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Of the 10 patients, 6 were admitted for NSTIs, 2 were admitted for sacral decubitus ulcers, and 2 were admitted for burn injuries. The patients’ wounds ranged from 30 cm2 to 1000 cm2, and 80% of patients ultimately underwent skin grafting for wound closure.

This case series highlights the spectrum of wounds that can be managed with NPWTi-d dressings to yield a clean wound environment to promote healing and preparation for wound closure.

This case series highlights the spectrum of wounds that can be managed with NPWTi-d dressings to yield a clean wound environment to promote healing and preparation for wound closure.

Negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been shown to be a viable option in abdominal wound healing protocols. To shed additional light on NPWTi-d, the present case study describes the treatment of a large postsurgical abdominal wound.

A 50-year-old female with multiple comorbidities underwent complete colectomy, end ileostomy, and percutaneous endoscopic gastronomy tube placement and subsequently developed a 27 cm x 22 cm x 7 cm abdominal wound that was approximately 85% covered by a thick layer of necrotic fat. After multiple surgical debridements over a 4-week timeframe, with recurrent adipose necrosis and failed surgical closure, NPWTi-d was initiated using 50 mL normal saline with 10-minute dwell time followed by 3.5 hours of continuous negative pressure at -125 mm Hg. Perforated foam was used in the wound bed. The NPWT dressings were changed twice weekly, and a physical debriding pad was used during dressing changes as needed. The instillation fluid was changed to an antimicrobial when an infection developed. Over the course of 6 weeks of treatment with NPWTi-d, progressive improvement was noted in wound size and depth; the final wound measurement was 25 cm x 22 cm x 4.5 cm, and 25% of the wound bed was covered with a thinner layer of necrotic tissue. Unfortunately, the patient died due to her underlying illness.

Despite the patient’s overall failure to thrive, poor nutrition, and persistent high acuity, this wound improved dramatically with attention to the complexities of stoma care and the use of NPWTi-d.

Despite the patient’s overall failure to thrive, poor nutrition, and persistent high acuity, this wound improved dramatically with attention to the complexities of stoma care and the use of NPWTi-d.Individualization of therapy based on a person’s specific type of diabetes is one key element of a “precision medicine” approach to diabetes care. However, applying such an approach remains difficult because of barriers such as disease heterogeneity, difficulties in accurately diagnosing different types of diabetes, multiple genetic influences, incomplete understanding of pathophysiology, limitations of current therapies, and environmental, social, and psychological factors. Monogenic diabetes, for which single gene mutations are causal, is the category most suited to a precision approach. The pathophysiological mechanisms of monogenic diabetes are understood better than those of any other form of diabetes. Thus, this category offers the advantage of accurate diagnosis of nonoverlapping etiological subgroups for which specific interventions can be applied. Although representing a small proportion of all diabetes cases, monogenic forms present an opportunity to demonstrate the feasibility of precision medicine strategies. In June 2019, the editors of Diabetes Care convened a panel of experts to discuss this opportunity. This article summarizes the major themes that arose at that forum. It presents an overview of the common causes of monogenic diabetes, describes some challenges in identifying and treating these disorders, and reports experience with various approaches to screening, diagnosis, and management. This article complements a larger American Diabetes Association effort supporting implementation of precision medicine for monogenic diabetes, which could serve as a platform for a broader initiative to apply more precise tactics to treating the more common forms of diabetes.Artificial intelligence (AI) technologies can play a key role in preventing, detecting, and monitoring epidemics. In this paper, we provide an overview of the recently published literature on the COVID-19 pandemic in four strategic areas (1) triage, diagnosis, and risk prediction; (2) drug repurposing and development; (3) pharmacogenomics and vaccines; and (4) mining of the medical literature. We highlight how AI-powered health care can enable public health systems to efficiently handle future outbreaks and improve patient outcomes.

Though COVID-19 vaccines are becoming more available, their ability to effectively control and contain the pandemic’s spread is highly contingent on an array of factors. This paper discusses how limitations to vaccine accessibility, issues associated with vaccine side effects, concerns regarding vaccine efficacy, along with the persistent prevalence of vaccine hesitancy in the public, including healthcare professionals, might impact COVID-19 vaccines’ capabilities to curb the pandemic. Drawing insights from the literature, we also identify practical solutions that could boost people’s adoption of COVID-19 and the accessibility of these vaccines. Cisplatin We conclude with a discussion of health experts and government officials’ moral and ethical responsibilities to the public, even in light of the urgency to adopt and endorse “the greatest amount of good for the greatest number” utilitarian philosophy in controlling and managing COVID-19.

Though COVID-19 vaccines are becoming more available, their ability to effectively control and contain the pandemic’s spread is highly contingent on an array of factors. This paper discusses how limitations to vaccine accessibility, issues associated with vaccine side effects, concerns regarding vaccine efficacy, along with the persistent prevalence of vaccine hesitancy in the public, including healthcare professionals, might impact COVID-19 vaccines’ capabilities to curb the pandemic. Drawing insights from the literature, we also identify practical solutions that could boost people’s adoption of COVID-19 and the accessibility of these vaccines. We conclude with a discussion of health experts and government officials’ moral and ethical responsibilities to the public, even in light of the urgency to adopt and endorse “the greatest amount of good for the greatest number” utilitarian philosophy in controlling and managing COVID-19.