参与。病人经历了好攻击的外科并且收到了由 5 氟尿嘧啶，出租机动三轮车磷酰胺， etoposide， doxorubicin，和 cisplatin 组成的手术后的辅助化疗。没有任何疾病，他在外科以后为 20 瞬间幸存。没有标准疗法协议被建立了。与手术后的多代理人助手化疗相结合的好攻击的外科被认为正当不仅减轻症状而且试着在这个先进 DSRCT 年轻病人改进结果。

Effect of Buerger’s Exercises on Improving Peripheral Circulation: A Systematic Review

The aim of this study was to systematically review the evidence for the effectiveness of Buerger’s exercise on the peripheral circulation or diabetic foot ulceration. A systematic search and 18 electronic databases were conducted. The intervention was predominantly focused on Buerger’s exercise as an outcome. Due to high heterogeneity, data were synthesized in a narrative format rather than by statistical methods. Nine studies that covered 592 participants were selected in the analysis, of which 8 of the 9 found an effect of Buerger’s exercise on peripheral circulation. The positive effects were indicative of improving blood flow, walking ability, reducing necrosis, reducing venous embolism, pain, swelling, cyanosis and the bed-rest times. However, the study design and quality appraisal were limited to Jadad score 2 and the sample size was small. Findings provide some evidence of the beneficial effects of Buerger’s exercises. It was seen as a low cost and low risk physical activity that most diabetic patients could undertake at home. This review highlighted a need for further investigation of standardized procedures of Buerger’s exercises. More high quality studies on the prevention of diabetic foot are required regarding Buerger’s exercises.

The devil is in the detail: Prevention of diabetic foot ulceration in rural area is possible

Background: Foot self-care capability is an important factor in diabetic foot ulceration, especially in disadvantaged rural areas. Aim: To explore the causes of foot ulceration and practice foot self-care behaviors before and after diabetic foot ulceration. Method: A descriptive, retrospective design was conducted in a rural hospital in southern Taiwan. Results: A total of 49 participants with diabetic foot ulcers participated in this study. More than half were male (63.3%), still working in farming or fishing (61.2%). All participants were suffering from peripheral neuropathy (100%) and 71.5% showed claudication. Nearly two thirds reported not having received diabetic foot care education and 82% not having received regular vasculopathy assessment before the wound appeared. The common reasons for foot ulcers were unnoticed trauma, neglect of foot self-care. Conclusions: Most diabetic foot ulcers are preventable, since they result from a high prevalence of peripheral neuropathy, inadequate provision of vasculopathy assessment and inappropriate management of foot self-care. Community health nurses can focus care toward screen regularly for early diabetic foot problems.

Preliminary evidence using negative pressure wound therapy to achieve limb salvage for the ischemic diabetic foot

Aim:Negative pressure wound therapy(NPWT)in diabetic foot ulcers(DFU)has been discussed in several studies,but without a focus on peripheral arterial disease(PAD),which is a common comorbidity.This study aims to investigate the feasibility of NPWT in the treatment of DFU with PAD in regards to limb salvage and the clinical course.Methods:The authors retrospectively collected patients with DFU and PAD diagnosed with either Doppler ultrasound or angiography as the PAD study group.Patients with DFU but no PAD were enrolled as the non-PAD comparison group.NPWT was applied to both PAD and non-PAD subjects.Results:There were 10 patients in the PAD group and 3 patients in the non-PAD group.In the PAD group,there was a 70%limb salvage rate with 14.70(±10.33)treatment days.The non-PAD comparison group had a higher limb salvage rate(100%vs.70%,respectively),but a longer treatment time(30.00 vs.14.70 days,P<0.05,respectively)when compared to the PAD group.The 3 patients in the PAD group who failed limb salvage all had issues related to uncontrolled infection.Conclusion:NPWT is a feasible adjuvant therapy for DFU in patients with PAD,with a 70%limb salvage rate.Prolonged treatment time was due to the initial severity of the subjects with multiple comorbidities.The main reason for limb loss was intractable infection.

Clinical pathway for an efficient wound care center

INTRODUCTION,Chronic wound significantly influence patients’quality of life,but wound care procedures can vary between hospitals.Wound management difficulties can be attributed to lack of standardized protocol,well-integrated multidisciplinary team,and specific wound care unit.An establishment of wound care center can help to solve above difficulties with providing wound management service.