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https://www.readbyqxmd.com/read/29244965/management-of-chronic-diabetic-foot-ulcers-using-platelet-rich-plasma
#1
V Babaei, H Afradi, H Z Gohardani, F Nasseri, M Azarafza, S Teimourian
OBJECTIVE: Platelet-rich plasma (PRP) has been proposed as an adjunct for the treatment of foot ulcers in patients with diabetes, as well as a treatment for chronic and acute wounds. This study examined the application of PRP in the treatment of diabetic foot ulcers (DFUs) in patients. METHODS: This prospective study was conducted between 2011 and 2014. We used PRP, produced by a kit, for the treatment of DFUs. Patients were allocated to one of three groups, according to size of ulcer...
December 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29244109/gadd45a-promotes-active-dna-demethylation-of-the-mmp-9-promoter-via-base-excision-repair-pathway-in-ages-treated-keratinocytes-and-in-diabetic-male-rat-skin
#2
Liyan Zhou, Wei Wang, Chuan Yang, Tingting Zeng, Mengdie Hu, Xiaoyi Wang, Na Li, Kan Sun, Chuan Wang, Jing Zhou, Meng Ren, Li Yan
Diabetes elevates matrix metalloproteinase-9 (MMP-9) levels in the skin and its keratinocytes, and activated MMP-9 impairs skin wound healing. Epigenetic regulation of the DNA methylation status within the MMP-9 promoter plays an important role in the alteration of MMP-9 expression. Our aim was to investigate the role and mechanism of growth arrest and DNA damage-inducible 45a (GADD45a), a well-known DNA demethylation regulatory protein that mediates DNA methylation, in the regulation of MMP-9 expression. In this study, we showed that GADD45a was markedly upregulated in skin tissues from patients with diabetic foot ulcers, in diabetic rats and in human keratinocyte (HaCaT) cells exposed to advanced glycation end products (AGEs)...
December 13, 2017: Endocrinology
https://www.readbyqxmd.com/read/29243399/diabetic-foot-ulcer-management-in-clinical-practice-in-the-uk-costs-and-outcomes
#3
Julian F Guest, Graham W Fuller, Peter Vowden
The aim of this study was to estimate the patterns of care and annual levels of health care resource use attributable to managing diabetic foot ulcers (DFUs) in clinical practice by the UK's National Health Service (NHS), and the associated costs of patient management. This was a retrospective cohort analysis of the records of 130 patients with a newly diagnosed DFU in The Health Improvement Network (THIN) database. Patients' characteristics, wound-related health outcomes and health care resource use were quantified, and the total NHS cost of patient management was estimated at 2015-2016 prices...
December 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29242313/dissection-of-glomerular-transcriptional-profile-in-patients-with-diabetic-nephropathy-srgap2a-protects-podocyte-structure-and-function
#4
Yu Pan, Song Jiang, Qing Hou, Dandan Qiu, Jingsong Shi, Ling Wang, Zhaohong Chen, Mingchao Zhang, Aiping Duan, Weisong Qin, Ke Zen, Zhihong Liu
Podocytes play a pivotal role in maintaining glomerular filtration function through their interdigitated foot processes. However, the mechanisms that govern the podocyte cytoskeletal rearrangement still remain unclear. Through analyzing transcriptional profile of renal biopsy from diabetic nephropathy (DN) patients and control donors, we identify Slit-Robo GTP activating protein 2a (SRGAP2a) as one of the main 'hub' genes that are strongly associated with proteinuria and glomerular filtration in type 2 DN patients...
December 14, 2017: Diabetes
https://www.readbyqxmd.com/read/29240587/reclaiming-autologous-amputated-tissue-for-limb-salvage-of-a-diabetic-foot-burn-with-underlying-critical-limb-ischemia
#5
Catherine N Tchanque-Fossuo, Andrew M Wishy, Kaitlyn I M West, David L Dawson, Sara E Dahle, John G Carson
BACKGROUND: Diabetes mellitus is a worldwide pandemic that impacts more than 387 million people, with 29 million individuals affected in the United States alone. Diabetic patients have a 25% lifetime risk of developing a diabetic foot ulcer (DFU). Having a DFU is associated with a risk of recurrence approaching 70%. In addition, 1 in 6 patients with DFU will have a lower-limb amputation, with an associated increase in mortality ranging from 47% to 70%. Therefore, limb salvage is critical in patients with DFU...
January 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29238034/inverse-relationship-between-serum-bilirubin-levels-and-diabetic-foot-in-chinese-patients-with-type-2-diabetes-mellitus
#6
Jifan Chen, Jian Wang, Xingxing Zhang, Hong Zhu
BACKGROUND Several studies demonstrated that bilirubin, a potent endogenous antioxidant, is a strong protective factor for many diabetic complications such as nephropathy, retinopathy, neuropathy, and vasculopathy. The purpose of this study was to assess the association between serum bilirubin levels and diabetic foot (DF) in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS The present cross-sectional study of bilirubin levels in relation to DF was conducted in 1,269 T2DM patients with (n=578) and without (n=691) DF...
December 14, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29237480/achilles-tenodesis-for-calcaneal-insufficiency-avulsion-fractures-associated-with-diabetes-mellitus
#7
Youngrak Choi, Young-Woo Kwon, Young-Suk Sim, Taeho Kim, Dayoung Song, Soohyun Lee
BACKGROUND: Calcaneal insufficiency avulsion (CIA) fractures often present with neuropathic etiology, such as Charcot neuroarthropathy (CN). Under the same surgical procedures, the outcomes of CIA fractures are less desirable, compared to the outcomes of the traumatic calcaneal avulsion fractures. Here, the study suggests Achilles tenodesis technique using suture anchor after resection of the CIA fracture fragments could provide satisfactory clinical results in the cases of surgically indicated CIA fractures...
December 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29236099/inpatient-management-of-diabetic-foot-infections-a-review-of-the-guidelines-for-hospitalists
#8
Emilia G Thurber, Flora Kisuule, Casey Humbyrd, Jennifer Townsend
Diabetic foot infections (DFIs) are common and represent the leading cause for hospitalization among diabetic complications. Without proper management, DFIs may lead to amputation, which is associated with a decreased quality of life and increased mortality. However, there is currently significant variation in the management of DFIs, and many providers fail to perform critical prevention and assessment measures. In this review, we will provide an overview of the diagnosis, management, and discharge planning of hospitalized patients with DFIs to guide hospitalists in the optimal inpatient care of patients with this condition...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29232436/cellular-versus-acellular-grafts-for-diabetic-foot-ulcers-altering-the-protocol-to-improve-recruitment-to-a-comparative-efficacy-trial
#9
Catherine N Tchanque-Fossuo, Sara E Dahle, Hadar Lev-Tov, Chin-Shang Li, R Rivkah Isseroff
Diabetic foot ulcers (DFUs) have a substantial impact on public health. The standard of care (SOC) for DFUs consists of a multidisciplinary approach involving glycemic control, wound care with debridement of necrotic tissue, application of a moist dressing, infection control, use of off-loading devices, and patient education. New therapeutic devices aim to target the extracellular matrix (ECM) that is impaired in DFU; however, there is insufficient data on the effectiveness of such therapies along with lack of evidence on their long-term effectiveness...
November 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29232319/knowledge-of-the-warning-signs-of-foot-ulcer-deterioration-among-patients-with-diabetes
#10
Yen-Fan Chin, Jiun-Ting Yeh, Hsing-Yi Yu, Li-Chueh Weng
BACKGROUND: Seeking treatment in a timely manner may prevent lower limb amputation subsequent to diabetic foot ulcers. Knowledge regarding the warning signs is one important factor that is related to the timely treatment seeking of patients with diabetic foot ulcers. However, there is no previous research on which aspects of such knowledge that patients with diabetes are lacking. PURPOSE: The aims of this study were to test the psychometric properties of a questionnaire that was designed to assess the knowledge of the warning signs of diabetic foot ulcer deterioration and to determine the knowledge of these warning signs among patients with a history of diabetic foot ulcers...
December 7, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29231774/modern-management-of-diabetic-foot-osteomyelitis-the-when-how-and-why-of-conservative-approaches
#11
Javier Aragón-Sánchez, Benjamin A Lipsky
Introduction Diabetic foot osteomyelitis (DFO) has long been considered a complex infection that is both difficult to diagnose and treat, and is associated with a high rate of relapse and limb loss. Areas covered DFO can usually be diagnosed by a combination of clinical evaluation, serum inflammatory markers and plain X-ray. When the results of these procedures are negative or contradictory, advanced imaging tests or bone biopsy may be necessary. Staphylococcus aureus remains the most frequent microorganism isolated from bone specimens, but infection is often polymicrobial...
December 12, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29230422/novel-semiquantitative-bone-marrow-oedema-score-and-fracture-score-for-the-magnetic-resonance-imaging-assessment-of-the-active-charcot-foot-in-diabetes
#12
L Meacock, N L Petrova, Ana Donaldson, A Isaac, A Briody, R Ramnarine, M E Edmonds, D A Elias
There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0-no oedema, 1-oedema < 50% of bone volume, and 2-oedema > 50% of bone volume) and fracture (0-no fracture, 1-fracture, and 2-collapse/fragmentation)...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29230289/accessory-anterolateral-talar-facet-impingement-with-tibialis-spastic-varus-foot
#13
Toshinori Kurashige
In recent years, some authors have reported accessory anterolateral talar facet impingement with flatfoot including peroneal spastic flatfoot. Conversely, to our knowledge, no case report has been published about accessory anterolateral talar facet impingement with tibialis spastic varus foot. We report the first case in a 22-year-old man with intellectual disability, bilateral cleft hands and type 1 diabetes mellitus. Since spraining his left ankle over a year earlier, he experienced left sinus tarsi pain while standing and walking...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29223467/does-insulin-therapy-matter-determinants-of-diabetes-care-outcomes
#14
Jennifer A Andersen, Larry Gibbs
OBJECTIVE: To evaluate adherence to care standards for people with diabetes (PWDs) on insulin therapy versus PWDs who are not on insulin therapy, controlling for social determinants. RESEARCH DESIGN AND METHODS: Utilizing the United States 2015 Behavioral Risk Factor Surveillance System Survey, this study used logistic regression analyses to estimate differences in self-care behaviors, healthcare provider quality of care, and diabetic complications for individuals on insulin therapy and individuals not on insulin therapy...
December 6, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/29222381/10-microvascular-complications-and-foot-care-standards-of-medical-care-in-diabetes-2018
#15
REVIEW
(no author information available yet)
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional...
January 2018: Diabetes Care
https://www.readbyqxmd.com/read/29220878/a-qualitative-study-of-the-experience-of-lower-extremity-wounds-and-amputations-among-people-with-diabetes-in-philadelphia
#16
Frances K Barg, Peter F Cronholm, Ebony E Easley, Trocon Davis, Michelle Hampton, D Scot Malay, Cornelius Donohue, Jinsup Song, Stephen R Thom, David J Margolis
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open-ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer (n = 19) or a lower extremity amputation (n = 20). Interviews were audio-recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts...
December 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29214861/podiatry-ankle-duplex-scan-readily-learned-and-accurate-in-diabetes
#17
Pasha Normahani, Katarzyna Powezka, Mohammed Aslam, Nigel J Standfield, Usman Jaffer
We aimed to train podiatrists to perform a focused duplex ultrasound scan (DUS) of the tibial vessels at the ankle in diabetic patients; podiatry ankle (PodAnk) duplex scan. Thirteen podiatrists underwent an intensive 3-hour long simulation training session. Participants were then assessed performing bilateral PodAnk duplex scans of 3 diabetic patients with peripheral arterial disease. Participants were assessed using the duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool and an "Imaging Score"...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29214854/prognostic-factors-in-diabetic-foot-ulcer
#18
Funda Sungur Biteker, Bülent Özlek, Eda Özlek, Murat Biteker
No abstract text is available yet for this article.
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29208058/low-protein-diet-supplemented-with-ketoacids-delays-the-progression-of-diabetic-nephropathy-by-inhibiting-oxidative-stress-in-the-kkay-mice-model
#19
Dongmei Liu, Ming Wu, Lin Li, Xiang Gao, Bo Yang, Shuqin Mei, Lili Fu, Changlin Mei
Diabetic nephropathy (DN) is a major cause of chronic kidney disease. We aimed to investigate the effect of the low-protein diets (LPD) supplemented with ketoacids (LPD+KA) in KKAy mice, an early type 2 DN model. KKAy mice were treated with normal protein diet (NPD), LPD or LPD+KA from 12 to 24 weeks of age. A period of 12-week treatment with LPD significantly reduced albuminuria as compared with that observed after NPD treatment. Treatment with LPD+KA further reduced albuminuria as compared with that observed with LPD treatment alone...
December 6, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/29207011/astragaloside-iv-prevents-kidney-injury-caused-by-iatrogenic-hyperinsulinemia-in-a-streptozotocin%C3%A2-induced-diabetic-rat-model
#20
Ke-Qiang He, Wei-Zu Li, Xiao-Qing Chai, Yan-Yan Yin, Yan Jiang, Wei-Ping Li
Diabetic patients are able to manage their blood glucose with exogenous insulin but, ultimately, remain at risk of diabetic nephropathy (DN). Long‑term use of insulin may lead to iatrogenic hyperinsulinemia, which has been suggested to cause kidney injury. However, there are no effective interventions for iatrogenic hyperinsulinemia leading to kidney damage. In the present paper, the hypothesis that astragaloside IV (AS‑IV), a novel saponin purified from Astragalus membranaceus (Fisch) Bunge, may prevent DN in iatrogenic hyperinsulinemic diabetic rats through antioxidative and anti‑inflammatory mechanisms was investigated...
November 17, 2017: International Journal of Molecular Medicine
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