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Treatment of Pressure Sores
Published in J G Webster, Prevention of Pressure Sores, 2019
Guttmann (1976) classified pressure sores by the degree of tissue damage. Transient was a disturbance of the circulation in the tissue marked by reversible erythema with some edema. Definite skin damage was divided into three cases. The mildest case was marked by the presence of erythema and congestion with discoloration and induration of the skin. Pressure sores that included superficial skin death, exposed cutis vena, and possible blister development were included in the second case of definite skin damage. The third and most severe case was marked by necrosis and ulcer formation with possible pigmentation of the border zones of the sore. Deep penetrating necrosis included sores that involved the subcutaneous tissues (fascia, muscle, and bone) and may have formed into large, grotesque shapes. Sinus sores communicating with bursae included sores that enclosed a sac or envelope lined with synovia and containing fluid. Closed ischial bursa was a specific form of pressure sores that were associated with the later stages of paraplegia. They were caused by acute trauma (e.g. bumping buttocks) and were marked by swelling with bloodstained fluid and/or a cavity. The most severe (and rarest) degree of pressure sore was cancerous degeneration.
Parenteral Drug Administration: Routes of Administration and Devices
Published in Sandeep Nema, John D. Ludwig, Parenteral Medications, 2019
Himanshu Bhattacharjee, Vivian Loveless, Laura A. Thoma
A SubQ injection (abbreviated as SubQ or Sub-Q) is administered as a bolus into the subcutis, the layer of skin directly below the dermis and epidermis, collectively referred to as the cutis (Figure 2.4). SubQ injections are highly effective in administering vaccines and such medications as insulin, morphine, diacetylmorphine, or goserelin. This route may be utilized if drugs cannot be administered orally because of lack of absorption from or inactivation by the contents of the gastrointestinal tract, if the patient is unable to ingest medications by mouth or if self-medication of parenterals (e.g., insulin) is desired. Drugs are more rapidly and more predictably absorbed by this route than by the oral route. However, absorption of drugs via this route is slower and less predictable compared to the IM route; this effect can be attributed to the difference in vascularity of the muscle and dermis. As with the IM route, if heart failure, shock, or vascular collapse exists, this route should not be depended upon. Hypodermoclysis is a special form of SubQ administration, that is, the infusion of large amounts of fluid into the SubQ tissues when IV sites are not available. This form of administration is rarely (if ever) used today but in the recent past was a common mode of replenishment of fluid and electrolytes in infants and elderly patients.
Biomolecules and Tissue Properties
Published in Joseph W. Freeman, Debabrata Banerjee, Building Tissues, 2018
Joseph W. Freeman, Debabrata Banerjee
Cutis laxa is an elastin related disorder that causes the loss of elastin and elastic fibers in the cutaneous and other connective tissue layers. It can occur in both genetic and acquired forms. In a severe form, the elastic fibers are almost undetectable in the skin and internal organs. This leads to the early death of the patient. (Remember, elastin is important for lungs, arteries, etc.) Other cutis laxa phenotypes only lead to a mild wrinkling of the skin. The acquired form of cutis laxa is usually a consequence of loss of cutaneous elastic fibers because of local or generalized inflammation usually caused by increased elastolytic activity. Cutis laxa occurs as the crosslinks of elastin are incorrectly or not at all synthesized, leading to abnormal fibers. In some cases, there is a lack of the C-terminal region in tropoelastin. The abnormal tropoelastin molecules are unable to give the correct supramolecular structures.
Wearable electroencephalography for ultra-long-term seizure monitoring: a systematic review and future prospects
Published in Expert Review of Medical Devices, 2021
Jonas Munch Nielsen, Dirk Rades, Troels Wesenberg Kjaer
Previous reviews have investigated either subcutaneous EEG [28] or noninvasive modalities (including surface EEG) [29–31] for seizure detection. Our objective is to review and discuss the current status on the field of wearable long-term surface- and subcutaneous EEG-based seizure detection. We focus on wearable setups with a limited number of surface electrodes (≤10) for two reasons. First, because the equipment should be mobile, somewhat easily self-applied and as discrete as possible. Second, to avoid confusions with standard EEG-recordings (10–20-system) for diagnostic purposes (e.g. home video-EEG). We define subcutaneous EEG as surgically implanted in the space between the cutis and the cranial bone, which leaves two options for implantation: either between the dermis and the galea (subcutaneous) or between the galea and the bone (subgaleal). Although these devices are surgically implanted, we refer to them as wearable because they generally require a wearable external companion for battery and storage and to emphasize their intended purpose of out-patient monitoring.