Amelogenin an extracellular matrix protein in the treatment of venous leg ulcers and other hard to heal wounds. experimental and clinical evidence

Abstract: Amelogenins are extracellular matrix proteins that, under physiological conditions, self-assemble into globular aggregates up to micron-sizes. Studies with periodontal fibroblasts indicate that attachment to these structures increases the endogenous secretion of multiple growth factors and cell proliferation. Pre-clinical and clinical studies indicate that cutaneous wounds benefit from treatment with amelogenins. A randomized controlled trial (RCT) involving patients with hard-to-heal venous leg ulcers (VLUs) (ie, ulcers with a surface area ≥10 cm2 and duration of ≥6 months) showed that the application of amelogenin (Xelma®, Molnlycke Health Care, Gothenburg, Sweden) as an adjunct treatment to compression results in significant reduction in ulcer size, improvement in the state of ulcers, reduced pain, and a larger proportion of ulcers with low levels of exudate, compared with treatment with compression alone. Amelogenin therapy was also shown to be safe to use in that there were no significant differences in adverse events noted between patients treated with amelogenin plus compression and those treated with compression alone. Case study evaluations indicate that the benefits of amelogenin therapy demonstrated in the RCT are being repeated in “real life” situations and that amelogenin therapy may also have a role to play in the treatment of other wound types such as diabetic foot ulcers

PENDETEKSIAN KRISIS KEUANGAN DI INDONESIA MENGGUNAKAN GABUNGAN MODEL VOLATILITAS DAN MARKOV SWITCHING DENGAN INDIKATOR M1 DAN M2 MULTIPLIER

Pada pertengahan tahun 1997 dan tahun 2008, Indonesia mengalami krisis keuangan. Dampak yang dihasilkan cukup parah terhadap perekonomian Indonesia sehingga perlu adanya sistem pendeteksian dini krisis keuangan. Krisis keuangan dapat dideteksi berdasarkan beberapa indikator ekonomi diantaranya M1 dan M2 Multiplier. Penelitian ini bertujuan untuk menentukan model yang sesuai untuk mendeteksi krisis keuangan di Indonesia berdasarkan indikator tersebut dengan menggunakan gabungan model volatilitas dan Markov switching tiga state. Kedua indikator dapat dimodelkan menggunakan model SWARCH untuk menentukan krisis keuangan di Indonesia pada tahun 2017. Selain itu,penelitian ini juga bertujuan untuk menentukan hubungan dari kedua indikator tersebut. Berdasarkan hasil dan pembahasan diperoleh data M1 dan M2 Multiplier dari Januari 1990 sampai November 2016 dapat dimodelkan dengan model SWARCH (3, 1) dan SWARCH (3, 2). Model tersebut dapat digunakan untuk mendeteksi krisis keuangan pada pertengahan tahun 1997 dan tahun 2008 berdasarkan nilai smoothed probability. Pada tahun 2017, peramalan nilai smoothed probability menunjukkan Indonesia rawan mengalami krisis keuangan. Selain itu, penelitian ini menunjukkan kedua indikator tersebut mempunyai hubungan dalam mendeteksi krisis keuangan di Indonesia

Rancang Bangun Layanan Informasi Trans Padang Berbasis Web

Trans Padang merupakan layanan angkutan massal di kota Padang. Untuk informasi seputar Trans Padang seperti rute, halte dan pencarian rute menjadi masalah utama bagi masyarakat yang ingin menikmati transportasi massal kebanggaan kota Padang. Untuk mengatasi hal itu maka dibutuhkan suatu layanan informasi yang menyediakan berbagai solusi dari masalah tersebut. Adapun layanan informasi yang baik dalam mengakomodasi kepentingan umum ini berbasis website. Salah satu kegunaan layanan informasi ini adalah pencarian rute berdasarkan halte kedatangan dan keberangkatan. Selain itu, layanan ini sudah mengakomodir kebutuhan manajemen data yang diperlukan dalam pengembangannya bagi Dinas Perhubungan Komunikasi dan Informatika kota Padang. Adapun layanan ini sudah menampilkan informasi rute dan halte sebanyak lima koridor. Informasi tersebut dapat dilihat detail perkoridornya ataupun langsung secara keseluruhan. Aplikasi ini sudah mengakomodir koridor 1, 2, 3, 5, dan 6, sedangkan kondisi terkini Trans Padang baru mengoperasikan koridor 1. Selain itu, layanan informasi ini sudah dapat mengakomodir kebutuhan bagi pengguna yang ingin mengakses menggunakan telepon selular. Untuk acuan data terkini dan pengembangannya, penelitian ini bereferensi kepada data dari Dinas Perhubungan Komunikasi dan Informatika kota Padang

The costs of non-training in chronic wounds : estimates through practice simulation

The high prevalence and incidence rates of chronic wounds represent high financial costs for patients, families, health services, and for society in general. Therefore, the proper training of health professionals engaged in the diagnosis and treatment of these wounds can have a very positive impact on the reduction of costs. As technology advances rapidly, the knowledge acquired at school soon becomes outdated, and only through lifelong learning can skills be constantly updated. Information and Communication Technologies play a decisive role in this field. We have prepared a cost estimate model of Non-Training, using a Simulator (Web Based System – e-fer) for the diagnosis and treatment of chronic wounds. The preliminary results show that the costs involved in the diagnosis and treatment of chronic wounds are markedly higher in health professionals with less specialized training

Atypical ulcers: Diagnosis and management

Atypical ulcers show atypical clinical features, histology, localization, and resistance to standard therapies. The persistence of a chronic ulcer despite treatment with standard therapies requires a more specific diagnostic investigation. Diagnosis involves obtaining the history and performing clinical examination and additional tests. A skin biopsy is frequently used to confirm unclear diagnosis. In difficult cases, microbiological and immunohistochem-ical examinations, laboratory blood tests, or instrumental tests should be evaluated. The treatment of atypical wounds is characterized by local systemic therapy and pain control. Our results highlight the need for early diagnosis, and standardized and targeted management by a multidisciplinary wound healing center

Surrounding skin management in venous leg ulcers: A systematic review

Objectives: Chronic venous insufficiency may lead to the development of venous leg ulcers, the most common form of chronic wounds in the lower extremity. Key to venous leg ulcer care is the maintenance of healthy skin surrounding the ulcer, as failure to maintain skin integrity may influence the healing outcome. We thus reviewed the scientific literature looking for assessment and management instruments regarding this common but often neglected issue. Method: The search included all studies published between 2000 and May 2019. Keywords used were: “peri-wound skin care”, “surrounding skin venous ulcers”, “surrounding skin management leg ulcers”, and “peri-lesional skin management”. Results: Management of moisture-balance with the selection of appropriate dressings is the most important target in surrounding-wound skin care. Moreover, contact dermatitis related to products and the dressings themselves is a neglected problem in patients with chronic leg ulcers which clinicians increasingly have to manage. The literature search revealed that there is an increasing interest in the use of noninvasive assessment tools in the field of wound care, and focusing on the surrounding-wound skin plays a role in assessing the potential of wound healing. Transepidermal water loss measurement (TEWL) and ultrasonography are two of the measurement techniques available. Conclusion: The integrity of the surrounding skin is necessary for wound healing, and appropriate management is needed to address this aspect which is part of an overall approach to treating wounds