Embedded Toenails

Wr, Murray

doi:10.1016/s0140-6736(75)92934-7

Cited by 31 publications

(1 citation statement)

References 4 publications

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“…Two studies were carried out to establish the long-term results of the method. In one, a preliminary retrospective study, 13 out of 25 patients who had received the gutter treatment were cured after one year compared with five out of 15 patients in whom the toenail had been avulsed. In a randomised prospective study 20 out of 36 patients (56%) treated by the gutter method were cured after one year compared with 27 out of 32 (84%) in whom the wedge resection procedure had been used.…”

Section: Gutter Treatment For Ingrowing Toenails W a Wallace D D Milmentioning

confidence: 99%

Gutter treatment for ingrowing toenails.

Andrew¹

1979

BMJ

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Summary and conclusionsThe gutter treatment for ingrowing toenails consists of introducing a small guard along the side of the toenail and requires only three outpatient attendances. The gutter is left in place for eight to 12 weeks and then removed by the patient. Two studies were carried out to establish the long-term results of the method. In one, a preliminary retrospective study, 13 out of 25 patients who had received the gutter treatment were cured after one year compared with five out of 15 patients in whom the toenail had been avulsed. In a randomised prospective study 20 out of 36 patients (56%) treated by the gutter method were cured after one year compared with 27 out of 32 (84%) in whom the wedge resection procedure had been used.The gutter treatment demands little skill and may be carried out in general practice. It gives an excellent cosmetic result with immediate pain relief and does not compromise further surgery should this be required, thus fulfilling the main requirements for the primary treatment of choice.

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Section: Gutter Treatment For Ingrowing Toenails W a Wallace D D Milmentioning

confidence: 99%

Gutter treatment for ingrowing toenails.

Andrew¹

1979

BMJ

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Intoxication aiguë au monoxyde de carbone et séquelles neurologiques : de la physiologie à la clinique

et al. 2011

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Intoxication au monoxyde de carbone et place de l’oxygénothérapie hyperbare

et al. 2011

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Le traitement par oxygénothérapie hyperbare (OHB) lors des intoxications au monoxyde de carbone est utilisé depuis plus de 50 ans. Néanmoins, le protocole à appliquer et le sous-groupe de patients pouvant bénéficier de l'OHB restent débattus. La physiopathologie de l'intoxication au monoxyde de carbone est complexe, expliquant la diversité des tableaux cliniques retrouvés neurologiques (troubles de la conscience et syndrome postintervallaire) mais aussi cardiaques (ischémie à coronaires saines notamment). La physiopathologie fait intervenir une hypoxie ané-mique par formation de carboxyhémoglobine mais aussi une hypoxie hypoxique par blocage de la chaîne respiratoire au niveau de la cytochrome oxydase, un stress oxydatif et des lésions d'ischémie-reperfusion. La carboxyhémoglobine (veineuse ou artérielle) n'est pas à prendre en compte pour le traitement ; le dosage de la troponine Ic au moindre doute est souhaitable. Les bases de traitement par l'OHB reposent d'abord sur des arguments physiopathologiques : détoxifica-tion plus rapide des protéines héminiques, effet antioxydant et amélioration de la physiologie cérébrale (diminution de la pression intracrânienne, diminution de l'oedème et préserva-tion de la zone de pénombre). Les autres arguments sont issus des essais thérapeutiques randomisés. Quatre des cinq études randomisées utilisant une OHB avec une pression supérieure à 2 ATA étaient positives. Deux études à 2 ATA étaient négatives. Ainsi, les recommandations européennes et américaines suggèrent l'utilisation d'OHB à 2,5 ATA au moins dans les situations à risque de séquelles neurologiques (tout signe neurologique objectif y compris perte de connaissance), en cas d'atteinte cardiaque ou de grossesse. Il faut insister sur un traitement par oxygénothérapie à fort débit pendant 8-12 heures en cas de non-indication de l'OHB. Pour citer cette revue : Réanimation 20 (2011). Mots clés Oxygénothérapie hyperbare · Intoxication au monoxyde de carboneAbstract Hyperbaric oxygen (HBO) is used since more than 50 years for carbon monoxide poisoning. However, HBO protocols and indications are still debated. Neurological (coma and delayed neuropsychological sequelae) and cardiac (ischemic changes with normal coronary arteries) clinical scenarios are explained by complex mechanisms. Carboxyhemoglobin formation, cytochrome oxydase inhibition, oxidative stress, as well as ischemia-reperfusion phenomenon are among these mechanisms. Venous and arterial carboxyhemoglobin levels are not correlated with the patient's final prognosis and thus not mandatory for indicating the treatment. Conversely, troponin IC measurement is strongly recommended if myocardial involvement is suspected. HBO treatment relies on mechanistic bases: earlier detoxification, anti-oxidant properties, and improvement in cerebral physiology (decrease in intracranial pressure and oedema, and ischemic penumbra preservation). Clinical basis is assessed by the results of the randomized clinical trials (RCTs). Four among the 5 RCTs using > 2 ATA OHB protocols were p...

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Embedded Toenails

Cited by 31 publications

References 4 publications

Gutter treatment for ingrowing toenails.

Gutter treatment for ingrowing toenails.

Intoxication aiguë au monoxyde de carbone et séquelles neurologiques : de la physiologie à la clinique

Intoxication au monoxyde de carbone et place de l’oxygénothérapie hyperbare

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