Pyoderma gangrenosum (PG) is a refractory, painful, non-infectious, ulcerative and inflammatory skin condition. Approximately 50% of patients with PG showed an existing systemic disease, such as inflammatory bowel conditions, haematological disorders, rheumatoid diseases or hepatopathies. Some patients developed PG following acute trauma or injury in a process known as pathergy. In the other cases, PG is characterised by isolated skin lesions with unknown causes and classified as idiopathic. However, in recent decades, PG has been reported in patients treated with certain medications. In this manuscript, we report two cases of PG, which were triggered by chemotherapy in patients with myelodysplastic syndrome (MDS) and chronic myelomonocytic leukaemia (CMML).
Industrial infrared thermometry devices are large and, despite being less expensive than the current gold standard Exergen Dermatemp medical infrared thermometer, are still not affordable enough to ensure unrestricted and consistent use of this assessment modality in regular wound-related day-to-day practice. An increased skin surface temperature differentiation of 3°F associated with a wound has a positive predictive ability to detect deep or surrounding wound infection. This study hypothesised that inexpensive, pen- or pocket-sized, no-touch surface infrared thermometry devices will be equal in ability to detect a 3oF increased skin temperature compared to the Exergen Dermatemp infrared device and be reliable in the hands of any wound assessor. The odds of the control and other thermometers to detect a 3oF temperature difference, irrespective of the raters, were achieved in all five of the mini thermometers tested, with a correct temperature difference prediction that occurred in 90.933% of the times (odds determined 9/10). As a result of this study mini, no-touch infrared thermometry, to detect a 3oF temperature difference in wound assessment to determine tendency, could be implemented into primary health care clinics, rural clinics, day-to-day hospital practice and standard outpatients departments at a small financial cost, regardless of which thermometer is put to use.
This case review discusses the importance of providing a holistic approach to the care of a patient with two stomas and an enterocutaneous fistula. In this case, the stomas and fistula significantly affected the patient; not just physically but emotionally and socially. The different challenges that arose in pouching a high-output ileostomy, enterocutaneous fistula and ileal conduit with Foley catheter in situ are explored. It also delves into the various options for discharging a patient with complex ostomy complications requiring different needs and resources. Finally, it aims to highlight the therapeutic comprehensive care the stomal therapy nurse provided to the patient and their family.
Objective: To investigate the correlation between stigma and ostomy adjustment in patients with a permanent colostomy.
Methods: A total of 118 patients (male 81/female 37 with an average age 57.4±15.0) from six grade 3 hospitals of the Midlands of China with a permanent colostomy were recruited. Participants responded to a questionnaire to obtain sociodemographic data, Social Impact Scale (SIS) scores to ascertain stigma level and Ostomy Adjustment Inventory (OAI-20) scores to identify the level of psychosocial adjustment.
Results: The patients’ average SIS score was (60.7±10.4). The QAI-20 total score was (41.3±10.8). The SIS total score and SIS subscores were negatively related to the total score and subscore of QAI-20 (r=-0.222~-0.537, all P<0.01). Multiple regression analysis revealed the level of self-stoma care performed, the degree of communication with medical staff, financial insecurity and social rejection when added into the regression equation had a significant negative impact on OAI-20.
Conclusion: In comparison to the average SIS score, the SIS score in this study sample is higher than midpoint, indicating stigma is closely related to ostomy adjustment. It is suggested that health professionals need to pay more attention to patients’ expressed feelings of stigma to improve their ability to adjust to living with a colostomy.