Background: Leg ulcers are an important cost factor in health care systems. It has been shown that a telemedical wound care consultation can improve quality of care and help reduce costs. In this study, we evaluated t...Background: Leg ulcers are an important cost factor in health care systems. It has been shown that a telemedical wound care consultation can improve quality of care and help reduce costs. In this study, we evaluated the feasibility of telemedical wound care using a new generation of mobile telephones with integrated cameras. Observations: Three physicians separately evaluated 61 leg ulcers for the following 9 variables: epithelialization, fibrin, necrosis, and granulation tissue at the center and normal border, erythema, cyanosis, eczema, and hyperpigmentation at the periphery. One physician performed the face-to-face consultation (gold standard), and 2 others performed the remote evaluation. The image was obtained with the mobile telephone and immediately sent via e-mail. To measure the agreement of the evaluation among the 3 physicians, we used Cohen κ statistics. Overall, the agreement between the remote and face-to-face evaluations was very good, with κ values of up to 0.94 The image quality was judged to be good in 36 cases (59% ) and very good in 12 (20% ). The participants felt comfortable making a diagnosis based on the pictures in 50 cases (82% ). Conclusion: Although this study was performed with the first generation of these devices, we were able to demonstrate the feasibility of such a telemedical wound care consultation.展开更多
Background:The high rate of morbidity and mortality resulting from long-term use of corticosteroids in pemphigus vulgaris(PV)warrants discovery of a new treatment strategy.Based on a new theory on the pathophysiology ...Background:The high rate of morbidity and mortality resulting from long-term use of corticosteroids in pemphigus vulgaris(PV)warrants discovery of a new treatment strategy.Based on a new theory on the pathophysiology of PV,cholinomimetics can block the process of blister formation.Aims:This study was conducted to evaluate the clinical effectiveness of Pilocarpinegel in the treatment of skin lesions of PV.Methods:In a double blind,placebo-controlled study,three PV patients with a total of 64 skin lesions were treated by either Pilocarpine or placebogel.After 15 days of treatment an epithelialization index ofthe two groups was compared.Results:The mean of the epithelializationindex in skin lesions that received Pilocarpinewas significantly higher than that of the placebo group(40.3±1.7 vs.24.4 ±3.3,P < 0.001).Conclusions:Pilocarpinegel effectively treats PV.展开更多
文摘Background: Leg ulcers are an important cost factor in health care systems. It has been shown that a telemedical wound care consultation can improve quality of care and help reduce costs. In this study, we evaluated the feasibility of telemedical wound care using a new generation of mobile telephones with integrated cameras. Observations: Three physicians separately evaluated 61 leg ulcers for the following 9 variables: epithelialization, fibrin, necrosis, and granulation tissue at the center and normal border, erythema, cyanosis, eczema, and hyperpigmentation at the periphery. One physician performed the face-to-face consultation (gold standard), and 2 others performed the remote evaluation. The image was obtained with the mobile telephone and immediately sent via e-mail. To measure the agreement of the evaluation among the 3 physicians, we used Cohen κ statistics. Overall, the agreement between the remote and face-to-face evaluations was very good, with κ values of up to 0.94 The image quality was judged to be good in 36 cases (59% ) and very good in 12 (20% ). The participants felt comfortable making a diagnosis based on the pictures in 50 cases (82% ). Conclusion: Although this study was performed with the first generation of these devices, we were able to demonstrate the feasibility of such a telemedical wound care consultation.
文摘Background:The high rate of morbidity and mortality resulting from long-term use of corticosteroids in pemphigus vulgaris(PV)warrants discovery of a new treatment strategy.Based on a new theory on the pathophysiology of PV,cholinomimetics can block the process of blister formation.Aims:This study was conducted to evaluate the clinical effectiveness of Pilocarpinegel in the treatment of skin lesions of PV.Methods:In a double blind,placebo-controlled study,three PV patients with a total of 64 skin lesions were treated by either Pilocarpine or placebogel.After 15 days of treatment an epithelialization index ofthe two groups was compared.Results:The mean of the epithelializationindex in skin lesions that received Pilocarpinewas significantly higher than that of the placebo group(40.3±1.7 vs.24.4 ±3.3,P < 0.001).Conclusions:Pilocarpinegel effectively treats PV.
