[Martorell's ulcer. Study of 6 cases].
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Biomedical subjects
M Rosina
Publications and source records attributed to M Rosina.
Effect of incremental doses of folate on homocysteine and metabolically related vitamin concentrations in nondiabetic patients on peritoneal dialysis.
The role of folate supplementation in reducing hyperhomocystinemia in patients on dialysis has been reported, but the optimal dose of folate is still unknown. The aim of the present study was to investigate whether greater than 5 mg/day folate supplementation provides any additional effect on plasma homocysteine (HCY) levels. The study was prospective, open, and had no control group. Of the 64 eligible nondiabetic patients on peritoneal dialysis with hyperhomocystinemia (>20 micromol/L), 56 were given oral folate (5 mg/day) for 3 months. When Hcy did not fall below 20 micromol/L, folate doses were increased by 5 mg every 3 months to up to 15 mg/day. With 5 mg/day supplementation, serum folate concentrations increased above the upper confidence limit in 23 patients and erythrocyte folate concentrations in 27 patients. Hcy levels decreased to less than 15 micromol/L in 6 cases and by more than 50% in 12 cases. Nineteen of the remaining patients were given 10 mg/day folate. After increasing the dose, serum and erythrocyte folate levels rose above the upper detection limit. In one patient, plasma Hcy concentrations decreased to less than 15 micromol/L. Ten patients were given 15 mg/day oral folate for an additional 3 months with no effect on homocystinemia. This study confirms that oral folate supplementation may improve hyperhomocystinemia even in patients on dialysis with normal serum or erythrocyte folate concentrations. In fact, serum and erythrocyte levels cannot predict the effect of supplementation on plasma Hcy levels. However, 5 mg/day folate supplementation normalized Hcy in 10% of cases and reduced Hcy levels in another 21%. Increasing the folate dose to greater than 5 mg/day had a minimal (10 mg/day) or no (15 mg/day) additional effect on Hcy concentrations. Despite the minimal effect of increasing folate doses, given the low cost, the absence of side effects, and the high cardiovascular risk for patients on peritoneal dialysis, a careful attempt to increase the dose of oral folate up to 10 mg/day might be suggested.
Administration, Oral↗
The effects of a hydrocolloid dressing on bacterial growth and the healing process of leg ulcers.
Thirty patients with lower extremity ulcers of different aetiologies, although mainly of venous origin, were treated with an occlusive hydrocolloid dressing twice a week for a maximum period of 12 weeks. No antibacterial chemotherapy was utilized. A culture was taken of the exudate of the ulcer before commencement of treatment and weekly or bi-weekly thereafter. The results showed a mixed flora with prevalence of Staphylococcus aureus. The average duration of the treatment period was 67 +/- 11 days with a total of 26 patients being healed by the end of this period. The average interval between dressing changes was 4.1 days. Subsequent bacterial cultures showed a persistence of the original flora, but there was no correlation between the type of flora present and clinical evidence of infection or between the type of flora present and the rate of healing of the ulcer. Clinical evaluation of the results obtained with the hydrocolloid dressing was favourable in respect to reduced risk of contamination of the ulcer, lower pain perception and less trauma to the granulation tissue during dressing changes.
Adult↗