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Diabetic ulceration

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https://www.readbyqxmd.com/read/28644115/evaluation-of-the-effectiveness-and-cost-effectiveness-of-lightweight-fibreglass-heel-casts-in-the-management-of-ulcers-of-the-heel-in-diabetes-a-randomised-controlled-trial
#1
William Jeffcoate, Frances Game, Vivienne Turtle-Savage, Alison Musgrove, Patricia Price, Wei Tan, Lucy Bradshaw, Alan Montgomery, Deborah Fitzsimmons, Angela Farr, Thomas Winfield, Ceri Phillips
BACKGROUND: Ulcers of the foot in people with diabetes mellitus are slow to heal and result in considerable cost and patient suffering. The prognosis is worst for ulcers of the heel. OBJECTIVE: To assess both the clinical effectiveness and the cost-effectiveness of lightweight fibreglass casts in the management of heel ulcers. DESIGN: A pragmatic, multicentre, parallel, observer-blinded randomised controlled trial. A central randomisation centre used a computer-generated random number sequence to allocate participants to groups...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28643380/microscopy-visualisation-confirms-multi-species-biofilms-are-ubiquitous-in-diabetic-foot-ulcers
#2
Khalid Johani, Matthew Malone, Slade Jensen, Iain Gosbell, Hugh Dickson, Honhua Hu, Karen Vickery
Increasing evidence within the literature has identified the presence of biofilms in chronic wounds and proposed that they contribute to delayed wound healing. This research aimed to investigate the presence of biofilm in diabetic foot ulcers (DFUs) using microscopy and molecular approaches and define if these are predominantly mono- or multi-species. Secondary objectives were to correlate wound observations against microscopy results in ascertaining if clinical cues are useful in detecting wound biofilm. DFU tissue specimens were obtained from 65 subjects...
June 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28638999/osteopontin-and-clusterin-levels-in-type-2-diabetes-mellitus-differential-association-with-peripheral-autonomic-nerve-function
#3
Raelene E Maser, M James Lenhard, Ryan T Pohlig, P Babu Balagopal
Osteopontin (OPN) and clusterin are secreted glycoproteins potentially associated with nerve function. Sudomotor dysfunction is associated with the development of foot ulcerations. The purpose of this study was to investigate the potential relationship of OPN and clusterin with sudomotor function (i.e., autonomic nerves that control sweating) in participants with type 2 diabetes mellitus (T2DM). Sudomotor function was assessed using SUDOSCAN® which measures electrochemical skin conductance (ESC) of the hands and feet...
June 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28638013/-surgical-treatment-of-diabetic-neuroosteoarthropathy-dnoap-and-its-long-term-results
#4
V M Bensman, Yu P Savchenko, S E Gumenyuk, K G Triandafilov, P P Vasil'chenko, S N Pyatakov, V V Khoritonenko
AIM: To develop pathogenetically justified surgical treatment of diabetic neuroosteoarthropathy (DNOAP). MATERIAL AND METHODS: 52 patients were operated and long-term results were studied in 36 of them. 2 groups were assessed depending on completeness of surgical treatment including changed synovial structures removal. Tarso-metatarsal arthrodesis was created after synovectomy in median foot to restore longitudinal arch. Cruro-calcaneal neoarthrosis was performed after elimination of posterior focus of DNOAP...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28636749/annual-direct-medical-costs-associated-with-diabetes-related-complications-in-the-event-year-and-in-subsequent-years-in-hong-kong
#5
F Jiao, C K H Wong, S C W Tang, C S C Fung, K C B Tan, S McGhee, R Gangwani, C L K Lam
AIM: To develop models to estimate the direct medical costs associated with diabetes-related complicationsin the event year and in subsequent years. METHODS: The public direct medical costs associated with 13 diabetes-related complications were estimated among a cohort of 128 353 people with diabetes over 5 years. Private direct medical costs were estimated from a cross-sectional survey among 1825 people with diabetes. We used panel data regression with fixed effects to investigate the impact of each complication on direct medical costs in the event year and subsequent years, adjusting for age and co-existing complications...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#6
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28627227/smarter-sole-survival
#7
Bijan Najafi, Eyal Ron, Ana Enriquez, Ivan Marin, Javad Razjouyan, David G Armstrong
OBJECTIVE: This study examined adherence to alert-based cues for plantar pressure offloading in patients with diabetic foot disease. METHOD AND DESIGN: Participants (n = 17) with in diabetic foot remission (history of neuropathic ulceration) were instructed to wear a smart insole system (the SurroSense Rx, Orpyx Medical Technologies Inc, Calgary, Canada) over a three-month period. This device is designed to cue offloading to manage unprotected sustained plantar pressures in an effort to prevent foot ulceration...
January 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28627224/real-time-smart-textile-based-system-to-monitor-pressure-offloading-of-diabetic-foot-ulcers
#8
Andrea Raviglione, Roberto Reif, Maurizio Macagno, Davide Vigano, Justin Schram, David Armstrong
BACKGROUND: The lifetime risk of developing a diabetic foot ulcer (DFU) is at least 25%. A DFU carries a 50% risk for infection and at least 20% of those receive some form of amputation. The most significant parameter that prevents or delays ulcer healing is high plantar pressure. To improve the patient's healing process, the DFU's plantar pressure should remain cumulatively low. Therefore, a tool that continuously measures the DFU loading, and provides real-time feedback can improve the healing outcome...
February 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28627029/treatment-by-a-moisturizer-of-xerosis-and-cracks-of-the-feet-in-men-and-women-with-diabetes-a-randomized-double-blind-placebo-controlled-study
#9
H Gin, M Rorive, S Gautier, M Condomines, M Saint Aroman, E Garrigue
AIM: To evaluate a moisturizer containing urea, glycerine and petrolatum for healing deep open fissures on the feet of people with diabetes. If left untreated, open fissures, an entry point for bacteria, can lead to infection, ulceration and further complications. METHODS: This randomized, double-blind, multicentre study at 19 hospitals, general practices and diabetologists in France and Belgium included participants with diabetes and a deep open target fissure on their heel...
June 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28626899/consideration-of-the-presence-of-inflammation-is-essential-for-interpretation-of-serum-micronutrient-results
#10
Emma Osland
It was with great interest I read the recent contribution by Christie-David and Gunton, 'Vitamin C deficiency and diabetes mellitus - easily missed?' [1], outlining their retrospective cohort study in 11 patients with poorly healing foot ulcers in the setting of diabetes mellitus. Their findings suggest previously unrecognized vitamin C deficiency may have been a contributing factor to the ulcers that were being treated in their clinic; a hypothesis supported by the healing reported to occur within 3 weeks of the commencement of vitamin C replacement [1]...
June 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28626746/frequency-of-cutaneous-fungal-infections-and-azole-resistance-of-the-isolates-in-patients-with-diabetes-mellitus
#11
Omid Raiesi, Mansour Siavash, Faezeh Mohammadi, Javaher Chabavizadeh, Behzad Mahaki, Mehrnoush Maherolnaghsh, Parvin Dehghan
BACKGROUND: Diabetic patients are more susceptible to cutaneous fungal infections. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. The main objective of this study was to find the frequency of fungal infections among cutaneous lesions of diabetic patients and to investigate azole antifungal agent susceptibility of the isolates. MATERIALS AND METHODS: In this study, type 1diabetes (n = 78) and type 2 diabetes (n = 44) comprised 47 cases (38...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28620441/impaired-wound-healing-facts-and-hypotheses-for-multi-professional-considerations-in-predictive-preventive-and-personalised-medicine
#12
REVIEW
Eden Avishai, Kristina Yeghiazaryan, Olga Golubnitschaja
Whereas the physiologic wound healing (WH) successfully proceeds through the clearly defined sequence of the individual phases of wound healing, chronic non-healing wounds/ulcers fail to complete the individual stages and the entire healing process. There are many risk factors both modifiable (such as stress, smoking, inappropriate alcohol consumption, malnutrition, obesity, diabetes, cardio-vascular disease, etc.) and non-modifiable (such as genetic diseases and ageing) strongly contributing to the impaired WH...
March 2017: EPMA Journal
https://www.readbyqxmd.com/read/28619097/adipose-tissue-derived-stromal-vascular-fraction-in-regenerative-medicine-a-brief-review-on-biology-and-translation
#13
REVIEW
Pablo Bora, Anish S Majumdar
Adipose/fat tissue provides an abundant source of stromal vascular fraction (SVF) cells for immediate administration and can also give rise to a substantial number of cultured, multipotent adipose-derived stromal cells (ADSCs). Recently, both SVF and ADSCs have gained wide-ranging translational significance in regenerative medicine. Initially used for cosmetic breast enhancement, this mode of treatment has found use in many diseases involving immune disorders, tissue degeneration, and ischaemic conditions. In this review, we try to address several important aspects of this field, outlining the biology, technology, translation, and challenges related to SVF- and ADSC-based therapies...
June 15, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28618729/risk-factors-associated-with-poor-outcome-in-diabetic-foot-ulcer-patients
#14
Saira Saleem, Nazim Hayat, Irshad Ahmed, Tanvir Ahmed, Abdul Gaffar Rehan
BACKGROUND/AIM: Diabetic foot ulcers and related complications are a major cause of morbidity and hospital admissions. Our aim was to evaluate the risk factors associated with poor outcome in diabetic foot ulcers. MATERIALS AND METHODS: A prospective study was conducted on patients with diabetic foot ulceration attending the Madinah Teaching Hospital from June 2014 to December 2015. Potential risk factors and laboratory test results at presentation were recorded and their association with outcome (healing vs...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28618043/nurses-knowledge-on-diabetic-foot-ulcer-disease-and-their-attitudes-towards-patients-affected-a-cross-sectional-institution-based-study
#15
Sriyani A Kumarasinghe, Priyadarshika Hettiarachchi, Sudharshani Wasalathanthri
AIMS AND OBJECTIVES: To assess nurses' knowledge on diabetic ulcer disease and their attitudes towards patients suffering from it and to identify factors which influence them. BACKGROUND: Diabetic wound care is an evolving specialty with the rising prevalence of diabetes foot complications. As nurses play a key role in wound care, their knowledge and attitudes are important in providing optimum care to patients. DESIGN: Descriptive cross sectional survey design...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28616361/hyperbaric-oxygen-therapy-side-effects-defined-and-quantified
#16
REVIEW
Marvin Heyboer, Deepali Sharma, William Santiago, Norman McCulloch
Significance: Hyperbaric oxygen therapy (HBOT) is an important advanced therapy in the treatment of problem wounds, including diabetic foot ulcers and late effect radiation injury. HBOT remains among the safest therapies used today. Nonetheless, there are side effects associated with HBOT. It is important for providers to be able to identify, understand, and quantify these side effects for prevention, management, and informed consent. Recent Advances: The past two decades have seen significant advancements in our understanding of the underlying mechanisms of HBOT...
June 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28616080/pedobarography-as-a-clinical-tool-in-the-management-of-diabetic-feet-in-new-zealand-a-feasibility-study
#17
Jason K Gurney, Uwe G Kersting, Dieter Rosenbaum, Ajith Dissanayake, Steve York, Roger Grech, Anthony Ng, Bobbie Milne, James Stanley, Diana Sarfati
BACKGROUND: The peripheral complications of diabetes mellitus remain a significant risk to lower-limb morbidity. In New Zealand, risk of diabetes, comorbidity and lower-limb amputation are highly-differential between demographic groups, particularly ethnicity. There is growing and convincing evidence that the use of pedobarography - or plantar pressure measurement - can usefully inform diabetic foot care, particularly with respect to the prevention of re-ulceration among high-risk patients...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28614678/diabetic-foot-ulcers-and-their-recurrence
#18
David G Armstrong, Andrew J M Boulton, Sicco A Bus
New England Journal of Medicine, Volume 376, Issue 24, Page 2367-2375, June 2017.
June 15, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28614088/magistral-prescription-with-silver-nitrate-and-peru-balsam-in-difficult-to-heal-diabetic-foot-ulcers
#19
Lawrence C Nwabudike, Alin L Tatu
No abstract text is available yet for this article.
June 13, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28613416/topical-antimicrobial-agents-for-treating-foot-ulcers-in-people-with-diabetes
#20
REVIEW
Jo C Dumville, Benjamin A Lipsky, Christopher Hoey, Mario Cruciani, Marta Fiscon, Jun Xia
BACKGROUND: People with diabetes are at high risk for developing foot ulcers, which often become infected. These wounds, especially when infected, cause substantial morbidity. Wound treatments should aim to alleviate symptoms, promote healing, and avoid adverse outcomes, especially lower extremity amputation. Topical antimicrobial therapy has been used on diabetic foot ulcers, either as a treatment for clinically infected wounds, or to prevent infection in clinically uninfected wounds...
June 14, 2017: Cochrane Database of Systematic Reviews
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