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foot and ankle, diabetes

M Satheesh Kumar, Ayush Lohiya, Viviktha Ramesh, Priyamadhaba Behera, Sarika Palepu, S A Rizwan
OBJECTIVES: To compare pulse oximetry and Ankle-Brachial Index (ABI) with duplex ultrasonography as reference standard to determine the diagnostic accuracy for screening asymptomatic PVD in type 2 diabetes mellitus. METHODS: This cross-sectional study was conducted in 2012 at tertiary hospital in Madurai among diabetic patients attending the medicine outpatient department (OPD). Type 2 Diabetes Mellitus patients, asymptomatic with regards to symptoms and signs of PVD, aged above 40 years were included...
August 2016: Journal of the Association of Physicians of India
A M Mahon, C MacGilchrist, C McIntosh, T O'Brien
BACKGROUND: Diabetes mellitus, coined the 'Black Death of the Twenty-First Century', is associated with complications, including foot ulceration with potential loss of limb. There is a need for development of new wound therapies through completion of robust clinical trials. AIMS: To profile demographics and wound characteristics of an Irish cohort with diabetes, forecast eligibility for entry to a clinical trial of advanced wound therapeutics, and adjust criteria to optimize eligibility for enrolment...
October 11, 2016: Irish Journal of Medical Science
Byung-Joon Jeon, Hwan Jun Choi, Jin Seok Kang, Min Sung Tak, Eun Soo Park
Diabetes mellitus is a common metabolic disorder. Among various complications, diabetic neuropathy and peripheral vascular disorders are closely associated with diabetic foot ulcers (DFUs). Lower extremity ulcers and amputations are ongoing problems among individuals with diabetes. There are several classification systems for DFUs; however, no prognostic system has to date been accepted as the gold standard or the optimum prediction tool for amputations. A retrospective study was designed. Demographic data and baseline laboratory data were gathered and scored or evaluated using five representative DFU classification systems...
October 10, 2016: International Wound Journal
Oscar H Del Brutto, Robertino M Mera, Nathan R King, Mauricio Zambrano, Lauren J Sullivan
BACKGROUND/OBJECTIVES: Prevalence of diabetes-related foot disorders (DRFD) in rural areas of developing countries is unknown. The burden of these conditions in Atahualpa, a rural Ecuadorian village, were assessed. METHODS: Using a population-based design, Atahualpa residents aged ≥40 years with diabetes mellitus were identified. Ankle brachial index determinations were used to assess presence of peripheral arterial disease, and the Michigan Neuropathy Screening Instrument was used to estimate peripheral neuropathy...
June 2, 2016: Foot
Sui-Whi Jane, Ming-Shyan Lin, Wen-Nan Chiu, Randal D Beaton, Mei-Yen Chen
OBJECTIVES: To explore the prevalence, discomfort, and self-relief behaviours of painful diabetic neuropathy (PDN) among rural community residents with type 2 diabetes. DESIGN: A community-based, cross-sectional study. SETTING: This study was part of a longitudinal cohort study of a nurse-led health promotion programme for preventing foot ulceration in Chiayi County, Taiwan. PARTICIPANTS: Six hundred and twenty-eight community adults with type 2 diabetes participated in this study...
October 3, 2016: BMJ Open
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
Ana Flávia Machado de Carvalho, Maura Cristina Porto Feitosa, Nayana Pinheiro Machado de Freitas Coelho, Veruska Cronemberger Nogueira Rebêlo, Juçara Gonçalves de Castro, Patrícia Regina Gomes de Sousa, Valrian Campos Feitosa, Emilia Angela Lo Schiavo Arisawa
OBJECTIVE: To evaluate the effects of low-level laser therapy isolated and associated with Calendula officinalis oil in treating diabetic foot ulcers. METHOD: An experimental, randomized, controlled, prospective, interventional clinical case study using a quantitative approach. The sample consisted of 32 diabetic patients of both genders. Participants were randomly divided into four groups. Doppler Ultrasound evaluation of the Ankle-Brachial Index, brief pain inventory and analog pain scale were performed at baseline and after 30 days...
July 2016: Revista da Escola de Enfermagem da U S P
Hyun Suk Suh, Tae Suk Oh, Ho Seung Lee, Seung Hwan Lee, Yong Pil Cho, Joong Ryul Park, Joon Pio Hong
BACKGROUND: Major vessels in the diabetic foot are often calcified and inadequate for use as recipient vessels. Thus, a supermicrosurgery technique using small branches or perforators from other collateral vessels with an adequate pulse may be an alternative method. This study evaluated outcome using the supermicrosurgery concept and the risk factors involved. METHODS: Ninety-five cases of diabetic foot reconstruction were reviewed; the average patient age was 57 years; average follow-up was 43...
October 2016: Plastic and Reconstructive Surgery
Travis J Dekker, Yash Avashia, Suhail K Mithani, Andrew P Matson, Alexander J Lampley, Samuel B Adams
: Introduction Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support...
September 23, 2016: Foot & Ankle Specialist
Derek S Anselmo, Marc Karpo, Ebony Love, Tracey Vlahovic
INTRODUCTION AND OBJECTIVES: The benefits of using amniotic tissue in skin regeneration are well documented. Today, cryopreservation technology allows for better availability and maintenance of mesenchymal stem cells. This is of particular interest in treating the diabetic foot ulcer as this population has fewer mesenchymal stem cells. The objective of this case series investigation was to compare the efficacy of cryopreserved human amniotic stem cells in treating foot wounds of different etiologies...
September 2016: Journal of the American Podiatric Medical Association
David Schweer, Jonathon J Carmouche, Daniel Jupiter, Timothy Ball, J Randolph Clements
The interrelationship between diabetes mellitus and cardiovascular disease is well-documented, and, secondary to the latter, is the use of antiplatelet therapy. Although diabetes and the associated vascular manifestations are driving forces behind lower extremity amputations, few data are available on the risks of perioperative antiplatelet therapy with foot and ankle amputations. The goal of the present study was to address the surgical effect of continuing or discontinuing antiplatelet therapy before foot and/or ankle amputation...
September 7, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Neal R Barshes, Everardo Flores, Michael Belkin, Panos Kougias, David G Armstrong, Joseph L Mills
BACKGROUND: Patients with diabetic foot ulcers (DFUs) should be evaluated for peripheral artery disease (PAD). We sought to estimate the overall diagnostic accuracy for various strategies that are used to identify PAD in this population. METHODS: A Markov model with probabilistic and deterministic sensitivity analyses was used to simulate the clinical events in a population of 10,000 patients with diabetes. One of 14 different diagnostic strategies was applied to those who developed DFUs...
August 26, 2016: Journal of Vascular Surgery
Y Gao, Z J Cui, X Shi, P F Guo, Q N Meng, G Y Yang, R Q Yang
OBJECTIVE: To explore the application of percutaneous transluminal angioplasty (PTA) in the surgical treatment of patients with diabetic feet. METHODS: The clinical data of 83 patients with diabetic feet, 95 limbs (95 wounds) in total, hospitalized in our unit from September 2011 to September 2014, conforming to the study criteria, were retrospectively analyzed. Patients were divided into conventional treatment group (CT, n=43, 51 wounds) and PTA group (n=40, 44 wounds) according to whether receiving PTA treatment or not...
August 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Benjamin C Taylor, Dane C Hansen, Ryan Harrison, Douglas E Lucas, Daniel Degenova
BACKGROUND: Ankle fragility fractures are difficult to treat due to poor bone quality and soft tissues as well as the near ubiquitous presence of comorbidities including diabetes mellitus and peripheral neuropathy. Conventional open reduction and internal fixation in this population has been shown to lead to a significant rate of complications. Given the high rate of complications with contemporary fixation methods, the present study aims to critically evaluate the use of acute hindfoot nailing as a percutaneous fixation technique for high-risk ankle fragility fractures...
2016: Iowa Orthopaedic Journal
Roslyn J Miller
Patients with peripheral neuropathy associated with ulceration are the nemesis of the orthopedic foot and ankle surgeon. Diabetic foot syndrome is the leading cause of peripheral neuropathy, and its prevalence continues to increase at an alarming rate. Poor wound healing, nonunion, infection, and risk of amputation contribute to the understandable caution toward this patient group. Significant metalwork is required to hold these technically challenging deformities. Neuropathic Minimally Invasive Surgeries is an addition to the toolbox of management of the diabetic foot...
September 2016: Foot and Ankle Clinics
M Venermo, N Settembre, A Albäck, P Vikatmaa, P-S Aho, M Lepäntalo, Y Inoue, H Terasaki
BACKGROUND: Ankle brachial index (ABI), toe pressures (TP), and transcutaneous oxygen pressure (TcPO2) are traditionally used in the assessment of critical limb ischemia (CLI). Indocyanine green (ICG) fluorescence imaging can be used to evaluate local circulation in the foot and to evaluate the severity of ischemia. This prospective study analyzed the suitability of a fluorescence imaging system (photodynamic eye [PDE]) in CLI. MATERIAL AND METHODS: Forty-one patients with CLI were included...
October 2016: European Journal of Vascular and Endovascular Surgery
Sankaran Sriram, Rajeswari Sankaralingam, Madeshwaran Mani, Tiruchengode Natesan Tamilselvam
AIM: To determine the role and efficacy of platelet rich plasma (PRP) in the healing of recalcitrant vasculitic ulcers and to study the rapidity of ulcer healing with respect to platelet concentration in the prepared PRP. METHODS: This is a pilot study which included 20 patients with biopsy-proven vasculitic ulcers after excluding human immunodeficiency virus, uncontrolled diabetes mellitus, hypertension, obesity, active smoking and platelet abnormalities in peripheral smear...
July 26, 2016: International Journal of Rheumatic Diseases
T E Wilbek, R B Jansen, B Jørgensen, O L Svendsen
Aim: To describe the number of minor lower extremity amputations and mortality for diabetes patients treated by a specialized multidisciplinary foot care team. Methods: A retrospective descriptive study of medical records from patients with diabetes treated with minor amputations at the Copenhagen Wound Healing Center (CWHC) at Bispebjerg Hospital from 1996-2013. Results: 777 diabetes patients treated with minor amputations were included. 77% were males and 23% were females. 80% had T2 diabetes and 20% had T1 diabetes...
October 2016: Experimental and Clinical Endocrinology & Diabetes
Latricia L Allen, Garrett Kalmar, Vickie R Driver
We report a case of calcaneal osteomyelitis that was surgically resected from a patient with diabetes and peripheral vascular disease. A 91-year-old male with history of type 2 diabetes, peripheral vascular disease, balloon angioplasty, and recent (2 months ago) stent of the superficial femoral artery presented to the emergency department with a left heel wound infection probed to bone. The patient reported having been on intravenous Zosyn for several months via an outside infectious disease provider for clinical suspicion of osteomyelitis, but noted no improvement...
June 2016: Techniques in Vascular and Interventional Radiology
Jin-Dan Wu, Sha Tao, Xing Jin, Lan-Lan Jiang, Yun Shen, Yong Luo, Peng Zhang, Kok-Onn Lee, Lei Ye, Jian-Hua Ma
BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common chronic complication of diabetes. We aim to investigate the efficacy of Prostaglandin E1 (PGE1) treatment in addition to intensive insulin therapy on DPN in patients with type 2 diabetes. METHODS: Seventy-seven patients with DPN received daily intravenous injection of Prostaglandin E1 (PGE1) in lipid microspheres (Lipo-PGE1) for 10days as an additional therapy to standard glucose control therapy (PGE1 group)...
July 12, 2016: Prostaglandins & Other Lipid Mediators
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