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https://www.readbyqxmd.com/read/28216809/healing-ulcers-and-preventing-their-recurrences-in-the-diabetic-foot
#1
S Raja Sabapathy, Madhu Periasamy
Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28198595/free-microvascular-rotationplasty-with-nerve-repair-for-rhabdomyosarcoma-in-a-18-month-old-patient
#2
Alberto Pérez-García, Marta Salom, María Eloísa Villaverde-Doménech, Francisco Baixauli, Eduardo Simón-Sanz
Rotationplasty is a limb-sparing surgical option in lower limb malignancies. Sciatic or tibial nerve encasement has been considered an absolute contraindication to this procedure. We report a case of an 18-month-old girl with a rhabdomyosarcoma that affected the leg and popliteal fossa, with neurovascular involvement. Knee and proximal leg intercalary resection was performed followed by reconstruction with free microvascular rotationplasty and neurorraphy from tibial division of sciatic nerve to sural and tibial nerves, and from saphenous nerve to superficial peroneal nerve...
February 15, 2017: Microsurgery
https://www.readbyqxmd.com/read/28195886/pedicled-sensate-composite-calcaneal-flap-in-children-with-congenital-tibial-pseudoarthrosis
#3
Mauricio L D Mongon, Fernando C Ribera, Antonio M A de Souza, Aurelio L Sposito, William D Belangero, Bruno Livani
BACKGROUND: The preservation and functionality of a limb affected by a malformation (such as congenital pseudoarthrosis of the tibia) or a severely mangled lower limb in children, despite modern reconstructive techniques, remains challenging, often eventually requiring amputation to achieve a better outcome. The classical Syme and Boyd procedures are functionally better than transtibial (TT) amputation, but are not feasible for congenital tibial pseudoarthrosis. TT amputation delivers an excellent, effective, and functional stump that usually leads, after prosthetization, to a functional gait...
February 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28194903/vitamin-k-antagonist-therapy-is-a-risk-factor-for-ulcer-development-and-death-among-dialyzed-patients
#4
Andreana De Mauri, Massimo Torreggiani, Marco Brambilla, Doriana Chiarinotti
Peripheral artery disease is a common complication among dialyzed patients. Since Vitamin K antagonists promote metastatic calcifications and these are the main determinants of vascular damage, we investigated their role in the development of lower limb ulcers in dialyzed patients. We retrospectively enrolled 316 dialyzed patients, aged 68 ± 15 years, 65% male, 32% diabetic, 43% with ischemic heart disease and followed them for 36 ± 25 months. 60 patients assumed Vitamin K antagonists: they were older, with a higher prevalence of heart disease, at greater risk of death and they developed more ulcers and underwent more lower limb amputations compared to the rest of our cohort...
February 14, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28194322/sural-artery-perforator-flap-with-posterior-tibial-neurovascular-decompression-for-recurrent-foot-ulcer-in-leprosy-patients
#5
Hossam El-Din Ali Ismail, Mohamed Hassan El Fahar
Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND) in recurrent foot ulcers in leprosy patients...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28167862/mycetoma-in-a-non-endemic-area-a-diagnostic-challenge
#6
Boubacar Efared, Layla Tahiri, Marou Soumana Boubacar, Gabrielle Atsam-Ebang, Nawal Hammas, El Fatemi Hinde, Laila Chbani
BACKGROUND: Mycetoma is a chronic granulomatous infectious disease caused by filamentous bacteria or by fungi. The disease is endemic in certain tropical and subtropical areas of the world but can be found elsewhere posing sometimes a diagnostic challenge for clinicians. CASE PRESENTATION: A 65-year- old man presented with a right foot swelling evolving for 25 years. During that time, several diagnosis and treatments have been made without any improvement. The disease spread to bones, and misdiagnosed as Kaposi's sarcoma...
2017: BMC Clinical Pathology
https://www.readbyqxmd.com/read/28167324/re-organizing-inpatient-care-saves-legs-in-patients-with-diabetic-foot-infections
#7
Miska Laakso, Mikael Honkasalo, Juha Kiiski, Meri Ala-Houhala, Heidi Haapasalo, Heikki-Jussi Laine, Tiina Luukkaala, Jorma Lahtela, Ilkka Kaartinen
AIMS: In this study, we evaluated the effects of the re-organization of inpatient care for patients with a diabetic foot infection, and the implementation of a specialized multi-disciplinary wound department at an academic tertiary hospital. METHODS: This was a retrospective cohort study, comprising 272 patients treated for diabetic foot infections in 2006-2007 (Group 1, n=124) and 2013-2014 (Group 2, n=148). In 2012, inpatient care of all chronic wounds was centralized at a single wound department with a multi-disciplinary team...
January 22, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28167063/complex-foot-injury-early-and-definite-management
#8
REVIEW
Tim Schepers, Stefan Rammelt
Complex foot injuries occur infrequently, but are life-changing events. They often present with other injuries as the result of a high-energy trauma. After initial stabilization, early assessment should be regarding salvagability. All treatment strategies are intensive. The initial treatment includes prevention of progression ischemia/necrosis, prevention of infection, and considering salvage or amputation. Definitive treatment for salvage includes anatomic reconstruction with stable internal fixation and early soft tissue coverage followed by aggressive rehabilitation...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28166662/-ischemic-origin-of-diabetic-foot-disease-epidemiology-difficulties-of-diagnosis-options-for-prevention-and-revascularization
#9
Endre Kolossváry, Zoltán Bánsághi, Gábor Viktor Szabó, Zoltán Járai, Katalin Farkas
"Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28166136/aesthetic-multiple-toe-reconstruction-with-combined-iliac-bone-graft-and-wraparound-free-anterolateral-thigh-flap-a-case-report-and-literature-review
#10
Soo-Ha Kwon, William Lao, Cheng-I Yen, Yu-Te Lin, Katie Pei-Hsuan Wu, Tommy Nai-Jen Chang
Compared with upper extremity injuries, toe amputations and their replantations are rare because of the difficulty of their relatively thinner soft tissue envelope. Consequently, fewer reconstructive options are available for toes and they are rarely reported in the literature. In this study, we reported a case of right third to fifth toe amputations and their subsequent reconstruction with iliac bone grafts and a free anterolateral thigh flap. After serial debulking and division procedures, 3 toes were divided successfully...
February 4, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28166066/prevalence-of-sensory-neuropathy-in-type-2-diabetes-mellitus-and-its-correlation-with-duration-of-disease
#11
D B Karki, S K Yadava, S Pant, N Thusa, E Dangol, S Ghimire
Background Peripheral neuropathy is one of the most common and distressing late complication of diabetes mellitus. Ignorance of the complications may develop foot ulcers and gangrene requiring amputation. Objective The main objective of this study is to find out the prevalence of sensory neuropathy in type 2 diabetes mellitus and to compare it with the duration of disease. Method Two hundred seventy one patients with type 2 diabetes mellitus of both gender age 30 years and above willing to participate were included in this study...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28165050/terahertz-imaging-for-early-screening-of-diabetic-foot-syndrome-a-proof-of-concept
#12
G G Hernandez-Cardoso, S C Rojas-Landeros, M Alfaro-Gomez, A I Hernandez-Serrano, I Salas-Gutierrez, E Lemus-Bedolla, A R Castillo-Guzman, H L Lopez-Lemus, E Castro-Camus
Most people with diabetes suffer some deterioration of the feet. Diabetic foot syndrome causes ulceration in about 15% of cases and such deterioration leads to amputation in about 2.5% of diabetic patients, diminishing their quality of life and generating extraordinary costs for patients and public health systems. Currently, there is no objective method for the detection of diabetic foot syndrome in its early stages. We propose terahertz imaging as a method for the evaluation of such deterioration. This screening method could aid the prevention and medical treatment of this condition in the future...
February 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28164133/the-geriatric-nutritional-risk-index-independently-predicts-mortality-in-diabetic-foot-ulcers-patients-undergoing-amputations
#13
Yuanyuan Xie, Hailing Zhang, Tingting Ye, Shengjie Ge, Ruyi Zhuo, Hong Zhu
Objective. Patients with diabetic foot ulcers undergoing amputations have poor prognosis. Malnutrition usually occurs in this population and is associated with increased risk of mortality. The geriatric nutritional risk index (GNRI) is a widely used, simple, and well-established tool to assess nutritional risk. The purpose of this study was to assess the association between GNRI and all-cause mortality in diabetic foot ulcers patients undergoing minor or major amputations. Methods. This was a retrospective cohort study including 271 adult patients...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28155264/surgical-and-endovascular-venous-arterialization-ready-to-take-on-the-desert-by-storm
#14
Michiel A Schreve, Çağdaş Ünlü, Steven Kum, Yih K Tan
Patients with critical limb ischemia have a poor life expectancy, and aggressive revascularization is accepted to maintain their independence in the end stage of life. Bypass surgery and, more recently, endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and resolve rest pain. Up to 20% of patients with critical limb ischemia are not suitable candidates for a vascular intervention because of extensive occlusions of the outflow in the crural and pedal vessels...
February 2, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28153676/a-model-to-estimate-cost-savings-in-diabetic-foot-ulcer-prevention-efforts
#15
Neal R Barshes, Samira Saedi, James Wrobel, Panos Kougias, O Erhun Kundakcioglu, David G Armstrong
BACKGROUND: Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. METHODS: A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes...
January 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28126335/two-biomechanical-strategies-for-locomotor-adaptation-to-split-belt-treadmill-walking-in-subjects-with-and-without-transtibial-amputation
#16
Brian P Selgrade, Megan E Toney, Young-Hui Chang
Locomotor adaptation is commonly studied using split-belt treadmill walking, in which each foot is placed on a belt moving at a different speed. As subjects adapt to split-belt walking, they reduce metabolic power, but the biomechanical mechanism behind this improved efficiency is unknown. Analyzing mechanical work performed by the legs and joints during split-belt adaptation could reveal this mechanism. Because ankle work in the step-to-step transition is more efficient than hip work, we hypothesized that control subjects would reduce hip work on the fast belt and increase ankle work during the step-to-step transition as they adapted...
January 14, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28125663/il-22r-ligands-il-20-il-22-and-il-24-promote-wound-healing-in-diabetic-db-db-mice
#17
Ganesh Kolumam, Xiumin Wu, Wyne P Lee, Jason A Hackney, Jose Zavala-Solorio, Vineela Gandham, Dimitry M Danilenko, Puneet Arora, Xiaoting Wang, Wenjun Ouyang
Diabetic foot ulcers (DFU) are one of the major complications in type II diabetes patients and can result in amputation and morbidity. Although multiple approaches are used clinically to help wound closure, many patients still lack adequate treatment. Here we show that IL-20 subfamily cytokines are upregulated during normal wound healing. While there is a redundant role for each individual cytokine in this subfamily in wound healing, mice deficient in IL-22R, the common receptor chain for IL-20, IL-22, and IL-24, display a significant delay in wound healing...
2017: PloS One
https://www.readbyqxmd.com/read/28120507/effect-of-systemic-insulin-treatment-on-diabetic-wound-healing
#18
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Gregory L Moneta, Amir F Azarbal
This study investigates if different diabetic treatment regimens affect diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a nonhealing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics, and outcome were collected. Nonhealing wound was defined as major or minor amputation or those who did not have complete healing until the last observation...
January 24, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28110796/effectiveness-of-hindfoot-arthrodesis-by-stable-internal-fixation-in-various-eichenholtz-stages-of-neuropathic-ankle-arthropathy
#19
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...
January 16, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28107790/a-qualitative-inquiry-of-lower-extremity-disease-knowledge-among-african-americans-living-with-type-2-diabetes
#20
Timethia Bonner, Idethia S Harvey, Ledric Sherman
The purpose of this study was to investigate how personal illness representations of type 2 diabetes affected the level of foot care knowledge and self-care strategies among African Americans adults. Thirteen African Americans (ages 32-72 years) participated in individual semistructured qualitative interviews regarding self-care practices and lower extremity disease knowledge related to type 2 diabetes. Using phenomenological methodology, all interviews were transcribed and analyzed by the research team for themes...
January 1, 2017: Health Promotion Practice
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