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https://www.readbyqxmd.com/read/28098565/bio-engineering-tissue-and-v-a-c-therapy-a-new-method-for-the-treatment-of-extensive-necrotizing-infection-in-the-diabetic-foot
#1
Andrea Armenio, Daniela Anna Cutrignelli, Maria Luisa Nardulli, Giulio Maggio, Giuseppe Memeo, Valerio De Santis, Giuseppe Giudice, Cosmo Maurizio Ressa
AIM: The aim of the study is to compare the standard care for progressive necrotizing infection in diabetic foot with a treatment protocol based on the association between autologous fibroblast grafts and vacuum-assisted closure therapy (V.A.C.). MATERIAL OF STUDY: A retrospective matched Case-Control study was carried out on 20 patients with diabetic foot infection, 10 treated with the standard care and 10 with our new protocol. Inclusion criteria were: acute diabetic foot necrosis (Wagner III and IV), ulcer size (30 to 80 cm2), tendon and bone exposure...
December 6, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28097629/radiomitigation-and-tissue-repair-activity-of-systemically-administered-therapeutic-peptide-tp508-is-enhanced-by-pegylation
#2
Scott D McVicar, Kempaiah Rayavara, Darrell H Carney
TP508 is a synthetically derived tissue repair peptide that has previously demonstrated safety and potential efficacy in phase I/II clinical trials for the treatment of diabetic foot ulcers. Recent studies show that a single injection of TP508 administered 24 h after irradiation significantly increases survival and delays mortality in murine models of acute radiation mortality. Thus, TP508 is being developed as a potential nuclear countermeasure. Because of the short plasma half-life of TP508, we hypothesize that increasing the peptide bioavailability would increase TP508 efficacy or reduce the dosage required for therapeutic effects...
January 17, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28096842/purple-stiff-lesions-resembling-varicose-veins-on-lower-limb-certainly-consider-kaposi-sarcoma
#3
Faruk Cingoz, Gokhan Arslan, Ali Fuat Cicek, Bilgehan Savas Oz
Kaposi's sarcoma (KS) typically presents multiple cutaneous lesions of the lower extremities. Lesions can rarely mimic varicose veins without venous insufficiency, vascular or stasis ulcers. As the initial diagnosis of KS is generally determined clinically, a high index of suspicion and palpation of lesions are necessary for all patients with atypical presentations of varicose-like lesions of lower extremities. Tissue biopsy with histological analysis is essential for all uncertain lesions. This is a case of KS occurring in a 79-year-old man who presented with indurated vascular plaques resembling varicose veins on the right foot...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28070472/utilizing-the-veraflo%C3%A2-instillation-negative-pressure-wound-therapy-system-with-advanced-care-for-a-case-study
#4
Rita K Driver
BACKGROUND:  Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial. NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen...
November 30, 2016: Curēus
https://www.readbyqxmd.com/read/28060006/resolving-epibole-with-polymeric-membrane-dressings-in-home-care
#5
Kimberly S Bare, Jerri Drain
BACKGROUND: The management of chronic (nonhealing) wounds with epibole is challenging and costly, especially when the problem is not promptly identified or the patient is intolerant to conventional treatments. CASE DESCRIPTION: We describe the use of a polymeric membrane dressing (PMD) in 3 patients with chronic (nonhealing) wounds and epibole who were unable to be treated with traditional interventions such as silver nitrate or sharp debridement. Patient 1 was a 51 year-old male with a right foot stasis ulcer with 60% fibrin/slough to the wound bed, patient 2 was a 58-year-old female with a stage 4 pressure injury of the left hip with undermining, and patient 3 was a 62-year-old female with a dehisced abdominal surgical wound...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28056476/-advanced-systemic-sclerosis-endovascular-reconstruction-of-the-aortic-bifurcation-for-limb-salvage
#6
Florian Stein, Lars Kamper, Konstantinos Meletiadis, Ulrich Kusenack, Patrick Haage
History and admission findings A 69-year-old patient was initially hospitalized because of a 1.5 cm ulceration at the back of the right foot which had existed for the last year and become increasingly swollen and painful. Medical history revealed PmScl-positive systemic sclerosis presenting with a massive calcinosis cutis, advanced pulmonary fibrosis and peripheral artery disease. Examinations Inflammatory markers were normal. MR-Angiography of the lower extremities revealed a multi-segmental high-grade stenosis of the aortic bifurcation due to extensively calcified plaques...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#7
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28054923/descriptive-longitudinal-study-results-applied-to-statistical-models-to-assess-the-impact-of-early-microbiological-cultures-on-the-economic-burden-of-treatment-for-infected-diabetic-foot-ulcers-at-a-mexican-public-health-facility
#8
Luz-Ma-Adriana Balderas-Peña, Daniel Sat-Muñoz, Rosa-Emilia Ramírez-Conchas, Moisés-Roberto Alvarado-Iñiguez, Javier-Eduardo García-de-Alba-García, Eduardo Cruz-Corona, José-Luis Chávez-Hurtado, José-Martín Chagollán-Ramírez
Infection plays a critical role in health care and impacts the cost of the treatment of diabetic foot ulcers (DFU). To examine the cost reduction associated with the multidisciplinary treatment of infected DFU (IDFU) by obtaining early (ie, within 48 hours of admission) microbiological culture results, a descriptive, longitudinal study was conducted. Data were collected prospectively from patient medical charts of a cohort of 67 patients (mean age, 56.14 ± 12.3 years; mean duration of diabetes, 14.95 ± 8 years) with IDFU treated at a Mexican public health facility from January 1 to April 30, 2010...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28053300/a-medical-thermal-imaging-device-for-the-prevention-of-diabetic-foot-ulceration
#9
Graham Machin, Aaron Whittam, Suhail Ainarkar, John Allen, John Bevans, Michael Edmonds, Ben Kluwe, Audrey Macdonald, Nina Petrova, Peter Plassmann, Francis Ring, Leon Rogers, Rob Simpson
In this paper a description is given of the development, characterisation and first results of a thermal imaging device aimed at significantly reducing the incidence of diabetic foot ulceration (DFU). These devices will be used in three clinical centres and in two preliminary clinical trials. The first will be on healthy volunteers to set a robust baseline for the overall research aims and the second on >100 patients at high risk of DFU. In the second phase of the project the objective is to demonstrate significant reduction in the incidence of DFU through a comparison of the results of standard care of high risk feet with standard care plus thermal imaging...
January 5, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28051251/observation-of-clinical-efficacy-of-rt-pa-intravenous-thrombolytic-treatment-for-patients-combined-with-grade-0-1-diabetic-foot-by-wagner-classification-and-acute-ischemic-stroke
#10
C-H Li, Y Chen, C-H Zhang, Z Dong, Z Wang, S-N Zhao, Y-X Wang, Z-Y Lv, P-L Zhang
OBJECTIVE: To evaluate the safety and efficacy of rt-PA intravenous thrombolytic treatment for patients with diabetic foot (DF) and acute ischemic stroke. PATIENTS AND METHODS: A retrospective analysis was performed on 76 patients admitted between June 2012 to December 2015 presenting with acute ischemic stroke and Grade 0-1 DF a (Wagner classification). The treatment group consisted of 44 patients who received rt-PA intravenous thrombolytic treatment, while 32 cases in the control group did not...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28043296/-meta-analysis-on-the-clinical-effects-of-allogenic-acellular-dermal-matrix-treatment-for-diabetic-foot-ulcer
#11
C L Xue, Z C Hu, Z X Yang, X J Li
Objective: To analyze the clinical effects of allogenic acellular dermal matrix (ADM) treatment for diabetic foot ulcer (DFU) with meta-analysis. Methods: Databases including PubMed, Cochrance Library, Embase, and OVID EBM Reviews were searched using key words " diabetic foot, diabetic ulcer, diabetic wound, acellular dermal matrix, acellular dermal regenerative tissue matrix, acellular regenerative tissue matrix, AlloDerm, SureDerm, KaroDerm, Graftjacket, Hyalomatrix PA, and Hyalograft 3D" , and Chinese Biological Abstracts, Chinese Journals Full-text Database, VIP Database, and Wanfang Database were searched using key words in Chinese version ",,," to obtain the published trials of allogenic ADM treatment for DFU from January 1990 to July 2015, and then meta-analysis was used to analyze the trials...
December 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28041815/non-invasive-lower-limb-small-arterial-measures-co-segregate-strongly-with-foot-complications-in-people-with-diabetes
#12
Sean Michael Lanting, Stephen M Twigg, Nathan Anthony Johnson, Michael Kevin Baker, Ian Douglas Caterson, Vivienne Helaine Chuter
AIMS: It is unclear how well non-invasive lower-limb vascular assessments can identify those at risk of foot complications in people with diabetes. We aimed to investigate the relationship between a history of foot complication (ulceration or amputation) and non-invasive vascular assessments in people with diabetes. METHODS: Bilateral ankle-brachial index (ABI), toe brachial index (TBI) and continuous wave Doppler (CWD) were performed in 127 adults with diabetes (97% type 2; age 66...
November 15, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28040821/over-the-counter-and-natural-remedies-for-onychomycosis-do-they-really-work
#13
Pierre Halteh, Richard K Scher, Shari R Lipner
Onychomycosis is a fungal infection of the nail unit that may lead to dystrophy and disfigurement over time. It accounts for up to 50% of all nail conditions, with toenails affected more commonly than fingernails. Onychomycosis may affect quality of life and increase the prevalence and severity of foot ulcers in patients with diabetes. Available oral agents approved by the US Food and Drug Administration (FDA) for the treatment of onychomycosis include terbinafine and itraconazole, which have demonstrated good efficacy but are associated with the risk of systemic side effects and drug-drug interactions...
November 2016: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28035908/plantar-pressures-increase-with-raising-body-weight-a-standardised-approach-with-paired-sample-using-neutral-shoes
#14
T Hotfiel, H D Carl, F Wendler, A Jendrissek, R Heiß, B Swoboda
BACKGROUND: Plantar pressure leads to stress on plantar tissue and can be seen as risk factor for metatarsal stress fractures or plantar ulcers and is associated with prolonged and complicated recurrence of existing tissue damages. A clear demarcation of a systematic raise of body load regarding its effect on plantar pressure has not been described. OBJECTIVE: Assessing plantar pressure in different conditions of body weight, comparing data to initial body weight...
December 23, 2016: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28034470/-cutaneous-granular-bacteriosis-occurring-in-staphylococcus-aureus-septicaemia
#15
D Mermin, A-L Védie, M-L Jullie, A Fauconneau, M Beylot-Barry, A Pham-Ledard
BACKGROUND: Herein we report a case of cutaneous granular bacteriosis, with discussion of the nosological setting of this entity based upon the clinical and histological findings. PATIENTS AND METHODS: A 62-year-old woman receiving methotrexate for Sezary syndrome was admitted for fever of 38.5̊C and overall impairment of her health. She presented a fistulous nodule on her right knee, and skin biopsy revealed a focus of ulcerated suppuration with quantities of Gram+ and Grocott+ granules containing no filament, enclosed by eosinophilic matter (Splendore-Hoeppli phenomenon)...
December 26, 2016: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/28031030/outcome-after-protected-full-weightbearing-treatment-in-an-orthopedic-device-in-diabetic-neuropathic-arthropathy-charcot-arthropathy-a-comparison-of-unilaterally-and-bilaterally-affected-patients
#16
Niklas Renner, Stephan Hermann Wirth, Georg Osterhoff, Thomas Böni, Martin Berli
BACKGROUND: Charcot neuropathic arthropathy (CN) is a chronic, progressive, destructive, non-infectious process that most frequently affects the bone architecture of the foot in patients with sensory neuropathy. We evaluated the outcome of protected weightbearing treatment of CN in unilaterally and bilaterally affected patients and secondarily compared outcomes in protected versus unprotected weightbearing treatment. METHODS: Patient records and radiographs from 2002 to 2012 were retrospectively analyzed...
December 29, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28029181/new-horizons-in-the-understanding-of-the-causes-and-management-of-diabetic-foot-disease-report-from-the-2017-diabetes-uk-annual-professional-conference-symposium
#17
M Clokie, A L Greenway, K Harding, N J Jones, K Vedhara, F Game, K K Dhatariya
Diabetes-related foot disease remains a common problem. For wounds, classic teaching recommends the treatment of any infection, offloading the wound and ensuring a good blood supply, as well as ensuring that the other modifiable risk factors are addressed and optimized. There remain, however, several questions about these and other aspects of the care of diabetes-related foot disease. Some of these questions are addressed in the present report; in particular, the impact of newer technologies in the identification of any organisms present in a wound, as well as the use of novel approaches to treat infections...
December 28, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28018920/delay-between-onset-of-symptoms-and-seeking-physician-intervention-increases-risk-of-diabetic-foot-complications-results-of-a-cross-sectional-population-based-survey
#18
Norina A Gavan, Ioan A Veresiu, Etta J Vinik, Aaron I Vinik, Bogdan Florea, Cosmina I Bondor
We present a post hoc analysis of 17,530 questionnaires collected as part of the 2012 screening for neuropathy using Norfolk Quality of Life tool in patients with diabetes in Romania, to assess the impact on foot complications of time between the onset of symptoms of diabetes/its complications and the physician visit. Odds ratios (ORs) for self-reporting neuropathy increased from 1.16 (95% CI: 1.07-1.25) in those who sought medical care in 1-6 months from symptoms of diabetes/its complications onset to 2.27 in those who sought medical care >2 years after symptoms onset...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28013263/invasive-systemic-infection-after-hospital-treatment-for-diabetic-foot-ulcer-risk-of-occurrence-and-effect-on-survival
#19
Shey-Ying Chen, John M Giurini, Adolf W Karchmer
BACKGROUND: Diabetic foot ulcers (DFUs) threaten limbs and prompt hospitalization. After hospitalization, remote-site invasive systemic infection related to DFU (DFU-ISI) may occur. The characteristics of DFU-ISIs and their effect on mortality risk have not been defined. METHODS: We conducted a retrospective cohort study of 819 diabetic patients hospitalized for treatment of 1212 unique DFUs during a 9-year period. We defined the index ulcer as that present at the first (index) DFU admission to our hospital...
February 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28012341/walking-cadence-affects-rate-of-plantar-foot-temperature-change-but-not-final-temperature-in-younger-and-older-adults
#20
Prabhav Nadipi Reddy, Glen Cooper, Andrew Weightman, Emma Hodson-Tole, Neil D Reeves
This study examined the relationship between (1) foot temperature in healthy individuals and walking cadence, (2) temperature change at different locations of the foot, and (3) temperature change and its relationship with vertical pressures exerted on the foot. Eighteen healthy adult volunteers (10 between 30 and 40 years - Age: 33.4±2.4years; 8 above 40 years - Age: 54.1±7.7years) were recruited. A custom-made insole with temperature sensors was placed directly onto the plantar surface of the foot and held in position using a sock...
December 6, 2016: Gait & Posture
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