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Neuropathic ulcer

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https://www.readbyqxmd.com/read/28479156/multi-center-feasibility-study-of-microwave-radiometry-thermometry-for-non-invasive-differential-diagnosis-of-arterial-disease-in-diabetic-patients-with-suspected-critical-limb-ischemia
#1
Stavros Spiliopoulos, Vasiliki Theodosiadou, Nikolaos Barampoutis, Konstantinos Katsanos, Periklis Davlouros, Lazaros Reppas, Panagiotis Kitrou, Konstantinos Palialexis, Chrysostomos Konstantos, Elias Siores, Dimitrios Alexopoulos, Dimitris Karnabatidis, Elias Brountzos
AIMS: Diagnosis of vascular involvement in diabetic foot ulceration (DFU) remains challenging. We conducted a proof of concept study to investigate the feasibility of microwave radiometry (MWR) thermometry for non-invasive differential diagnosis of critical limb ischemia (CLI) in subjects with DFU. METHODS: This prospective, multi-center, study included 80 participants, divided into four groups (group N: normal control subjects; group DN: participants with diabetes and verified neuropathic ulcers without vascular involvement; group DC: participants with diabetes and CLI and group NDC: participants with CLI without diabetes)...
April 28, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28476389/diabetic-driving-studies-part-3-a-comparison-of-mean-brake-response-time-between-neuropathic-diabetic-drivers-with-and-without-foot-pathology
#2
Laura E Sansosti, Kerianne E Spiess, Andrew J Meyr
We have previously demonstrated an abnormally delayed mean brake response time and an increased frequency of abnormally delayed brake responses in a group of neuropathic diabetic drivers compared with a control group of drivers with neither diabetes nor lower extremity neuropathy. The objective of the present case-control study was to compare the mean brake response time between neuropathic diabetic drivers with and without specific diabetic foot pathology. The braking performances of the participants were evaluated using a computerized driving simulator with specific measurement of the mean brake response time and the frequency of abnormally delayed brake responses...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28459164/effectiveness-of-total-contact-orthosis-for-plantar-pressure-redistribution-in-neuropathic-diabetic-patients-during-different-walking-activities
#3
Muhammad Nouman, Wipawan Leelasamran, Surapong Chatpun
BACKGROUND: Using a total contact orthosis (TCO) is an effective method to offload in diabetic patients with foot neuropathy. However, the redistribution of peak plantar pressure is mostly observed during level walking, which may differ from other walking activities. The aim of this study was to investigate the plantar pressure from 4 regions of the foot during different walking activities (level walking, ramp ascending, ramp descending, stair ascending, and stair descending) in neuropathic diabetic patients with and without a TCO...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28436710/ischemic-ulcer-pain-is-both-nociceptive-and-neuropathic-pain-based-on-a-discriminant-function-analysis-using-the-mcgill-pain-questionnaire
#4
Takamichi Kogure, Masahiko Sumitani, Hiroaki Abe, Jun Hozumi, Reo Inoue, Kazuhito Mietani, Kazuo Kawahara, Yoshitsugu Yamada
The McGill Pain Questionnaire (MPQ) is composed of 78 words reflecting the mechanisms underlying chronic pain conditions. Ischemic ulcer pain is generally regarded as a nociceptive and inflammatory pain condition. However, it is sometimes refractory to nonsteroidal anti-inflammatory drug (NSAID) and opioid treatment. We categorized ischemic pain into nociceptive/inflammatory pain (NocP) or neuropathic pain (NeP), on the basis of patients' descriptions of their pain using the MPQ. We investigated pain characteristics of 365 patients with NeP and 124 with NocP using the 78 words of the MPQ...
April 24, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28326159/effects-of-weight-bearing-exercise-on-a-mini-trampoline-on-foot-mobility-plantar-pressure-and-sensation-of-diabetic-neuropathic-feet-a-preliminary-study
#5
Wararom Kanchanasamut, Praneet Pensri
Objective: Foot and ankle exercise has been advocated as a preventative approach in reducing the risk of foot ulceration. However, knowledge about the appropriate types and intensity of exercise program for diabetic foot ulcer prevention is still limited. The current study aimed to examine the effects of an eight-week mini-trampoline exercise on improving foot mobility, plantar pressure and sensation of diabetic neuropathic feet. Methods: Twenty-one people with diabetic peripheral neuropathy who had impaired sensation perception were divided into two groups...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28277993/maggot-therapy-for-wound-care-in-iran-a-case-series-of-the-first-28-patients
#6
A Mirabzadeh, M J Ladani, B Imani, S A B Rosen, R A Sherman
OBJECTIVE: The need for improved wound care is receiving considerable attention in the Islamic Republic of Iran. Beginning in 2003, maggot therapy (MT) became part of Iran's effort to advance its wound care technology. The first cohort of patients treated with MT was analysed to evaluate the use of this treatment. METHOD: Patients treated with MT at three hospitals in Tehran were analysed retrospectively. Primary outcomes were time to wound debridement and time to wound healing...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28270310/leprosy-trophic-skin-ulcers
#7
Najeeba Riyaz, Virendra N Sehgal
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Approximately 30% of patients with leprosy develop nerve damage. Trophic, or neuropathic, ulcer is a common complication of an anesthetic foot. The term plantar, trophic, or perforating ulcer was introduced in 1959. It was defined as a chronic ulceration of the anesthetic foot, situated in well-defined areas overlying bony prominences, resistant to local and/or systemic therapy, and characterized by a marked tendency to recur. It is responsible for much of the morbidity associated with leprosy...
2017: Skinmed
https://www.readbyqxmd.com/read/28268140/comparison-of-metatarsal-head-resection-versus-conservative-care-in-treatment-of-neuropathic-diabetic-foot-ulcers
#8
Alireza Kalantar Motamedi, Mohammad Ansari
Complications from diabetic foot ulcers often lead to increased patient morbidity. Much debate still ensues concerning surgical versus conservative management of neuropathic diabetic foot ulcerations. The present study assessed and compared the efficacy of metatarsal head resection and medical approach in the treatment of neuropathic diabetic foot ulcers located at the plantar surface of metatarsal heads. In a retrospective cohort study, 24 consecutive neuropathic diabetic foot ulcers in the lower area of the metatarsal heads that had undergone metatarsal head resection were included as the operative group...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28267678/enzymatic-debridement-of-chronic-nonischemic-diabetic-foot-ulcers-results-of-a-randomized-controlled-trial
#9
Juan Carlos Jimenez, Patrick S Agnew, Perry Mayer, John R Clements, Joseph M Caporusso, Darrell L Lange, Jaime E Dickerson, Herbert B Slade
OBJECTIVE: The aim of this randomized, controlled multicenter trial was to evaluate the clinical outcomes associated with the use of clostridial collagenase ointment (CCO) for up to 12 weeks in 215 patients with type 1 or type 2 diabetes mellitus and a neuropathic, nonischemic diabetic foot ulcer (DFU). MATERIALS AND METHODS: Patients were randomized into either a group receiving CCO applied once daily at a thickness of ~2 mm or a group receiving standard care (SC) consisting of a daily application of a hydrogel as needed to maintain a moist ulcer environment...
February 27, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28267677/diabetic-foot-ulcers-treated-with-porcine-urinary-bladder-extracellular-matrix-and-total-contact-cast-interim-analysis-of-a-randomized-controlled-trial
#10
Oscar M Alvarez, Tashara Smith, Thomas W Gilbert, Neh J Onumah, Martin E Wendelken, Rachelle Parker, Lee Markowitz
OBJECTIVE: To evaluate the effectiveness of a porcine urinary bladder-derived extracellular matrix (UBM) for the treatment of recalcitrant, neuropathic diabetic foot ulcers (DFUs). MATERIALS AND METHODS: This prospective, parallel, randomized, single-center study involving 17 subjects was performed in an outpatient wound care center setting. Each subject with a DFU was randomized (2:1) to receive the urinary bladder matrix (UBM) plus offloading with a total contact cast (TCC) or standard care (nonadherent dressing plus TCC)...
February 27, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28167343/association-between-ankle-equinus-and-plantar-pressures-in-people-with-diabetes-a-systematic-review-and-meta-analysis
#11
REVIEW
A Searle, M J Spink, A Ho, V H Chuter
BACKGROUND: Diabetes is one of the most common chronic diseases in the world and is associated with a life-time risk of foot ulcer of 12-25%. Diabetes related restriction in ankle joint range of dorsiflexion is proposed to contribute to elevated plantar pressures implicated in the development of foot ulcers. METHODS: A systematic search of EBSCO Megafile Premier (containing MEDLINE, CINAHL, SPORTSdiscus and Academic Search Complete) and The Cochrane Library was conducted to 23rd November 2016...
January 31, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28110796/effectiveness-of-hindfoot-arthrodesis-by-stable-internal-fixation-in-various-eichenholtz-stages-of-neuropathic-ankle-arthropathy
#12
Silvampatty R Sundararajan, Kanchana P Srikanth, Handenahally S Nagaraja, Shanmuganathan Rajasekaran
The optimal time to treat neuropathic (Charcot) arthropathy of the ankle and peritalar joint is controversial because of the various treatment options available and the variable results reported in published studies. We sought to determine the outcome of hind foot arthrodesis with stable internal fixation in patients with different Eichenholtz stages of arthropathy. We prospectively studied patients with substantial disabilities caused by neuropathic arthropathy in deformed, unstable ankle and peritalar joints, with or without ulcerations, who had undergone treatment from July 2007 to December 2012...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28105902/cost-effectiveness-of-using-adjunctive-porcine-small-intestine-submucosa-tri-layer-matrix-compared-with-standard-care-in-managing-diabetic-foot-ulcers-in-the-us
#13
J F Guest, D Weidlich, H Singh, J La Fontaine, A Garrett, C J Abularrage, C R Waycaster
OBJECTIVE: To estimate the cost-effectiveness of using tri-layer porcine small intestine submucosa (SIS; Oasis Ultra) as an adjunct to standard care compared with standard care alone in managing diabetic foot ulcers (DFUs) in the US, from the perspective of Medicare. METHOD: A Markov model was constructed to simulate the management of diabetic neuropathic lower extremity ulcers over a period of one year in the US. The model was used to estimate the cost-effectiveness of initially using adjunctive SIS compared with standard care alone to treat a DFU in the US at 2016 prices...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28103857/ameliorative-potential-of-alstonia-scholaris-linn-r-br-against-chronic-constriction-injury-induced-neuropathic-pain-in-rats
#14
Hasandeep Singh, Rohit Arora, Saroj Arora, Balbir Singh
BACKGROUND: Alstonia scholaris commonly known as 'Saptaparni' is an Indian traditional medicinal plant used in Ayurveda. It is commonly used to treat various disorders like asthma, bronchitis, diarrhea, dysentery and malaria. In folklore medicine the milky juice of the plant is applied on wounds and ulcers to treat pain, ear ache and also in rheumatic pains. AIM: The present study was designed to investigate the potential of A. scholaris R. Br. in chronic constriction injury of sciatic nerve (CCI) induced neuropathic pain in rats...
January 19, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28031030/outcome-after-protected-full-weightbearing-treatment-in-an-orthopedic-device-in-diabetic-neuropathic-arthropathy-charcot-arthropathy-a-comparison-of-unilaterally-and-bilaterally-affected-patients
#15
Niklas Renner, Stephan Hermann Wirth, Georg Osterhoff, Thomas Böni, Martin Berli
BACKGROUND: Charcot neuropathic arthropathy (CN) is a chronic, progressive, destructive, non-infectious process that most frequently affects the bone architecture of the foot in patients with sensory neuropathy. We evaluated the outcome of protected weightbearing treatment of CN in unilaterally and bilaterally affected patients and secondarily compared outcomes in protected versus unprotected weightbearing treatment. METHODS: Patient records and radiographs from 2002 to 2012 were retrospectively analyzed...
December 29, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28002690/diabsat-telemedicine-itinerant-screening-of-chronic-complications-of-diabetes-using-a-satellite
#16
Marie-Christine Turnin, Solène Schirr-Bonnans, Marie-Christine Chauchard, Patrice Deglise, Catherine Journot, Yann Lapeyre, Antonio Güell, Benoit Lepage, Helene Hanaire, Jacques Martini
BACKGROUND: Health authorities recommend regular screening for the chronic complications of diabetes. The ENTRED (*) survey results show that insufficient screening is undertaken. The DIABSAT (†) program aims to improve care for diabetes patients in rural areas of the Midi-Pyrénées region, telemonitoring complications of diabetes through an itinerant screening service. METHODS: A vehicle was equipped with a satellite dish and medical equipment for screening ophthalmological, renal, vascular, and neuropathic damage and assessing the level of risk of diabetic foot ulceration...
May 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27936243/can-wound-exudate-from-venous-leg-ulcers-measure-wound-pain-status-a-pilot-study
#17
Taichi Goto, Nao Tamai, Gojiro Nakagami, Aya Kitamura, Ayumi Naito, Masayuki Hirokawa, Chisako Shimokawa, Kazuo Takahashi, Junichi Umemoto, Hiromi Sanada
We investigated the associations between the self-evaluated pain status and two pain biomarker candidates, nerve growth factor and S100A8/A9, in exudate from venous leg ulcer to finally develop an objective pain evaluation method. Patients with venous leg ulcer participated in this cross-sectional observational study conducted between April and October 2014 at two medical facilities. During routine wound care, each participant self-evaluated their pain status at each examination using the 10-point numerical rating scale (present pain intensity) and the short-form McGill Pain Questionnaire 2 (continuous pain, intermittent pain, neuropathic pain, affective descriptors, and total score)...
2016: PloS One
https://www.readbyqxmd.com/read/27875539/secular-trends-in-admissions-and-mortality-rates-from-diabetes-mellitus-in-the-central-belt-of-ghana-a-31-year-review
#18
Osei Sarfo-Kantanka, Fred Stephen Sarfo, Eunice Oparebea Ansah, Benjamin Eghan, Nana Kwame Ayisi-Boateng, Emmanuel Acheamfour-Akowuah
INTRODUCTION: Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa...
2016: PloS One
https://www.readbyqxmd.com/read/27865313/surgical-equinus-correction-for-the-diabetic-charcot-foot-what-the-evidence-reveals
#19
REVIEW
Claire M Capobianco
Triceps surae contracture, or equinus, is a known deforming force in the foot and ankle. Biomechanical studies have shown that ankle equinus significantly alters gait and plantar pressures, and in the diabetic neuropathic patient population, this can propagate plantar ulceration and/or Charcot neuroarthropathy (CN). Surgical correction of equinus is globally and frequently used to aid in plantar wound healing in the neuropathic diabetic patient, with and without CN. Treatment guidelines for equinus correction in this medically complex population are undefined and lack evidence from high-quality published peer-reviewed studies...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27849290/the-prevention-of-diabetic-foot-ulceration-how-biomechanical-research-informs-clinical-practice
#20
Frank E DiLiberto, Judith F Baumhauer, Deborah A Nawoczenski
Background: Implementation of interprofessional clinical guidelines for the prevention of neuropathic diabetic foot ulceration has demonstrated positive effects regarding ulceration and amputation rates. Current foot care recommendations are primarily based on research regarding the prevention of ulcer recurrence and focused on reducing the magnitude of plantar stress (pressure overload). Yet, foot ulceration remains to be a prevalent and debilitating consequence of Diabetes Mellitus...
November 16, 2016: Brazilian Journal of Physical Therapy
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