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foot diabetes

Silvano Esposito, Silvana Noviello, Francesco De Caro, Giovanni Boccia
Skin and soft tissue infections (SSTIs) involve a heterogeneous group of entities with different clinical presentations classified according to several specific criteria. Because of their great variability, their incidence and prevalence is difficult to accurately determine. Yet it is generally thought that the rate of SSTIs is globally increasing due to an aging population, strictly associated with the increase in the number of critical and immunocompromised patients. The aetiology of SSTIs is also extremely variable, reflecting the noteworthy heterogeneity of their clinical presentations and their epidemiology...
March 1, 2018: Le Infezioni in Medicina
Channabasappa Shivaprasad, Goel Amit, Kolly Anish, Boppana Rakesh, Biswas Anupam, Yalamanchi Aiswarya
AIMS: To investigate the factors associated with abnormal electrochemical skin conductance (ESC) in patients with type 2 diabetes mellitus (T2D) and early diabetic peripheral neuropathy (DPN). METHODS: We recruited 523 consecutive patients with T2D (median age: 50 [interquartile range: 16] years; median T2D duration: 4 [5] years). Sudomotor dysfunction was defined as an ESC <60 µS, and DPN as a neuropathy disability score (NDS) ≥6. Logistic regression was performed to determine the predictors of sudomotor dysfunction in patients with DPN...
March 7, 2018: Diabetes Research and Clinical Practice
Şahizer Eraydin, Gülçin Avşar
PURPOSE: The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. DESIGN: Prospective, randomized controlled study. SUBJECT AND SETTINGS: Sixty-five patients from an outpatient clinic with grade 1 or 2 ulcers (Wagner classification) who met study criteria agreed to participate; 60 patients completed the study and were included in the final analysis. Subjects were followed up between February 2014 and June 2015...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Paul J Kim, Christopher E Attinger, Thomas Bigham, Robert Hagerty, Samantha Platt, Ersilia Anghel, John S Steinberg, Karen K Evans
Outpatient-based sharp debridement is considered an important element for the care of a chronic ulcer. OBJECTIVE: The aim of this study is to evaluate the change in bacterial amounts with sharp debridement in a clinical setting. MATERIALS AND METHODS: Bacterial autofluorescence, quantitative cultures, semiquantitative cultures, and qualitative speciation were performed predebridement and postdebridement during a single clinic visit. RESULTS: Thirty-six wounds were included in the analysis...
February 23, 2018: Wounds: a Compendium of Clinical Research and Practice
Marek Kawecki, Jarosław Pasek, Grzegorz Cieślar, Aleksander Sieroń, Grzegorz Knefel, Mariusz Nowak, Justyna Glik
BACKGROUND: Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. OBJECTIVES: The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. MATERIAL AND METHODS: The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
B González-García, S García-Isidoro, J Contreras-Alcántara, J A Martínez-Gil, M A Díaz Y Orea, V O Castellanos-Sánchez
The most frequent diabetes-related complications are diabetic foot and glaucoma, which lead to amputation and loss of vision, respectively. Current scientific and technologic developments have permitted the design and implementation of prosthetic systems that are optimal for these patients, as the latter adapt themselves to them and can resume activities of daily living. The lack of economic resources compromises the quality of the prostheses patients can afford, as they resort to «artisanal» or «rustic» systems that hamper their adaptation process...
September 2017: Acta Ortopédica Mexicana
Andor W J M Glaudemans, Thomas C Kwee, Riemer H J A Slart
No abstract text is available yet for this article.
March 2, 2018: Current Pharmaceutical Design
Sinuo Chen, Renren Li, Chun Cheng, Jing-Ying Xu, Caixia Jin, Furong Gao, Juan Wang, Jieping Zhang, Jingfa Zhang, Hong Wang, Lixia Lu, Guo-Tong Xu, Haibin Tian
Macrophages play critical roles in wound healing process. They switch from "classically activated" (M1) phenotype in the early inflammatory phase to "alternatively activated" (M2) phenotype in the later healing phase. However, the dynamic process of macrophage phenotype switching in diabetic wounds burdened with bacteria is unclear. In this report, Pseudomonas aeruginosa, frequently detected in diabetic foot ulcers, was inoculated into cutaneous wounds of db/db diabetic mice to mimic bacterium-infected diabetic wound healing...
March 7, 2018: Cell Biology International
Chris Manu, Elisabetta Lacopi, Benjamin Bouillet, Julien Vouillarmet, Raju Ahluwalia, Claas Lüdemann, José Luis Garcia-Klepzig, Marco Meloni, Víctor Rodriguez-Saenz De Buruaga, Juan Pedro Sánchez-Ríos, Mike Edmonds, Jan Apelqvist, Jose Luis Lazaro Martinez, Kristien Van Acker
OBJECTIVE: Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units. METHOD: A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU...
March 2, 2018: Journal of Wound Care
David Russell, Leanne Atkin, April Betts, Caroline Dowsett, Francis Fatoye, Sarah Gardner, Julie Green, Chris Manu, Tracey McKenzie, Helena Meally, Louise Mitchell, Julie Mullings, Isaac Odeyemi, Andrew Sharpe, Gillian Yeowell, Nancy Devlin
OBJECTIVE: Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing...
March 2, 2018: Journal of Wound Care
Julian F Guest, Heenal Singh, Peter Vowden
OBJECTIVE: To estimate whether a collagen-containing dressing could potentially afford the UK's National Health Service (NHS) a cost-effective intervention for the management of diabetic foot ulcers (DFUs). METHOD: A decision model depicting the management of a DFU was constructed and populated with a combination of published clinical outcomes, resource use estimates and utilities for DFUs. The model estimated the incremental cost-effectiveness of a collagen-containing dressing plus standard care compared with standard care alone over a period of four months in terms of the incremental cost per quality-adjusted life year (QALY) gained...
March 2, 2018: Journal of Wound Care
Ilker Uckay, Francois R Jornayvaz, Dan Lebowitz, Giacomo Gastaldi, Karim Gariani, Benjamin A Lipsky
Factors strongly related to the risk of developing diabetic foot infections include vascular, neuropathic and hyperglycemic complications of long-standing diabetes mellitus. These infections are common and serious, posing a worldwide burden on administrative providers of healthcare, patients and physicians. The most appropriate approach to these infections is with a multidisciplinary team. This subchapter summarizes the current state-of-the-art concerning therapy, and scientific knowledge, for peripheral arterial insufficiency, hyperglycemia, and peripheral neuropathy of the diabetic foot, with an emphasis on the infectious complications...
March 2, 2018: Current Pharmaceutical Design
Onno August Mennes, J J van Netten, R H J A Slart, Wiendelt Steenbergen
BACKGROUND: The most severe diabetic foot ulcers are those related with critical ischemia, which is primarily diagnosed with non-invasive diagnostics. However, these diagnostics have several disadvantages. For example, they only provide global indications of the (macro)level of ischemia. A potential solution can be found in novel optical imaging techniques for local assessment of the microcirculation in diabetic foot ulcers. This review provides an overview of these imaging techniques (laser Doppler perfusion imaging, laser speckle contrast imaging; photoacoustic imaging and hyperspectral imaging) and their applicability for the diagnostic assessment of microcirculation in diabetic foot ulcers...
March 2, 2018: Current Pharmaceutical Design
Arthur Grünerbel
No abstract text is available yet for this article.
March 2018: MMW Fortschritte der Medizin
Caitlin W Hicks, Joseph K Canner, Nestoras Mathioudakis, Ronald L Sherman, Kathryn Hines, Christopher Lippincott, James H Black, Christopher J Abularrage
BACKGROUND: Socioeconomic deprivation is associated with poor glycemic control and higher hospital admission rates in patients with diabetes. We sought to quantify the effects of neighborhood socioeconomic deprivation on wound healing among a cohort of patients with diabetic foot ulceration (DFU) treated in a multidisciplinary setting. METHODS: Socioeconomic disadvantage was calculated for all patients using the area deprivation index (ADI) stratified by quartile (from ADI-0: least through ADI-3: most)...
April 2018: Journal of Surgical Research
D Li, J Yufeng Yang, T Wang, S Shen, H Tang
BACKGROUND: The U.S. Food and Drug Administration recently issued a safety communication requiring new warnings of increased leg and foot amputation risk be added to canagliflozin drug labelling. However, the risk associated with other sodium-glucose co-transporter 2 inhibitors (SGLT2i) remains uncertain. AIM: This meta-analysis aimed to evaluate the potential risks of diabetic foot syndrome (DFS) and amputation associated with SGLT2i. METHODS: Relevant databases were searched from inception to June 14, 2017 to identify randomized controlled trials (RCTs) that evaluated risks of DFS and amputation associated with SGLT2i use...
February 13, 2018: Diabetes & Metabolism
Guang-Jiang Shi, Guang-Rui Shi, Jia-Yin Zhou, Wen-Jin Zhang, Chen-Ying Gao, Ya-Ping Jiang, Zhen-Guo Zi, Hai-Hong Zhao, Yong Yang, Jian-Qiang Yu
Diabetes mellitus (DM) is a major endocrine metabolic disease and is marked by a lack of insulin. The complication of DM is one of the most difficult problems in medicine. The initial translational studies revealed that growth factors have a major role in integrating tissue physiology and in embryology as well as in growth, maturation and tissue repair. In some tissues affected by diabetes, growth factors are induced by a relative deficit or excess. Fibroblast growth factor 21 (FGF21) is a promising regulator of glucose and lipid metabolism with multiple beneficial effects including hypoglycemic and lipid-lowering...
March 1, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Patrick Esser, Johnny Collett, Kevin Maynard, Dax Steins, Angela Hillier, Jodie Buckingham, Garry D Tan, Laurie King, Helen Dawes
This study explored the potential utility of gait analysis using a single sensor unit (inertial measurement unit [IMU]) as a simple tool to detect peripheral neuropathy in people with diabetes. Seventeen people (14 men) aged 63±9 years (mean±SD) with diabetic peripheral neuropathy performed a 10-m walk test instrumented with an IMU on the lower back. Compared to a reference healthy control data set (matched by gender, age, and body mass index) both spatiotemporal and gait control variables were different between groups, with walking speed, step time, and SDa (gait control parameter) demonstrating good discriminatory power (receiver operating characteristic area under the curve >0...
February 2018: Diabetes & Metabolism Journal
Il Hoon Sung, Dong Woo Jang, Se Wan Kim, Youn Hwan Kim, Sang Wha Kim
BACKGROUND: Reconstruction of complicated diabetic lower leg and foot defects involving multiple tissue components remains a challenge. The purpose of this report is to introduce thoracodorsal artery perforator (TDAP) chimeric flaps for reconstructing diabetic lower leg and foot soft tissue defects. PATIENTS AND METHODS: Between April 2010 and August 2016, 17 patients with multiple diabetic lower leg and foot defects underwent reconstruction with TDAP chimeric flaps...
March 5, 2018: Microsurgery
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...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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