Granulation Tissue

肉芽组织
  • 文章类型: Journal Article
    在怀疑违反欧洲和国家立法的情况下,对动物进行法医验尸。在丹麦,也可能在其他大规模生产牛的国家,牛定期提交法医评估。不幸的是,牛的法医病理学研究很少。本文对2010年1月至2021年12月丹麦牛的法医案件档案进行了回顾性研究。病例档案根据病变类型进行了表征,病变的年龄评估和其他参数,如年龄和性别。共有118份法医案件档案已存档,涉及132头牛(14周至20岁;68%为女性,30%男性和2%未知性别)有228个病灶。运动障碍构成了大多数病变。然而,恶病质/消瘦,皮肤溃疡和角过度生长也很常见。大多数病变是慢性的(91%),并且对79%的病变进行了超过2周的年龄评估。这表明至少在丹麦,有必要考虑如何及时治疗患有运动障碍的牛,以避免长期徒劳的治疗,因此,痛苦。在1-2周且持续时间较长的病变中,存在明显可见的修复性肉芽组织和新骨形成。然而,由于缺乏对牛病变的年龄评估进行科学的法医学研究,因此所有年龄评估均以较宽的时间间隔进行。因此,为了改善法医牛病例的年龄评估,关于牛组织修复的年代学研究是有必要的。我们还提出了牛的法医检查指南。
    Forensic post-mortem examinations of animals are carried out on suspicion of violation of European and national legislation. In Denmark, and probably also in other countries with large-scale cattle production, cattle are regularly submitted for forensic assessment. Unfortunately, only few studies of forensic pathology in cattle are available. This paper presents a retrospective study of forensic case files on Danish cattle from January 2010 to December 2021. The case files were characterized with respect to types of lesion, age assessments of lesions and other parameters such as age and sex. A total of 118 forensic case files had been archived and related to 132 cattle (14 weeks-20 years of age; 68% female, 30% male and 2% unknown sex) with 228 lesions. Locomotor disorders constituted the majority of lesions. However, cachexia/emaciation, skin ulcerations and overgrowth of cornual horn were also frequent. Most lesions were chronic (91%) and age assessments for more than 2 weeks were stated for 79% of the lesions. This indicates that in Denmark at least, there is a need to consider how cattle with locomotor disorders are treated in a timely manner in order to avoid prolonged futile treatment and, thereby, suffering. Grossly visible reparative granulation tissue and new bone formation were present in lesions of 1-2 weeks and longer duration. However, all age assessments were stated in broad time intervals due to the lack of scientifically based forensic studies of age assessments of lesions in cattle. Therefore, to improve age assessments in forensic cattle cases, studies concerning the chronology of tissue reparation in cattle are warranted. We also present a guideline for the forensic examination of cattle.
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  • 文章类型: Consensus Development Conference
    目的:就有助于卫生专业人员在日常实践中选择合适的伤口敷料的建议达成共识,因为系统评价仅发现有限的证据支持现代伤口敷料的报告适应症。
    方法:一个指导委员会从具有长期伤口护理经验的护理人员和医师(专家或全科医生)名单中选出了一个由27名没有声明利益冲突的专家组成的小组。这些名单是由15个法国学会提出的。
    方法:小组成员收到了最近的文献系统综述,由工作组确定的适应症分类,和敷料的定义。
    方法:指导委员会为两个小组中的每个小组设计了关于慢性伤口和急性伤口(包括烧伤)的问卷。共识方法来自RAND/UCLA采用的名义组技术。小组成员根据已发表的证据和他们自己的经验,对每种可能的敷料-适应症组合的相关性进行了评估。第一轮评级后,他们开会讨论结果并提出建议,然后参加第二轮评级。工作组同行审查了最终建议。
    结论:对于以下组合的使用达成了强烈共识:对于慢性伤口,(1)清创阶段,水凝胶;(2)造粒阶段,泡沫和低粘附性敷料;和(3)上皮形成阶段,水胶体和低粘附性敷料;对于急性伤口的上皮形成阶段,低依从性敷料。对于具体情况,以下敷料是有利的:脆弱的皮肤,低粘附性敷料;用于出血性伤口,藻酸盐;和恶臭伤口,活性炭。
    OBJECTIVE: To seek a consensus on recommendations that would help health professionals choose appropriate wound dressings in daily practice, since a systematic review found only limited evidence to support reported indications for modern wound dressings.
    METHODS: A steering committee selected a panel of 27 experts with no declared conflicts of interest from lists of nursing staff and physicians (specialists or general practitioners) with long-standing experience of wound care. The lists were put forward by 15 French learned societies.
    METHODS: The panelists received a recent systematic review of the literature, a classification of indications established by a working group, and definitions for the dressings.
    METHODS: The steering committee designed questionnaires on chronic wounds and on acute wounds including burns for each of the 2 panels. The consensus method was derived from the nominal group technique adapted by RAND/UCLA. Panelists rated the relevance of each possible dressing-indication combination on the basis of the published evidence and their own experience. After the first round of rating, they met to discuss results and propose recommendations before taking part in a second round of rating. The working group peer reviewed the final recommendations.
    CONCLUSIONS: A strong consensus was reached for use of the following combinations: for chronic wounds, (1) debridement stage, hydrogels; (2) granulation stage, foam and low-adherence dressings; and (3) epithelialization stage, hydrocolloid and low-adherence dressings; and for the epithelialization stage of acute wounds, low-adherence dressings. For specific situations, the following dressings were favored: for fragile skin, low-adherence dressings; for hemorrhagic wounds, alginates; and for malodorous wounds, activated charcoal.
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  • 文章类型: Journal Article
    OBJECTIVE: The introduction of clearly defined histopathological criteria for a standardised evaluation of the periprosthetic membrane, which can appear in cases of total joint arthroplasty revision surgery.
    METHODS: Based on histomorphological criteria, four types of periprosthetic membrane were defined: wear particle induced type (detection of foreign body particles; macrophages and multinucleated giant cells occupy at least 20% of the area; type I); infectious type (granulation tissue with neutrophilic granulocytes, plasma cells and few, if any, wear particles; type II); combined type (aspects of type I and type II occur simultaneously; type III); and indeterminate type (neither criteria for type I nor type II are fulfilled; type IV). The periprosthetic membranes of 370 patients (217 women, 153 men; mean age 67.6 years, mean period until revision surgery 7.4 years) were analysed according to the defined criteria.
    RESULTS: Frequency of histopathological membrane types was: type I 54.3%, type II 19.7%, type III 5.4%, type IV 15.4%, and not assessable 5.1%. The mean period between primary arthroplasty and revision surgery was 10.1 years for type I, 3.2 years for type II, 4.5 years for type III and 5.4 years for type IV. The correlation between histopathological and microbiological diagnosis was high (89.7%), and the inter-observer reproducibility sufficient (85%).
    CONCLUSIONS: The classification proposed enables standardised typing of periprosthetic membranes and may serve as a tool for further research on the pathogenesis of the loosening of total joint replacement. The study highlights the importance of non-infectious, non-particle induced loosening of prosthetic devices in orthopaedic surgery (membrane type IV), which was observed in 15.4% of patients.
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  • 文章类型: Journal Article
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