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Related Concept Videos

Clinical Applications of Epidermal Stem Cells01:19

Clinical Applications of Epidermal Stem Cells

Epidermal stem cells (EpiSCs) are mainly located at the basal layer of the epidermis. These cells repair minor injuries of the skin and replace dead skin cells. However, EpiSCs’ cannot heal severe wounds such as major burns or those from diabetes or hereditary disorders. In such cases, culturing the epidermal stem cells from the patient is possible and has yielded successful treatment options, such as laboratory-grown skin grafts. These grafts are synthesized using a patient’s own EpiSCs...
Assessment of the Cardiovascular System II: Inspection01:29

Assessment of the Cardiovascular System II: Inspection

Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
Head and Neck
Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
Healing II: Complications01:24

Healing II: Complications

Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...
Diabetic Foot Ulcer01:31

Diabetic Foot Ulcer

Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory neuropathy reduces pain perception,...

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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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Points to consider for skin ulcers in systemic sclerosis.

Felice Galluccio1, Yannick Allanore2, Lázló Czirjak3

  • 1Department of Clinical and Experimental Medicine, Division of Rheumatology, University of Florence, AOU Careggi, Florence, Italy.

Rheumatology (Oxford, England)
|October 10, 2017
PubMed
Summary

Designing clinical trials for systemic sclerosis (SSc) skin ulcers requires careful patient selection and outcome measure validation. Key considerations include defining patient populations, excluding confounders, and validating objective measures and biomarkers for robust trial design.

Keywords:
clinical trialsoutcome measuresskin ulcerssystemic sclerosis

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Area of Science:

  • Rheumatology
  • Dermatology
  • Clinical Trial Design

Background:

  • Systemic sclerosis (SSc) frequently causes skin ulcers, impacting patient quality of life.
  • Standardized approaches for clinical trials targeting SSc skin ulcers are lacking.

Purpose of the Study:

  • To outline critical considerations for designing effective clinical trials for SSc-related skin ulcers.
  • To guide researchers in selecting appropriate patient populations and outcome measures.

Main Methods:

  • Review of existing methodologies and challenges in SSc skin ulcer clinical trials.
  • Discussion of patient stratification based on disease duration, digital ulcer history, and capillaroscopic patterns.
  • Exploration of confounding factors (infection, calcinosis, trauma) and their management in trial design.

Main Results:

  • Importance of using validated definitions for SSc skin ulcers.
  • Need for uniform patient population criteria, including disease characteristics.
  • Consideration of various outcome measures (healing time, new ulcer prevention, pain, function) and objective assessments (ultrasound, laser Doppler, thermography).

Conclusions:

  • Validated definitions and uniform patient populations are crucial for SSc skin ulcer trials.
  • Outcome measures, including objective assessments and biomarkers, require validation before widespread use.
  • Pre-planned statistical analysis, accounting for missing data, is essential for reliable trial results.