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Foot, ankle, diabetic ulcers

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https://www.readbyqxmd.com/read/30081878/frequency-of-foot-ulcers-in-people-with-type-2-diabetes-presenting-to-specialist-diabetes-clinic-at-a-tertiary-care-hospital-lahore-pakistan
#1
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
https://www.readbyqxmd.com/read/30020090/effect-of-exercise-on-risk-factors-of-diabetic-foot-ulcers-a-systematic-review-and-meta-analysis
#2
Fuyuan Liao, Ruopeng An, Fang Pu, Stephanie Burns, Sa Shen, Yih-Kuen Jan
The objectives of this study were to examine the effectiveness of different types of exercise on risk factors of diabetic foot ulcers, including glycated hemoglobin (HbA1c), peripheral arterial disease (PAD), and diabetic peripheral neuropathy, in people with type 2 diabetes mellitus (T2DM). PubMed, Web of Science, Cochrane Library, Scopus, and CINAHL were searched from inception to January 2018 for relevant articles. Eligible studies were randomized controlled trials (RCTs) that examined effects of exercise on the selected risk factors...
July 16, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/30012065/a-foreign-body-through-the-shoe-of-a-person-with-diabetic-peripheral-neuropathy-alters-contralateral-biomechanics-captured-through-innovative-plantar-pressure-technology
#3
Katie E Chatwin, Caroline A Abbott, Prabhav N Reddy, Frank L Bowling, Andrew J M Boulton, Neil D Reeves
High plantar pressure as a result of diabetic peripheral neuropathy is often reported as a major risk factor for ulceration. However, previous studies are confined to laboratories with equipment limited by cables, reducing the validity of measurements to daily life. The participant concerned in this case report was wearing an innovative plantar pressure feedback system as part of a wider study. The system allows for continuous plantar pressure monitoring and provides feedback throughout all activities of daily living...
June 2018: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29981730/supervised-short-stretch-compression-therapy-in-mixed-leg-ulcers
#4
A Stansal, E Tella, A Yannoutsos, I Keita, R Attal, V Gautier, D Sfeir, I Lazareth, P Priollet
OBJECTIVES: This study was conducted to determine hemodynamic and clinical tolerance under short-stretch compression therapy in elderly patients suffering from mixed-etiology leg ulcers. DESIGN: Transversal observational study conducted in 25 hospitalized patients with a moderate peripheral arterial occlusive disease defined as an ankle-brachial pressure index>0.5, an ankle pressure of>70mmHg and a toe cuff pressure (TP)>50mmHg. MATERIAL AND METHODS: Short-stretch bandages were applied daily with pressures from 20 to 30mmHg...
July 2018: Journal de médecine vasculaire
https://www.readbyqxmd.com/read/29928559/clinical-etiological-anatomical-and-bacteriological-study-of-diabetic-foot-patients-results-of-a-single-center-study
#5
Ashwinikumar Patil, Datta More, Anant Patil, Kishor A Jadhav, Myriam E Vijil Mejia, Suresh S Patil
OBJECTIVE: To examine the clinical pattern of foot-related complications in type 2 diabetes patients. MATERIAL AND METHODS: A cross-sectional study was conducted among indoor, adult type 2 diabetes patients with risk factors for diabetic foot complications. The diabetic neuropathy symptom score (DNSS), Doppler scanning, ankle brachial pressure index (ABPI) assessment, neuropathy assessment, neuropathic disability score (NDS), biothesiometry evaluation, and bacteriological examination was performed...
April 18, 2018: Curēus
https://www.readbyqxmd.com/read/29890399/effect-of-different-casting-design-characteristics-on-offloading-the-diabetic-foot
#6
Manon Westra, Jaap J van Netten, Hendrik A Manning, Jeff G van Baal, Sicco A Bus
BACKGROUND: Non-removable knee-high devices, such as a total contact cast (TCC), are recommended for offloading diabetic plantar forefoot ulcers. However, it is insufficiently known how each of the different design characteristics of these devices contribute to offloading the diabetic foot. RESEARCH QUESTION: What is the offloading effect of the different design characteristics that make up a non-removable knee-high cast for people with diabetes and active or previous plantar forefoot ulcers? METHODS: Sixteen persons with diabetes, peripheral neuropathy and a healed or active plantar forefoot ulcer had their plantar pressures measured during walking in a non-removable knee-high device (TCC), in that device made removable (BTCC), in that device made below-ankle (cast shoe), in that cast shoe worn with a different walking sole and in a newly made cast shoe without a custom-moulded foot-device interface...
July 2018: Gait & Posture
https://www.readbyqxmd.com/read/29881185/electromagnetic-simulation-of-non-invasive-approach-for-the-diagnosis-of-diabetic-foot-ulcers
#7
Roshen Borkar, James Rizkalla, Youngmin Kwon, Paul Salama, Maher Rizkalla
Diabetic foot ulcers are systemic diseases that affect all blood vessels within the human body. From major blood vessels to microvasculature, hardening, thickening, and narrowing of blood vessels ultimately results to diminished blood flow to end organs. The detrimental effects of peripheral vascular disease are well recognized across medicine, particularly with regards to diabetic foot ulcers. Diabetic foot ulcers (DFU) are common across all fields of medicine, including but not limited to: orthopedics, vascular surgery, podiatry, general internal medicine, and infectious disease...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29859538/weight-bearing-versus-non-weight-bearing-ankle-dorsiflexion-measurement-in-people-with-diabetes-a-cross-sectional-study
#8
A Searle, M J Spink, V H Chuter
BACKGROUND: Accurate measurement of ankle dorsiflexion is important in both research and clinical practice as restricted motion has been associated with many foot pathologies and increased risk of ulcer in people with diabetes. This study aimed to determine the level of association between non-weight bearing versus weight bearing ankle dorsiflexion in adults with and without diabetes, and to evaluate the reliability of the measurement tools. METHODS: One hundred and thirty-six adults with diabetes and 30 adults without diabetes underwent ankle dorsiflexion measurement non-weight bearing, using a modified Lidcombe template, and weight bearing, using a Lunge test...
June 2, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29845508/systematic-review-of-methods-used-for-the-microvascular-assessment-of-peripheral-arterial-disease
#9
REVIEW
Qinzhong Chen, Robert S Rosenson
Lower extremity peripheral arterial disease (LEAD) is increasing in prevalence in low with approximately 202 million people affected with LEAD worldwide. Certain subgroups of individuals (cigarette smokers, diabetics) that are particularly high risk for LEAD and major adverse limb events (MALE). Conventionally, the ankle-brachial index (ABI) is the recommended screening test for LEAD. However, the ABI has several limitations, particularly in patients with diabetes. These limitations include increased measurement variability with severity of LEAD, non-compressible calcified arteries inability to detect arterial disease distal to the ankle precludes assessment of disease in the foot where many ulcers can occur, and underestimation of the extent of microvascular occlusive disease...
June 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29791040/presence-of-chronic-diabetic-foot-ulcers-is-associated-with-more-frequent-and-more-advanced-retinopathy
#10
A Sellman, P Katzman, S Andreasson, M Löndahl
AIMS: To clarify the frequency and severity of diabetic retinopathy in a group of people with Type 2 diabetes and chronic diabetic foot ulcers, and to compare visual acuity, levels of retinopathy and clinical significant macular oedema with a matched control group of people with Type 2 diabetes without a history of chronic diabetic foot ulcers. METHODS: Visual acuity and fundus imaging were evaluated in 90 white people with at least 3 months' duration of full-thickness diabetic foot ulcers below the ankle and the results compared with those in 180 white people with Type 2 diabetes without a history of chronic diabetic foot ulcers (control group)...
May 23, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29753996/risk-factors-for-diabetic-foot-ulcer-recurrence-a-prospective-2-year-follow-up-study-in-egypt
#11
Walaa A Khalifa
OBJECTIVES: To determine the frequency of diabetic foot ulcer recurrence and its potential risk factors. METHODS: This study included 93 patients with type 2 diabetes and followed for 2 years after primary healed foot ulceration. Demographic, diabetes related, comorbid and ulcer related variables were investigated as risk factors. Multiple logistic regression analysis was used to identify independent risk factors. RESULTS: 61.3% of patients had recurrent ulcers particularly in the forefoot (33...
December 28, 2017: Foot
https://www.readbyqxmd.com/read/29748311/radiotracer-imaging-allows-for-noninvasive-detection-and-quantification-of-abnormalities-in-angiosome-foot-perfusion-in-diabetic-patients-with-critical-limb-ischemia-and-nonhealing-wounds
#12
Jessica L Alvelo, Xenophon Papademetris, Carlos Mena-Hurtado, Sangchoon Jeon, Bauer E Sumpio, Albert J Sinusas, Mitchel R Stacy
BACKGROUND: Single photon emission computed tomography (SPECT)/computed tomography (CT) imaging allows for assessment of skeletal muscle microvascular perfusion but has not been quantitatively assessed in angiosomes, or 3-dimensional vascular territories, of the foot. This study assessed and compared resting angiosome foot perfusion between healthy subjects and diabetic patients with critical limb ischemia (CLI). Additionally, the relationship between SPECT/CT imaging and the ankle-brachial index-a standard tool for evaluating peripheral artery disease-was assessed...
May 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29707757/transcutaneous-oxygen-pressure-as-a-predictor-for-short-term-survival-in-patients-with-type-2-diabetes-and-foot-ulcers-a-comparison-with-ankle-brachial-index-and-toe-blood-pressure
#13
K Fagher, P Katzman, M Löndahl
AIMS: Ankle-brachial index (ABI) is the most commonly used test when diagnosing peripheral vascular disease and is considered a marker for cardiovascular risk. Transcutaneous oxygen pressure (TcPO2 ), a test associated with microvascular function, has in several studies shown better correlation with diabetic foot ulcer (DFU) healing. Whether a low TcPO2 could be a marker for mortality in the high-risk population of DFU patients has not been evaluated before. The aim of this study was to evaluate the predictive value of TcPO2 in comparison with ABI and toe blood pressure (TBP) on 1-year mortality in type 2 diabetes patients with DFU...
August 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29679687/indocyanine-green-angiography-to-prognosticate-healing-of-foot-ulcer-in-critical-limb-ischemia-a-novel-technique
#14
Hiten M Patel, Shahzad S Bulsara, Shubhabrata Banerjee, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: To predict wound healing in patients with critical limb ischemia (CLI) is an ongoing issue. Current methods such as ankle-brachial index (ABI), color Doppler and transcutaneous oxygen pressure (TCPO2 ), and computed tomography angiography are lacking in demonstrating regional perfusion. Indocyanine green angiography (ICGA) has the potential to provide regional perfusion information lacking in other methods. This study was conducted to demonstrate successes of revascularization procedure in CLI patients based on ICGA data...
August 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29666111/decreasing-an-offloading-device-s-size-and-offsetting-its-imposed-limb-length-discrepancy-lead-to-improved-comfort-and-gait
#15
Ryan T Crews, Joseph Candela
OBJECTIVE: Patient adherence is a challenge in offloading diabetic foot ulcers (DFUs) with removable cast walkers (RCWs). The size and weight of an RCW, changes to gait, and imposed limb-length discrepancies may all discourage adherence. This study sought to determine whether RCW size and provision of a contralateral limb lift affected users' comfort and gait. RESEARCH DESIGN AND METHODS: Twenty-five individuals at risk for DFUs completed several 20-m walking trials under five footwear conditions: bilateral standardized shoes, a knee-high RCW with shoe with or without an external shoe lift contralaterally, and an ankle-high RCW with shoe with or without an external shoe lift contralaterally...
July 2018: Diabetes Care
https://www.readbyqxmd.com/read/29617058/multicenter-randomized-controlled-observer-blinded-study-of-a-nitric-oxide-generating-treatment-in-foot-ulcers-of-patients-with-diabetes-pronox1-study
#16
Michael E Edmonds, Harvey J Bodansky, Andrew J M Boulton, Paul J Chadwick, Cuong N Dang, Ryan D'Costa, Atholl Johnston, Brian Kennon, Graham Leese, Satyan M Rajbhandari, Thomas E Serena, Matthew J Young, Joanne E Stewart, Arthur T Tucker, Marissa J Carter
The aim of this multicenter, prospective, observer-blinded, parallel group, randomized controlled trial was to assess the safety and efficacy of EDX110, a nitric oxide generating medical device, in the treatment of diabetic foot ulcers in a patient group reflecting "real world" clinical practice compared against optimal standard care. Participants were recruited from ten hospital sites in multidisciplinary foot ulcer clinics. The ulcers were full thickness, with an area of 25-2,500 mm2 and either a palpable pedal pulse or ankle brachial pressure index > 0...
April 4, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29602761/prevalence-and-related-risk-factors-of-diabetic-foot-ulcer-in-ahvaz-south-west-of-iran
#17
Leila Yazdanpanah, Hajieh Shahbazian, Iraj Nazari, Hamid Reza Arti, Fatemeh Ahmadi, Seyed Ehsan Mohammadianinejad, Bahman Cheraghian, Seyed Mahmoud Latifi
AIMS: The aim of this study was to evaluate the prevalence of diabetic foot ulcer and its related risk factors. MATERIALS AND METHODS: In this descriptive cross-sectional study, 605 patients with diabetes were evaluated in July 2014. A checklist was used to obtain demographic data, diabetes related data, past medical history, and physical examination data. RESULTS: The prevalence of diabetic foot ulcer was 6.4% (95% CI: 4.64-8.73). Seventeen cases of them were female (4...
July 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29600673/-clinical-efficacy-analysis-of-transverse-tibial-bone-transport-combined-with-vacuum-drainage-for-the-treatment-of-diabetic-foot-ulcer
#18
Zhong-Wei Jia, Jian-Ping Yu, Yun-Xing Su, Xiu-Sheng Guo, Jin-Bin Yu, Zhi-Jun Yang, Jia-Wei Niu, Jie Wei
OBJECTIVE: To investigate clinical effect of transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage in treating diabetic foot ulcer. METHODS: From November 2015 and December 2016, clinical data of 19 diabetic foot ulcer patients treated with transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage were retrospective analyzed, including 15 males and 4 females aged from 42 to 82 years old with an average of (64...
March 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29595101/orthopedic-aspects-of-the-diabetic-foot
#19
Elvira J A Tijdens-Creusen, Paul C Jutte, Wim M H H Schoumakers, Melanie M Van der Klauw, Marjan Wouthuyzen-Bakker
BACKGROUND: Diabetes Mellitus (DM) is a common medical condition affecting more than 6% of the world population. Besides well-known pathology like diabetic retinopathy and renal insufficiency, it carries important orthopedic implications, especially around the foot and ankle (diabetic foot). Focus: This article focusses on the three major areas confronting the orthopedist: 1) changes in foot statics and biology leading to ulceration with or without osteomyelitis, 2) ankle fractures, particularly complications after a fracture and 3) Charcot foot...
2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29503134/squamous-cell-carcinoma-from-marjolin-s-ulcer-of-the-foot-in-a-diabetic-patient-case-study
#20
Raymond Cavaliere, Danielle M Mercado, Malary Mani
Squamous cell carcinoma (SCC) has been commonly reported by foot and ankle specialists. Marjolin's ulcer is a malignancy that involves a posttraumatic scar or ulceration that can develop into SCC from chronic neuropathic pedal wounds, venous stasis, or decubitus ulcerations. Most Marjolin's ulcers are found in the lower extremity, specifically the feet, and it is twice as common in females as males. Biopsy of the tumor is the reference standard to diagnose SCC, and wide excision of SCC is the most common treatment option...
July 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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