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Background: Negative pressure wound therapy (NPWT) has been used to accelerate the formation of granulation tissue and to promote wound closure in the treatment of difficult-to-heal wounds. This study compared the effectiveness between gauze- and foam-based NPWT for stage 4 pressure injuries. Materials and Methods: A total of 38 patients with 48 wounds of stage 4 pressure injuries were recruited and randomly divided into gauze-based and foam-based groups. After initial debridement therapy, gauze-based and foam-based fillers were used, and clinical observations were recorded when dressings were changed, twice a week for 3 weeks. The system was connected to a 1-bottle water-seal chest drainage system and standard wall suction at 125 mmHg negative pressure. The percentages of wound area reduction (PWAR), the scores of Pressure Ulcer Scale for Healing (PUSH) tool and the scores of Bates-Jensen wound assessment tool (BWAT) were used to evaluate wound healing activity. Results: Both groups showed significant changing trends in the wound assessments of PWAR, PUSH, and BWAT during follow-up. However, the area of healing at each clinical observation was consistently greater in the foam group than in the gauze group during the follow-up period, while the PUSH score was consistently greater in the gauze group than that in the foam group. The declining trends of BWAT were alike in both groups. Conclusion: Gauze-based therapy is noninferior to foam-based therapy with respect to PWAR, PUSH, and BWAT for stage 4 pressure injuries.

Infant feeding decisions depend on breastfeeding attitudes. This study examined the high school and the vocational school students’ attitudes toward breastfeeding. The descriptive cross-section survey was applied. A stratified random sample of 1,319 male and female students was carried out. The results revealed that female students were more positive than male students in breastfeeding attitudes. Of the female students, 34.7% (n = 458) reported that they will plan to breastfeed, and 29% (n = 382) male students indicated that they will encourage breastfeeding. Moreover, two-thirds (60.7%, n = 801) of the participants favored the inclusion of breastfeeding information in the school curriculum. Findings from this study suggest that breastfeeding information needs to be addressed earlier among adolescent students to increase positive breastfeeding attitudes.

Inflammation plays an important role in the pathogenesis of cardiovascular disease in patients with advanced chronic kidney disease (CKD). Neutrophil-to-lymphocyte ratio (NLR), an inflammatory biomarker, has not been evaluated in patients who have advanced CKD with peripheral artery disease (PAD) undergoing percutaneous transluminal angioplasty (PTA), especially in Taiwan.We retrospectively evaluated 148 advanced CKD (creatinine clearance rate ≤ 30 mL/min/1.73 mDuring the mean follow-up time of 8.6 ± 7.8 months, 35.1% of the cases achieved primary composite endpoint (all-cause mortality or major amputation), 25.5% underwent death from any cause, and 14.9% underwent major or minor amputation. Rutherford grade 6, either NLR or NLR ≥ 3.76, and a history of hypertension had a positively prognostic impact on the occurrence of primary composite endpoint, whereas higher albumin level (≥ 3.0 mg/dL) and technical success had a significantly protective effect. History of hypertension, either NLR or NLR ≥ 3.76, and age were associated with all-cause mortality. In addition, Rutherford 6, higher albumin level (≥ 3.0 mg/dL), technical success, NLR, and age could predict the occurrence of major amputation.NLR, but not C-reactive protein or platelet-lymphocyte ratio, is an important prognostic predictor of all major clinical outcomes in patients with advanced CKD and PAD receiving PTA. Further studies are warranted to establish a better strategy and healthcare program in this clinical setting.

The contents of an incarcerated inguinal hernia sac usually consist of small bowel or omentum. Amyand’s hernia, the situation in which appendicitis is noted in the hernia sac, is a rare occurrence. Also, neoplasms of the appendix is quite uncommon. The occurrence of these two conditions together is even more rarely reported. We report the case of a 62-year-old male with these two diseases simultaneously. Incarcerated inguinal hernia was noted before operation. Amyand’s hernia was noted during the operation. Adenocarcinoid tumor of the appendix was noted after the operation. Operative decisions were changed during the medical course.