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diabetic foot ulceration

F Crawford, G Cezard, M Chappell
AIMS: Diabetes guidelines recommend screening for the risk of foot ulceration but vary substantially in the underlying evidence base. Our purpose was to derive and validate a prognostic model of independent risk factors for foot ulceration in diabetes using all available individual patient data from cohort studies conducted worldwide. METHODS: We conducted a systematic review and meta-analysis of individual patient data from 10 cohort studies of risk factors in the prediction of foot ulceration in diabetes...
August 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Huidi Tchero, Pauline Kangambega, Lazarre Noubou, Beatrice Becsangele, Fluieraru Sergiu, Luc Teot
Diabetic foot infection is a common diabetic complication that may end in lower limb amputation if not treated properly. We performed this systematic review to assess the clinical efficacy of different antibiotic regimens, whether systemic or topical, in the treatment of moderate to severe diabetic foot infections. We searched Medline, Web of Science, SCOPUS, Cochrane CENTRAL and ScienceDirect for randomized controlled trials that evaluated the efficacy of antibiotic regimens in moderate to severe diabetic foot infections...
August 12, 2018: Wound Repair and Regeneration
Jocelyn Lu, Michael V DeFazio, Chrisovalantis Lakhiani, Michel Abboud, Morgan Penzler, Tammer Elmarsafi, Paul J Kim, Christopher E Attinger, Karen K Evans
BACKGROUND:  Recent evidence documenting high success rates following microvascular diabetic foot reconstruction has led to a paradigm shift in favor of more aggressive limb preservation. The primary aim of this study was to examine reconstructive and functional outcomes in patients who underwent free tissue transfer (FTT) for recalcitrant diabetic foot ulcers (DFUs) at our tertiary referral center for advanced limb salvage. METHODS:  Between June 2013 and June 2016, 29 patients underwent lower extremity FTT for diabetic foot reconstruction by the senior author (K...
August 12, 2018: Journal of Reconstructive Microsurgery
S Borys, J Hohendorff, T Koblik, P Witek, A H Ludwig-Slomczynska, C Frankfurter, B Kiec-Wilk, M T Malecki
PURPOSE: Negative pressure wound therapy (NPWT) is an adjunct method used in the treatment of diabetic foot ulceration (DFU). Real world data on its effectiveness and safety is scarce. In this prospective observational study, we assessed the short-term efficacy, safety, and long-term outcomes of NPWT in patients with type 2 diabetes (T2DM) and neuropathic, noninfected DFUs. METHODS: Based on wound characteristics, mainly area (>1 vs. ≤1 cm2 ), 75 patients with DFUs treated in an outpatient clinic were assigned to NPWT (n = 53) or standard therapy (n = 22)...
August 11, 2018: Endocrine
Biplab Giri, Sananda Dey, Tanaya Das, Mrinmoy Sarkar, Jhimli Banerjee, Sandeep Kumar Dash
Chronic exposure of glucose rich environment creates several physiological and pathophysiological changes. There are several pathways by which hyperglycemia exacerbate its toxic effect on cells, tissues and organ systems. Hyperglycemia can induce oxidative stress, upsurge polyol pathway, activate protein kinase C (PKC), enhance hexosamine biosynthetic pathway (HBP), promote the formation of advanced glycation end-products (AGEs) and finally alters gene expressions. Prolonged hyperglycemic condition leads to severe diabetic condition by damaging the pancreatic β-cell and inducing insulin resistance...
August 8, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Charles E Ananian, Yadwinder S Dhillon, Carl C Van Gils, D Craig Lindsey, Raymond J Otto, Cyaandi R Dove, Jessica T Pierce, Molly C Saunders
Randomized controlled clinical trials (RCTs), the gold standard to determine treatment efficacy against control, have demonstrated advantages of skin substitutes for the treatment of chronic diabetic foot ulcers (DFUs) in comparison to standard of care (SOC). However, RCTs comparing efficacy between 2 or more skin substitutes are very limited. With growing numbers of new skin substitutes, such studies are essential for treatment and policy-making decisions by wound care providers and payers. In this study, we analyzed clinical outcomes and product cost between a viable cryopreserved placental membrane (vCPM) and a human fibroblast-derived dermal substitute (hFDS) for the treatment of chronic DFUs in a prospective, multicenter, single-blind study...
August 11, 2018: Wound Repair and Regeneration
B Saka, A E Abilogoun-Chokki, S Akakpo, J Teclessou, G W Soga, G Mahamadou, W Gnassingbe, A Mouhari-Toure, K Kombate, E D Dosseh, V P Pitche
The aim of this study was to document the profile and causes of chronic leg ulcers (CLU) in patients hospitalized in Lomé, Togo. This retrospective study reviewed records from the dermatology departments (CHU Sylvanus Olympio and Campus, and the dermatology center of Gbossimé) from 2000 to 2017 and from the general surgery department of CHU Sylvanus Olympio from 2013 to 2017 to identify cases. In all, 125 cases of CLU were identified during the study period. The patients' mean age was 56.6 years and the sex ratio (M/F) was 0...
August 8, 2018: Médecine et Santé Tropicales
R Herring, D Russell-Jones
Despite advances in insulin analogues and monitoring, and changes in insulin delivery, Type 1 diabetes is still difficult to control. It can result in significant short- and long-term adverse health effects including renal failure, blindness, early cardiovascular disease and foot ulceration. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have potential benefit as an adjunct treatment in people not achieving adequate glycaemic control with insulin alone. This article is protected by copyright. All rights reserved...
August 8, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Olga Kashpur, Avi Smith, Behzad Gerami-Naini, Anna G Maione, Rossella Calabrese, Ana Tellechea, Georgios Theocharidis, Liang Liang, Irena Pastar, Marjana Tomic-Canic, David Mooney, Aristidis Veves, Jonathan A Garlick
Diabetic foot ulcers (DFUs) are a major complication of diabetes, and there is a critical need to develop novel cell- and tissue-based therapies to treat these chronic wounds. Induced pluripotent stem cells (iPSCs) offer a replenishing source of allogeneic and autologous cell types that may be beneficial to improve DFU wound-healing outcomes. However, the biologic potential of iPSC-derived cells to treat DFUs has not, to our knowledge, been investigated. Toward that goal, we have performed detailed characterization of iPSC-derived fibroblasts from both diabetic and nondiabetic patients...
August 8, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Roberto Ferraresi, Andrea Casini, Maurizio Caminiti, Fabrizio Losurdo, Giacomo Clerici
The diabetic foot represents one of the most dangerous complications of diabetic disease, and it is characterized by the presence of infection, ulceration, or necrosis of the foot tissues associated with various degrees of neuropathy or ischemia. If not correctly and promptly treated, it leads to high rates of major amputations. Although in Italy diabetics are about 5% of the population, more than 50% of major amputations are performed in diabetic patients. Compared to non-diabetic patients, diabetic peripheral artery disease localizes more distally, mostly in the below-the-knee vessels, is typically bilateral with multi-level involvement, and presents earlier onset and more aggressive course...
September 2018: Giornale Italiano di Cardiologia
Sivakamasundari Pichu, Selvaraj Vimalraj, Jayalalitha Sathiyamoorthy, Vijay Viswanathan
Hypoxia inducible factor 1 alpha (HIF-1α) is a key regulator of the genes involved in the cellular response to hypoxia. This study aims to determine the HIF-1α gene polymorphism and its association with protein expression in diabetic subjects with and without diabetic foot ulcers (DFU). A total of 529 patients with T2DM (N = 185), DFU (N = 199) and Control (N = 145) were accounted for the study. PCR-RFLP experiment was carried out in order to find the allelic and genotypic comparison of HIF-1α gene in various groups of patients...
August 4, 2018: International Journal of Biological Macromolecules
Alessandro Mantovani, Ilaria Teobaldi, Vincenzo Stoico, Fabrizia Perrone, Marina Zannoni, Luca Cima, Massimiliano Bruti, Lucia Mingolla, Maddalena Trombetta, Enzo Bonora
After basal cell carcinoma, the cutaneous squamous cell carcinoma (cSCC) is the second most frequent non-melanoma skin cancer worldwide, and, classically, arises from the upper coats of the epidermis of sun-exposed areas or from skin areas constantly exposed to a chronic inflammatory stimulus. The occurrence of cSCC seems to be linked to several factors, including exposure to sunlight (or other ultraviolet radiations), immunosuppression, chronic scarring conditions and some familial cancer syndromes. Although the majority of cSCCs are adequately eradicated by surgical excision, a subgroup of cSCC may be linked with an increased risk of recurrence, metastasis and death...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Bilal Bin Younis, Adeela Shahid, Rozina Arshad, Saima Khurshid, Muhammad Ahmad, Haroon Yousaf
BACKGROUND: Diabetic foot ulceration is a serious limb-threatening complication of diabetes. It is the common cause of hospital admissions and amputations. The objective of the study was to determine the prevalence of diabetic foot ulcers (DFU) and its association with age, gender, duration of diabetes, peripheral neuropathy (PN), peripheral arterial disease (PAD) and HbA1c. METHODS: A total of 1940 people (≥ 30 years of age) with type 2 diabetes coming to the Sakina Institute of Diabetes and Endocrine Research (specialist diabetes clinic) at Shalamar Hospital, Lahore, Pakistan, were recruited over a period of 1 year from January 2016 to January 2017...
August 6, 2018: BMC Endocrine Disorders
Ketan Dhatariya, Stephen C Bain, John B Buse, Richard Simpson, Lise Tarnow, Margit Staum Kaltoft, Michael Stellfeld, Karen Tornøe, Richard E Pratley
OBJECTIVE: Diabetes-related foot ulcers (DFUs) and their sequelae result in large patient and societal burdens. Long-term data determining the efficacy of individual glucose-lowering agents on DFUs are lacking. Using existing data from the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial, we conducted post hoc analyses assessing the impact of liraglutide versus placebo in people with type 2 diabetes and at high risk of cardiovascular (CV) events on the incidence of DFUs and their sequelae...
August 2, 2018: Diabetes Care
Jie Gao, Yuanhong Wang, Wei Li, Jiayuan Zhang, Yanling Che, Xuan Cui, Boyu Sun, Gang Zhao
Chronic diabetic foot ulcer (DFU) is a major cause of disability and mortality in patients with diabetes. Dysfunctional endothelial progenitor cells (EPCs) play important roles in preventing vascular complications in these patients. Our results determined the elevated expression of histone deacetylase 2 (HDAC2) both in patients with DFU and in high glucose (HG) induced EPCs. In this study, HDAC2 siRNA (si-HDAC2) was transfected to investigate the effects of HDAC2 on EPCs. Cell proliferation decreased in HG-induced EPCs, but it was upregulated after si-HDAC2 transfection...
July 28, 2018: Gene
Mohammad Zubair, Jamal Ahmad
Objective: The study aims to investigate the potential role of C2437T (Met493Thr) single nucleotide polymorphism (SNP) of the heat shock protein (HSP) 70 in diabetic foot ulcer patients. Methods: In this prospective cohort study, SNP of the HSP70 hom gene, also called HSPA1L, was studied among diabetic patients with an ulcer (Group A: n = 50), diabetic patients without an ulcer (Group B: n = 50), and healthy subjects (Group C: n = 50). Results: There was a higher frequency of T/T genotype in group A (76%) as compared to group B (44%) and group C (14%)...
July 27, 2018: Journal of Clinical Medicine
Joachim Feldkamp, Karsten Jungheim, Matthias Schott, Beatrix Jacobs, Michael Roden
No abstract text is available yet for this article.
July 30, 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Samuel Kogan, Adit Sood, Mark S Granick
INTRODUCTION: Recent advances in the preservation and processing of amnion/chorion tissue have dramatically increased the bioavailability of these wound healing factors as well as the shelf life of their related tissue products, allowing for a surge in clinical use. Many studies, including basic science, clinical trials, and randomized controlled trials, have emerged examining the biologic properties of amnion/chorion membrane products and their efficacy in wound healing. OBJECTIVE: A literature review was conducted regarding the safety and efficacy of amniotic membrane adjuncts...
June 2018: Wounds: a Compendium of Clinical Research and Practice
Katherin Steffy, G Shanthi, Anson S Maroky, S Selvakumar
Nanobiotechnology has been emerged as an efficient technology for the development of antimicrobial nanoparticles through an eco-friendly approach. In this study, green synthesized phytonanocomposite of ZnO from Strychnos nux-vomica leaf aqueous extract was characterized by X-ray diffraction analysis (XRD), UV-visible-spectroscopy, Photoluminescence spectroscopy (PL), Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), High-resolution Transmission Electron Microscopy (HR-TEM), and Energy dispersive X-ray analysis (EDX)...
January 2018: Journal of Advanced Research
Malihe Imeni, Fakhri Sabouhi, Parvaneh Abazari, Bijan Iraj
Background: Body image, as an important factor in quality of life (QOL) satisfaction, in amputee patients is strongly affected by amputation, which can put the patient at risk of psychological disorders such as depression. Hence, this study was conducted to investigate the effect of spiritual care on body image in patients with type 2 diabetes-related amputation. Materials and Methods: In this study, an experimental pretest-posttest design with two groups was used...
July 2018: Iranian Journal of Nursing and Midwifery Research
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