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Mites
Published in Jerome Goddard, Public Health Entomology, 2022
Scabies causes much misery and suffering among humans worldwide every year, and has done so since ancient times. Furthermore, in persons with compromised immune systems, the mites may multiply uncontrollably, leading to a condition called crusted scabies or Norwegian scabies. Most biting mites such as scabies or tropical rat mites only cause itching and dermatitis; however, at least one group, the chiggers, may transmit a disease agent in parts of Asia (see the previous paragraph). In the United States, rickettsialpox, carried by the house mouse mite, is a relatively mild bacterial infection caused by Rickettsia akari, a member of the spotted fever group rickettsiae. The disease often begins with a nonitchy red papule where the infected mite bit the patient. This may further develop into an ulcer-like sore that turns into a brown or black scab called an eschar. Fever, headache, malaise, and myalgias accompany the signs at the bite site(s). The disease is relatively rare, with only about 1,000 cases ever reported.7
Burns and burn surgery
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
A variety of methods are used to remove the burn eschar, depending on the depth of the wound, the time post-burn and the changes occurring in the eschar over time. Tangential, sequential, or layered excision (procedure of choice in children)Fascial excisionDelayed escharectomyThe use of synthetic and biological skin substitutesDermal substitution
Dermatological problems and treatment in long-term/nursing-home care
Published in Robert A. Norman, Geriatric Dermatology, 2020
Eschar is a form of necrotic tissue, and removal of the devitalized tissue is considered necessary for wound healing; the wound will appear larger as the debridement progresses. When a wound involves necrotic tissue, staging cannot be confirmed until its base is visible. The Agency for Health Care Policy and Research (AHCPR) guidelines recommend that heel ulcers with dry eschar need not be debrided if they do not have edema, erythema, fluctuance, or drainage. These wounds should be assessed daily to monitor for pressure ulcer complications that would require debridement (e.g. edema, erythema, fluctuance, drainage).
Hysteroscopy Combined with Laser Vaporesection for Endometrial Polyps
Published in Journal of Investigative Surgery, 2022
Hongyan Ren, Hua Duan, Sha Wang, Yanan Chang
2 μm laser is a kind of high energy laser. The maximum absorption peak of water on the laser is 1.94 μm, which can be absorbed by the human tissue water efficiently. And it can also achieve high tissue ablation rate. Moreover, the operation effect is not dependent on the color of vascularization or organization change [26]. It has the advantage of continuous wave laser beam [27]. In clinical application, it can achieve efficient tissue vaporization by moving the laser fiber quickly and tangentially to the tissue surface. The thermal damage to the tissue during tissue cutting is relatively superficial, so as to reduce the occurrence of intraoperative bleeding. Due to the shallow penetration of laser to tissue, the coagulation zone had almost no effect on specimen pathology [28]. However, in electrosurgical operation, high-frequency electric heating can be used to cut the tissue. And the temperature is high, and it is easy to produce scab on the section surface of the tissue. After the eschar falls off, it usually causes bleeding.
Spotted fever diagnosis: Experience from a South Indian center
Published in Pathogens and Global Health, 2021
Elangovan D, Perumalla S, Gunasekaran K, Rose W, Verghese V p, Abhilash K Pp, Prakash Jaj, Dumler Js
Among these 48 spotted fever (SF) cases, 41 (84%) were children. Male (n = 28) to female (n = 21) ratio among these was 4:3. Rash appeared by the fifth day after fever onset in 45 (92%) of the 48 cases. Maculopapular rash was observed in 34 (70.8%) patients; while six (12.5%) had macular rash, purpuric or petechial rash (severe rash) was seen in 8 patients (16.7%). Rash on palms and soles was observed in 35 (71.4%), pedal edema in 19 (39.6%) and hepatomegaly in one (2.1%) case. Among the 48 patients, 43 received doxycycline and 5 received azithromycin, and all demonstrated defervescence of fever within 72 hours of initiation of therapy. Rickettsia-specific therapy (doxycycline or azithromycin) was initiated in 44 (90%) of the 48 patients before samples were sent for spotted fever diagnostic assays. None of our spotted fever cases had eschar and there were no fatalities.
Microneedle arrays for the treatment of chronic wounds
Published in Expert Opinion on Drug Delivery, 2020
Lindsay Barnum, Mohamadmahdi Samandari, Tannin A. Schmidt, Ali Tamayol
A common problem associated with both drug delivery tools and sensing systems used in wound care is the selection of the point of action. This is more important for chronic wounds because they are often covered with eschar that topically delivered drugs must pass through to reach the healthy cells below while combating the transport of exudate in the reverse direction. Therefore, the actual local bioavailability of drugs near healthy cells can be much lower than the dose delivered. Similarly, the values measured using topical sensors may not precisely reflect the changes in the physiological environment of healthy cells below eschar. There is increasing evidence suggesting the importance of the delivery/sampling point in wound care systems. MNAs have emerged as a minimally invasive tool that reduces the distance between healthy cells and the delivery/sampling point. In the following sections, we will discuss strategies used for the fabrication of MNAs and examples showing their successful use in wound care practice.