693 research outputs found
Hidradenitis suppurativa beyond the skin:from pathogenesis to disease burden
Hidradenitis suppurativa (HS) is an underestimated serious skin disease, with debilitating consequences for the personal and professional lives of patients. The estimated prevalence of 1% is probably an undervaluation, since it is still often not recognized by physicians, despite increasing awareness for HS. In addition, there is a patient’s delay in HS, due to embarrassment for the disease, which can include lesions with foul smelling drainage. This often leads to a diagnostic delay of approximately 7-10 years, in which the disease may progress. The exact pathophysiology of HS is not clarified yet and the clinical presentation is heterogeneous, which makes the treatment of HS challenging and the burden for patients tremendous. Medical and surgical interventions are the two main therapeutic approaches for HS. Even though the latter is less well investigated, it remains one of the most effective treatment options for HS. However, surgery itself can add to the burden of patients, as the experience can be traumatizing. Moreover, the clinical appearance of HS often does not correspond with the patient’s own experience of her or his disease. The chronic and unpredictable nature of HS can lead to fear, shame and inhibition of daily activities. Further increasing awareness and a better insight into the prevalence can help reduce the diagnostic delay and help initiate treatment earlier, decreasing the burden for the patient. Therefore, the general aim of this thesis is to gain more insight into the prevalence, treatment targets and outcomes and the extent of the burden of this disease
Adalimumab and infliximab survival in patients with hidradenitis suppurativa:a daily practice cohort study
Background: Biologics are often required for the treatment of hidradenitis suppurativa (HS). However, data on the drug survival of biologics in daily practice are currently lacking. Objectives: To assess the d
La pedagogía de géneros textuales como opción didáctica transversal para el mejoramiento de la comprensión lectora en el ciclo media de la IED Villanueva
La Institución Educativa Distrital Villanueva es una institución pública situada al nororiente de Barranquilla, en la calle 5 Nº 42 D 24, detrás del mercado público. Una de las principales falencias de la institución es la poca comprensión de textos de los estudiantes. Debido al poco hábito lector de padres e hijos se dificulta la labor de los maestros de la institución educativa. Dicha problemática se ve reflejada en las asignaturas y pruebas externas del colegio. En la actualidad la IED Villanueva está clasificada como institución D, en pruebas Saber11 ICFES. El presente proyecto de investigación: Promover la pedagogía de géneros textuales como opción didáctica transversal para el mejoramiento de la comprensión lectora en el ciclo media en la IED VILLANUEVA, se justifica para el desarrollo de competencias lecto-escritoras necesarias para el desempeño personal, profesional y laboral de los estudiantes, una de las metas y objetivos principales del Ministerio de Educación Nacional. Desde el punto de vista metodológico se utiliza la investigación acción para el acompañamiento y la reflexión de la práctica docente; un maestro empoderado, critico, capaz de cuestionar, indagar, analizar, interpretar las prácticas y situaciones académicas que el quehacer docente conlleva. Como técnicas de recolección de datos: la entrevista, la encuesta, mesa de reflexión, panel social, análisis documental. El proyecto de investigación muestra que dentro de la institución están definidos el PEI, el PMI, el SIEE y el modelo pedagógico institucional; no obstante, no existe asamblea general de padres de familia, los docentes no tienen apropiado el modelo pedagógico dentro del aula y se hace necesario capacitarlos, no están explícitos mecanismos y estrategias para reducir la repitencia y la deserción, la cultura institucional adolece de reconocimiento de logros, identificación y divulgación de buenas prácticas. En el diseño curricular existen falencias en los proyectos transversales y la planeación de la clase. Los resultados obtenidos con este proyecto muestran un proceso de transformación de la práctica docente evidenciado en un modelo de planeación de clases, con la opción didáctica de la pedagogía de géneros.MaestríaMagister en Educació
High and discordant prevalences of clinical and sonographic enthesitis in patients with hidradenitis suppurativa
Needle-free electronically controlled jet injection with corticosteroids in recalcitrant keloid scars:a retrospective study and patient survey
First-line treatment of keloids consists of intralesional needle injections with corticosteroids, but generally entails multiple painful sessions, resulting in variable clinical outcomes. Novel needle-free jet injectors may facilitate more effective and patient-friendly dermal drug delivery. Here, we evaluated the effectiveness, tolerability and patient satisfaction of intralesional triamcinolone-acetonide (TCA) treatment in recalcitrant keloids using an electronically controlled pneumatic injector (EPI). A retrospective study was conducted in recalcitrant keloid patients with a history of severe pain during needle injections who received three sessions of EPI + TCA. Outcome measures included Patient and Observer Scar Assessment Scale (POSAS), Global Aesthetic Improvement Scale (GAIS), treatment-related pain (NRS), adverse effects, and patient satisfaction (survey). Ten patients with in total 283 keloids were included. The POSAS score significantly improved at follow-up and GAIS was reported as ‘(very) improved’ for all patients. EPI + TCA was well-tolerated with a significantly lower NRS pain score compared to needle + TCA (pilot treatment). Only minor adverse effects occurred, and 90% of patients preferred EPI over needle treatment. EPI + TCA is an effective and tolerable treatment for patients with recalcitrant keloids. The minimal treatment-related pain and high patient satisfaction makes it a promising treatment for patients with needle-phobia and/or severe pain during needle injections
Assessment tools and phenotype classification for hidradenitis suppurativa
Hidradenitis suppurativa (HS) is a heterogeneous chronic relapsing skin disease. Several assessment tools are used to assess disease severity and to classify disease phenotype; however, no consensus exists. This review evaluates the various assessment tools and phenotypes, assessing their validity and reliability. Numerous assessment tools and phenotype classifications have been proposed for identifying various subtypes within the hidradenitis suppurativa disease spectrum. Each has a different purpose, such as use in daily practice or in clinical trial settings. Several assessment tools and phenotype classifications have been validated but not always with satisfactory results and often with studies showing divergent intra-rater reliability results. A consensus is needed for a validated, easy-to-use, and timesaving assessment tool for routine daily practice. For clinical trials, a validated and extensive assessment tool that also measures response to treatment is also needed.</p
Is mechanical stress an important pathogenic factor in hidradenitis suppurativa?
Hidradenitis suppurativa (HS) is a chronic of recurrent, inflammatory, follicular disease that usually presents after puberty with painful deep-seated, inflamed lesions in the inverse skin areas of the body. It has been hypothesized that mechanical pressure or friction is a risk factor for HS. We describe the case of a man with a lower leg amputation who presented HS-like lesions on his leg stump after wearing a leg prosthesis. Although pilonidal sinus-like disease could not be excluded, we diagnosed him with HS-like lesions, induced by prosthesis-related friction. We argue that this case supports the concept that mechanical friction and a warm humid microclimate by occlusion contribute to HS development
Lentigo maligna - anatomic location as a potential risk factor for recurrences after non-surgical treatment
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