Prevalence Of Leg Ulcers Research Articles

Is Hb A2 Elevated in Adults with Sickle-A-Thalassemi (βS/βS; -α/-α)

Thirteen patients with sickle cell anemia (SS) were found to have two a gene deletions with a presumptive genotype of βs/βs; -α/-α. Hematological data showed that this group of patients had elevated Hb A2 level. in order to determine whether the elevation of Hb A2 is typical of SS with a two α gene deletion or is due to undiagnosed S-β°-thalassemia with a two a gene deletion we looked for the presence or absence of β°-thalassemia by molecular techniques. The latter included reverse dot-blot hybridization to rule out a β-thalassemia mutation, digestion with Cvn endonuclease followed by Southern blotting and hybridization with a β genomic probe, and, in selected patients, determination of the synthetic α/β ratio. One of the 13 patients had S-β°-thalassemia with a G→A mutation at IVS-11-1 indicating that her genotype was βs/β° thalassemia; -α/-α. The remaining 12 patients were homozygous for the sickle gene, had relatively elevated Hb levels, increased Hb A2 values, and Hb F levels similar to those in patients with SS and four or three α genes. At the clinical level, the 12 patients with SS and a two α gene deletion had increased prevalence of avascular necrosis, retinopathy, and splenomegaly, but decreased prevalence of leg ulcers and cerebrovascular accidents. Together, the data indicate that SS with a two a gene deletion (βs/βs; -α/α) is a unique subset of patients with SS characterized by distinct hematological and clinical features.

Prevalence and Aetiology of Leg Ulcers in a Defined Population of Industrial Workers

Objective: To assess leg ulcer prevalence and aetiology in people below retirement age. Design: A validated cross-sectional questionnaire survey. Respondents with a history of leg ulcers were examined. Setting: A defined population of industrial workers. Subjects: All 2785 employees, aged 30–65 years, at the Volvo motor engine factories in Skövde were included. Men predominated (81%) and the median age was 44 years in both men and women. A questionnaire was used to select people with a history of ulceration. A leg ulcer was defined as ‘any wound below the knee (foot ulcers included) that did not heal within a 6-week period after onset of ulceration’. Main outcome measures: Point prevalence of open leg ulcers, overall prevalence of leg ulcer history and aetiological classification. Results: The overall response rate was 87%, and 131 out of 153 subjects with a ‘history of leg ulcers’ were examined (86%). In 98% of positive responders the answers were validated. The overall false-positive response rate was 64%. Fifty-four had a true history of ulcers, of whom 16 had open ulcers. Of the latter, 12 were self-caring (75%). Overall venous causation dominated (41%). The ratio of open to healed ulcers was 1:2. The point prevalence for open ulcers was 0.6% and the overall prevalence of ulcer history was 1.6%, if excluding pure traumatic ulcers. The point prevalence was tenfold higher in people aged below 50 years and seven times higher in the age decade 50–59 years if compared with previous estimates based on patients known to health-care professionals. Conclusion: Leg ulcer prevalence has been underestimated in people of working age because they are often self-caring. Since many ulcers have curable causes it is necessary to inform the public of the importance of seeking professional help early.

North Derbyshire Leg Ulcer Survey

INTRODUCTION The North Derbyshire Wound Management Working Party has, for a number of years, carried out pressure sore prevalence surveys which have helped to highlight and tackle practice issues and have led to an increased level of resources being made available to treat and prevent sores. Wound management, however, covers more than just pressure sores and in the spring of 1995 it was agreed to carry out a leg ulcer prevalence survey to examine this problem and to try to establish baseline information.

The prevalence of chronic lower-limb ulceration has been underestimated: Results of a validated population questionnaire

A validated population questionnaire was used to survey 12,000 randomly selected inhabitants, aged 50-89 years, in two defined regions of Sweden. The sample included 7 per cent of the total population in the age interval. Overall response rate was 91 per cent. Open ulcers were reported by 306 subjects and 143 (47 per cent) agreed to be examined. The false-positive response rate was high (43 per cent). The observed point prevalence of open leg ulcers was 0.63 (95 per cent confidence interval 0.54-0.72) per cent of the total population. The overall prevalence of leg ulcer history (open plus healed) in the population was estimated to be around 2 per cent and the ratio of open: previous ulcers was 1:2. This study shows a point prevalence more than double that expected, indicating a high rate of self treatment. Assessments of leg ulcer prevalence through the health care system, without knowledge of the rate of self care, measure only the workload of health care professionals. The problem of leg ulcers has generally been underestimated.

The Prevalence of Leg Ulcers in Older People: Implications for Community Nursing

The prevalence of chronic leg ulcers has been investigated in older people living in the community. This condition has a low prevalence, but major health costs are associated with frequent home nursing visits, community nursing services being the main providers of care. An estimate was made of the prevalence of chronic leg ulcers in a cross-sectional random sample of noninstitutionalized older people living in a major Australian city (N = 1,050). The prevalence estimate is compatible with estimates of 1% in the over-60 age group found in Swedish and Northern American studies. Age-adjusted gender ratios demonstrate slightly higher prevalence in females than males (1.25:1). Implications for community nursing services for primary, secondary, and tertiary prevention are outlined and include education programs for seniors dispelling myths that leg ulcers are a natural part of aging, screening for venous and arterial peripheral vascular disease in the older community, collaborative nurse and podiatrist foot care clinics, and the location of leg ulcer clinics in geriatric day care centers.

Comparison of ciprofloxacin or trimethoprim therapy for venous leg ulcers: Results of a pilot study

The prevalence of leg ulcers varies from 0.6% to 1.15% in women 65 to 84 years of age and from 0.3% to 0.5% in men of similar age.' Most of the leg ulcers (80% to 90%) are of venous origin. Because local treatment is not always effective.r uncomplicated leg ulcers (ulcers without cellulitis or osteomyelitis) are often treated with systemic antimicrobial agents. Although short-term antimicrobial therapy is ineffective.P preliminary evidence indicates that long-term ciprofloxacin therapy may be beneficial. 6 However, placebo-controlled trials with standardized local treatment, including compression bandages, have not been performed.

High prevalence of diabetes in chronic leg ulcer patients: a cross-sectional population study.

In a cross-sectional survey, designed to detect all patients with current chronic leg ulcers, 27% of the patients had diabetes mellitus. The outcome for the 104 examined diabetic patients has been evaluated and compared with the 278 nondiabetic patients. The purpose was to establish the prevalence of leg ulcers among diabetic patients and to assess potential causes. The point prevalence was calculated by extrapolating the leg ulcer frequency to the total diabetic population in the studied area. The point prevalence for active leg ulcers (including foot ulcers) in diabetic patients was 3.5% (95% CI 2.8-4.2). Ulcers above the malleoli were almost as common as foot ulcers. Peripheral vascular disease was present in 67% of all ulcerated legs in patients with diabetes compared to 42% in nondiabetic patients (p < 0.001). In 72% of foot ulcers in diabetic patients arterial impairment was judged to be a contributing aetiological factor and in nondiabetic patients 45% (p < 0.001). Ulcers solely attributed to possible neuropathy were less common (15%). Ulcers with multifactorial causes were common above the malleoli. This survey has given the size of the problem and indicates macroangiopathy to be the dominating factor responsible for slow or nonhealing ulcers in diabetic patients. Objective assessment of arterial circulation is mandatory and signs of arterial impairment require consultation with a vascular surgeon.

Ulcers of the leg in Cooley's anemia.

THE prevalence of leg ulcers in sickle-cell anemia has been estimated at 25 per cent1 to 75 per cent2 and at 6.5 per cent in hereditary spherocytic anemia.3 In contrast to these forms of familial hemolytic anemia, the occurrence of leg ulcers in Cooley's anemia is rare. Only 7 cases have thus far been recorded,4 5 6 7 8 2 of them by us.5 , 8 One of these was presented in abstract form.8 A subsequent comparative study of this case with those previously reported disclosed a number of interesting facts that merit fuller consideration.Case ReportM.P., a 27-year-old man of Italian descent, born in . . .