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diabetic osteomyelitis

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https://www.readbyqxmd.com/read/28547674/diagnostic-accuracy-of-various-modalities-relative-to-open-bone-biopsy-for-detection-of-long-bone-posttraumatic-osteomyelitis
#1
Vivek Chadayammuri, Benoit Herbert, Jiandong Hao, Andreas Mavrogenis, Juan C Quispe, Ji Wan Kim, Heather Young, Mark Hake, Cyril Mauffrey
BACKGROUND: Long bone posttraumatic osteomyelitis (PTOM) is a relatively common complication following surgical fixation of open fractures. There is a lacking consensus on ideal strategies for diagnostic evaluation of long bone PTOM. While open bone biopsy and culture is considered the 'gold diagnostic standard,' its cost and invasiveness are often prohibitive and have prompted the search for alternate diagnostic methods. OBJECTIVE: To evaluate the sensitivity and specificity of various diagnostic modalities relative to open bone biopsy and culture for the detection of long bone PTOM...
May 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28540152/epidemiological-clinical-and-microbiological-characteristics-of-patients-with-post-traumatic-osteomyelitis-of-limb-fractures-in-southwest-china-a-hospital-based-study
#2
Jiachen Peng, Youliang Ren, Wenbin He, Zhengdao Li, Jin Yang, Yi Liu, Zhonghui Zheng, Stephen L Kates, Edward M Schwarz, Chao Xie, Youjia Xu
Objective To determine the epidemiological, clinical and microbiological characteristics, of patients with post-traumatic osteomyelitis of extremity fractures, and provide evidence-based guidelines for early diagnosis and treatment, including empiric antibiotic therapy. Methods Human subject research was performed using institutional review board approved protocols. A retrospective chart review was conducted on 5,368 patients diagnosed with extremity traumatic fractures from January 1, 2012 to December 31, 2015, to identify osteomyelitis patients...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28497940/evaluation-of-diabetic-foot-infection-in-nuclear-medicine
#3
Sherif Heiba, Karin Knešaurek
Diabetic foot infection is not only the most common cause of hospitalization among diabetic patients, but is also associated with high morbidity, mortality and major utilization of the resources. Managing diabetic patients with suspected foot infection is highly dependent on an early and accurate determination of its presence and location. Medical imaging is often used in the workup of these patients, as clinical diagnosis of osteomyelitis is often difficult, and invasive bone biopsy is infrequently used due to many limitations...
May 12, 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28497161/outcomes-in-diabetic-foot-ulcer-patients-with-isolated-t2-marrow-signal-abnormality-in-the-underlying-bone-should-the-diagnosis-of-osteitis-be-changed-to-early-osteomyelitis
#4
Dennis Duryea, Stephanie Bernard, Donald Flemming, Eric Walker, Cristy French
OBJECTIVE: To evaluate the variability of clinical treatment and outcomes based on reporting of diabetic foot ulcer MRI findings of adjacent marrow T2 hyperintensity with normal T1 signal. MATERIALS AND METHODS: A retrospective review was conducted of 46 MRI examinations evaluating diabetic foot ulcers that demonstrated normal T1 marrow signal, but T2 marrow hyperintensity deep to the ulcer. The cohort was divided based on MRI report impressions into three groups; "osteitis without osteomyelitis" (OW), "osteitis but cannot exclude early osteomyelitis" (OCEO) and "early osteomyelitis" (EO)...
May 11, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28480283/using-nuclear-medicine-imaging-wisely-in-diagnosing-infectious-diseases
#5
REVIEW
Andrea Censullo, Tara Vijayan
In recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine's "Choosing Wisely" campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad. This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28476396/nonsurgical-treatment-of-osteomyelitis-of-the-hallux-sesamoids-a%C3%A2-case-series-and-literature-review
#6
Flavien Mauler, Florian Wanivenhaus, Thomas Böni, Martin Berli
The aim of the present study was to determine the effectiveness of nonsurgical treatment for osteomyelitis of the hallucal sesamoids. Osteomyelitis of the hallucal sesamoids in young and healthy patients is rare and might originate from hematogenous spread or after a puncture wound. In diabetic patients with peripheral neuropathy, it often results from direct contiguous seeding from adjacent ulceration. The superiority of surgical versus nonsurgical therapy is still debated. In our institution, all patients presenting with osteomyelitis of the hallucal sesamoids are first treated nonsurgically but eventually usually require a surgical procedure...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28473089/acr-appropriateness-criteria-%C3%A2-suspected-osteomyelitis-septic-arthritis-or-soft-tissue-infection-excluding-spine-and-diabetic-foot
#7
Francesca D Beaman, Paul F von Herrmann, Mark J Kransdorf, Ronald S Adler, Behrang Amini, Marc Appel, Erin Arnold, Stephanie A Bernard, Bennett S Greenspan, Kenneth S Lee, Michael J Tuite, Eric A Walker, Robert J Ward, Daniel E Wessell, Barbara N Weissman
Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue from osseous infection often determines the appropriate clinical therapeutic course. Radiographs are the recommend initial imaging examination, and although often not diagnostic in acute osteomyelitis, can provide anatomic evaluation and alternative diagnoses influencing subsequent imaging selection and interpretation. MRI with contrast is the examination of choice for the evaluation of suspected osteomyelitis, and MRI, CT, and ultrasound can all be useful in the diagnosis of soft tissue infection...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28465790/osteomyelitis-in-diabetic-foot-a-comprehensive-overview
#8
REVIEW
Laura Giurato, Marco Meloni, Valentina Izzo, Luigi Uccioli
Foot infection is a well recognized risk factor for major amputation in diabetic patients. The osteomyelitis is one of the most common expression of diabetic foot infection, being present approximately in present in 10%-15% of moderate and in 50% of severe infectious process. An early and accurate diagnosis is required to ensure a targeted treatment and reduce the risk of major amputation. The aim of this review is to report a complete overview about the management of diabetic foot osteomyelitis. Epidemiology, clinical aspects, diagnosis and treatment are widely described according to scientific reccomendations and our experience...
April 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28440774/diagnostic-and-therapeutic-update-on-diabetic-foot-osteomyelitis
#9
José Luis Lázaro-Martínez, Aroa Tardáguila-García, José Luis García-Klepzig
Diabetic foot osteomyelitis (DFO) is the most common infection associated to diabetic foot ulcers (DFU). This review is designed to provide an update on the diagnosis and treatment of DFO based on an analysis of MEDLINE through PubMed using as search criterion "Diabetic Foot Osteomyelitis". Authors have included in this review the most relevant manuscripts regarding diagnosis and treatment of DFO. After review and critical analysis of publications, it may be concluded that diagnosis of DFO is not simple because of its heterogeneous presentation...
February 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28417857/nuclear-medicine-imaging-in-pediatric-infection-or-chronic-inflammatory-diseases
#10
REVIEW
Alberto Signore, Andor W J M Glaudemans, Olivier Gheysens, Chiara Lauri, Onofrio A Catalano
In this review article, we focus on the most recent applications of nuclear medicine techniques (mainly (99m)Tc/(111)In white blood cells (WBC) scan, [(18)F]-FDG-PET/CT, [(18)F]-FDG-PET/MRI, and (99m)Tc-IL-2 scintigraphy) in the study of children affected by peripheral bone osteomyelitis, fungal infections, inflammatory bowel diseases, and type 1 diabetes, owing to recent important published evidences of their role in the management of these diseases. For osteomyelitis in children, both bone scintigraphy and [(18)F]-FDG-PET have a major advantage of assessing the whole body in one imaging session to confirm or exclude multifocal involvement, whereas WBC scan has a limited role...
May 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28406331/treatment-options-for-diabetic-foot-osteomyelitis
#11
Eric Senneville, Olivier Robineau
Diabetic foot osteomyelitis therapeutical options are based on antibiotic therapy and surgical resection of the infected bone(s). Surgical and medical approaches of patients suffering from a diabetic foot osteomyelitis do not oppose but are complementary and need to be discussed as a tailored manner. Areas covered: The aim of the present article is to discuss data issued from the most recent guidelines of the Infectious Diseases Society of America and the International Working Group on the Diabetic Foot on the management of the diabetic foot infection and from a search in the current literature using the terms diabetic foot osteomyelitis and treatment/therapy/therapeutical in both PubMed and Medline, restricted to the last five years...
June 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28350291/a-rare-clinical-entity-staphylococcus-related-glomerulonephritis
#12
Numune Aliyeva, Erol Demir, Yasar Caliskan, Halil Yazici, Alaattin Yildiz
Staphylococcus aureus is a rare cause of postinfectious glomerulonephritis, and Staphylococcus-related glomerulonephritis primarily occurs in middle-aged or elderly patients. Patients with Staphylococcus-related glomerulonephritis also present with hematuria, proteinuria of varying degrees, rising serum creatinine levels, and/or edema. The severity of renal insufficiency is proportional to the degree of proliferation and crescent formation. Here, we present a diabetic patient admitted with a history of 1 week of left elbow pain...
March 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28341493/procalcitonin-as-a-biomarker-for-predicting-amputation-level-in-lower-extremity-infections
#13
Matthew M Reiner, Wissam E Khoury, Michael B Canales, Richard A Chmielewski, Kartick Patel, Mark C Razzante, Coleman O Cloughtery, Douglas Y Rowland
Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Procalcitonin is a newer inflammatory marker that is specific for an infectious process. Originally, procalcitonin was used to monitor antibiotic therapy and sepsis for patients in the intensive care setting, but it has now been expanded to other facets of medicine...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28336046/charcot-arthropathy-versus-osteomyelitis-evaluation-and-management
#14
REVIEW
John Womack
Charcot arthropathy of the foot and ankle is a severe complication of peripheral neuropathy and is most commonly seen in the developed world in association with diabetes mellitus. Correct diagnosis and differentiation from osteomyelitis of the foot and ankle are critical to guide treatment. It can exist concomitantly with osteomyelitis, typically in the setting of an advanced midfoot ulcer. Simple plain radiographs and contrasted MRI studies often yield inconclusive or confusing data. Correct use of imaging studies and a clinical algorithm can be effective tools to help make accurate and early diagnoses and guide clinical interventions for these conditions...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#15
Mehmet Orçun Akkurt, Ismail Demirkale, Ali Öznur
Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28320836/adaptive-upregulation-of-clumping-factor-a-clfa-by-s-aureus-in-the-obese-type-2-diabetic-host-mediates-increased-virulence
#16
Christopher W Farnsworth, Eric M Schott, Sarah E Jensen, Jacob Zukoski, Abigail M Benvie, Majed A Refaai, Stephen L Kates, Edward M Schwarz, Michael J Zuscik, Steven R Gill, Robert A Mooney
Obesity and associated type 2 diabetes (T2D) are important risk factors for infection following orthopaedic implant surgery. Staphylococcus aureus, the most common pathogen in bone infections, adapts to multiple environments to survive and evade host immune responses. Whether adaptation of S. aureus to the unique environment of the obese/T2D host accounts for its increased virulence and persistence in this population is unknown. Thus, we assessed implant-associated osteomyelitis in normal versus high fat-diet obese/T2D mice and found that S...
March 20, 2017: Infection and Immunity
https://www.readbyqxmd.com/read/28301358/hyperbaric-oxygen-therapy-exploring-the-clinical-evidence
#17
Gretl Lam, Rocky Fontaine, Frank L Ross, Ernest S Chiu
GENERAL PURPOSE: To provide information about hyperbaric oxygen therapy (HBOT), its mechanisms, indications and safe applications based on clinical evidence. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
April 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28286632/can-ratio-of-neutrophil-to-lymphocyte-count-and-erythrocyte-sedimentation-rate-in-diabetic-foot-infecti-on-predict-osteomyelitis-and-or-amputation
#18
Oktay Yapıcı, Hande Berk, Nefise Öztoprak, Derya Seyman, Alper Tahmaz, Alparslan Merdin
The aim of this study was to search for any relations between the neutrophil-to-lymphocyte ratio (NLR) and the development of osteomyelitis and the need for amputation in patients with diabetic foot infection (DFI). All data included DFI patients who were hospitalized in our Infectious Diseases Clinic between 2012 and 2015 and who were classified according to International Classification Disease Code System. 75 patients were analyzed in the study. The DFI patients were stratified into 3 groups of whom had amputation procedure, whom had only debridement/drainage procedure and whom had any surgery procedure...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28277993/maggot-therapy-for-wound-care-in-iran-a-case-series-of-the-first-28-patients
#19
A Mirabzadeh, M J Ladani, B Imani, S A B Rosen, R A Sherman
OBJECTIVE: The need for improved wound care is receiving considerable attention in the Islamic Republic of Iran. Beginning in 2003, maggot therapy (MT) became part of Iran's effort to advance its wound care technology. The first cohort of patients treated with MT was analysed to evaluate the use of this treatment. METHOD: Patients treated with MT at three hospitals in Tehran were analysed retrospectively. Primary outcomes were time to wound debridement and time to wound healing...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28276619/hospital-admissions-by-the-oldest-old-past-trends-in-one-of-the-most-ageing-countries-in-the-world
#20
Daniela Brandão, Oscar Ribeiro, Alberto Freitas, Constança Paúl
AIM: To examine discharges of octogenarians, nonagenarians and centenarians from Portuguese public hospitals, namely admission type, principal diagnoses, comorbidities and length of stay. METHODS: The present study used administrative data from public acute care hospitals in the Portuguese National Health Service. All discharges of persons aged ≥80 years between 2000 and 2014 were analyzed. HCUP Clinical Classifications Software was considered to aggregate principal diagnosis, and comorbidities were assessed using the Charlson Comorbidity Index computed using International Classification of Diseases 9th Revision Clinical Modification codes...
March 9, 2017: Geriatrics & Gerontology International
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