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osteomyelitis foot

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https://www.readbyqxmd.com/read/29655648/osteomyelitis-of-the-first-metatarsal-head-treated-with-joint-preserving-surgery-and-a-synthetic-resorbable-bone-graft-substitute-a-case-report
#1
Konstantinos Anagnostakos, Katrin Koch
Managing infections of the first metatarsophalangeal joint can be demanding because many patients present with late-stage infection and partial or total amputation of the first ray or the phalanx could be necessary. We describe such a patient who was successfully treated with a calcium-based resorbable bone substitute that preserved the first metatarsophalangeal joint. A 38-year-old female presented to our department with a foot infection. Examination revealed a methicillin-susceptible Staphylococcus aureus infection of the first metatarsophalangeal joint...
April 11, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29644884/prospective-analysis-of-surgical-bone-margins-after-partial-foot-amputation-in-diabetic-patients-admitted-with-moderate-to-severe-foot-infections
#2
Brian M Schmidt, Jonathan B McHugh, Rajiv M Patel, James S Wrobel
BACKGROUND: Osteomyelitis is common in diabetic foot infections and medical management can lead to poor outcomes. Surgical management involves sending histopathologic and microbiologic specimens which guides future intervention. We examined the effect of obtainment of surgical margins in patients undergoing forefoot amputations to identify patient characteristics associated with outcomes. Secondary aims included evaluating interobserver reliability of histopathologic data at both the distal-to and proximal-to surgical bone margin...
April 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29626020/bone-and-joint-infection
#3
Julia Colston, Bridget Atkins
Bone and joint infections include septic arthritis, prosthetic joint infections, osteomyelitis, spinal infections (discitis, vertebral osteomyelitis and epidural abscess) and diabetic foot osteomyelitis. All of these may present through the acute medical take. This article discusses the pathogenesis of infection and highlights the importance of taking a careful history and fully examining the patient. It also emphasises the importance of early surgical intervention in many cases. Consideration of alternative diagnoses, appropriate imaging and high-quality microbiological sampling is important to allow appropriate and targeted antimicrobial therapy...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29605553/negative-pressure-wound-therapy-followed-by-basic-fibroblast-growth-factor-spray-as-a-recovery-technique-in-partial-necrosis-of-distally-based-sural-flap-for-calcaneal-osteomyelitis-a-case-report
#4
Taro Mikami, Eriko Kaida, Yuichiro Yabuki, Sho Kitamura, Ken'ichi Kokubo, Jiro Maegawa
The distally based sural flap is regarded as the first choice for reconstruction in the distal part of the lower leg because the flap is easy to raise, reliable in its blood supply, and prone to only a few complications. Limited data have investigated the details of treatment in cases of failure of distally based sural flaps. We report a case of calcaneal osteomyelitis in which a successful outcome was finally obtained with a partially necrosed, distally based sural flap using negative pressure wound therapy with basic fibroblast growth factor spray...
March 28, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29595101/orthopedic-aspects-of-the-diabetic-foot
#5
E J A Tijdens-Creusen, Paul C Jutte, W M H H Schoumakers, M 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...
March 28, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29574036/prognostic-scoring-system-for-patients-undergoing-reconstructive-foot-and-ankle-surgery-for-charcot-neuroarthropathy-the-charcot-reconstruction-preoperative-prognostic-score
#6
David Rettedal, Alissa Parker, Adam Popchak, Patrick R Burns
Charcot neuroarthropathy is a destructive process that occurs in patients with peripheral neuropathy, often due to poorly controlled diabetes mellitus. Surgical reconstruction can be necessary to provide a plantigrade foot that is wound free. A risk of major amputation exists after a Charcot event and after attempted reconstruction. We retrospectively reviewed the data from 34 patients (36 reconstructions) who had undergone reconstructive surgery for Charcot neuroarthropathy. The mean patient age was 56.44 years...
March 21, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29564946/virulence-factor-genes-in-staphylococcus-aureus-isolated-from-diabetic-foot-soft-tissue-and-bone-infections
#7
Gerardo Víquez-Molina, Javier Aragón-Sánchez, Cristian Pérez-Corrales, Christian Murillo-Vargas, María Eugenia López-Valverde, Benjamin A Lipsky
The aim of this study is to describe the presence of genes encoding for 4 virulence factors (pvl, eta, etb, and tsst), as well as the mecA gene conferring resistance to beta-lactam antibiotics, in patients with diabetes and a staphylococcal foot infection. We have also analyzed whether isolates of Staphylococcus aureus from bone infections have a different profile for these genes compared with those from exclusively soft tissue infections. In this cross-sectional study of a prospectively recruited series of patients admitted to the Diabetic Foot Unit, San Juan de Dios Hospital, San José, Costa Rica with a moderate or severe diabetic foot infection (DFI), we collected samples from infected soft tissue and from bone during debridement...
March 1, 2018: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29532115/-inflammatory-changes-of-the-foot
#8
REVIEW
S D Sprengel, B Klaan, L Kintzele
BACKGROUND: Inflammatory changes of the foot are comparatively rare and can be a challenge for radiologists with respect to the differential diagnosis, especially in cases with pre-existing degenerative changes of the foot skeleton. Comprehensive anamnesis and the use of contrast-enhanced MRI diagnostics are therefore often essential for diagnosis. OBJECTIVES: This review provides a cursory overview of the morphological characteristics of inflammatory changes of the foot and their differential diagnoses with a focus on osteomyelitis, joint infections, rheumatological diseases and tenosynovitis...
March 12, 2018: Der Radiologe
https://www.readbyqxmd.com/read/29501595/heel-wounds-predict-mortality-but-not-amputation-after-infrapopliteal-revascularization
#9
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Rabih A Chaer, Steven A Leers, Aureline Boitet, Michael J Singh, Eric S Hager
OBJECTIVE: Ischemic heel ulcerations are generally thought to carry a poor prognosis for limb salvage. We hypothesized that patients undergoing infrapopliteal revascularization for heel wounds, either bypass or endovascular intervention, would have lower wound healing rates and amputation-free survival than patients with forefoot wounds. METHODS: A retrospective chart review was performed of patients who presented between 2006 and 2013 to our institution with ischemic foot wounds and infrapopliteal arterial disease and underwent either pedal bypass or endovascular tibial artery intervention...
February 28, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29491344/intracardiac-abscess-and-pacemaker-lead-infection-secondary-to-hematogenous-dissemination-of-methicillin-sensitive-staphylococcus-aureus-from-a-prior-diabetic-foot-ulcer-and-osteomyelitis
#10
Kristopher S Pfirman, Robel Haile
BACKGROUND Intracardiac abscesses are an unusual occurrence in developed countries. With the increase in use of implantable cardiac devices, the increase use of and advancements in antibiotics, and the longevity of patients with cardiac devices, one may expect an increase in such infections; however, case reports are rare. We are presenting a case in which hematogenous dissemination of methicillin-sensitive Staphylococcus aureus (MSSA) infection from a lower extremity diabetic ulcer propagated into an infected pacemaker lead and ultimately an intracardiac abscess of the right atrium...
March 1, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29484984/diabetic-foot-infection-the-role-of-pet-ct-imaging
#11
Elite Arnon-Sheleg, Zohar Keidar
Osteomyelitis in the diabetic foot can be difficult to diagnose and has serious consequences. Although 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) positron emission tomography (PET) was traditionally used in oncology, it is emerging as a useful method in inflammatory and infectious entities. In this chapter, original research articles, meta-analyses, and reviews on the performance of FDG PET in diagnosing osteomyelitis in the diabetic foot will be discussed. In addition, PET available data in comparison to different imaging methods, different analysis methods, and impact of other co-existing conditions such as hyperglycemia, and long-term antibiotic treatment on the performance of FDG PET will be reviewed...
February 26, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29484983/new-imaging-tracers-for-the-infected-diabetic-foot-nuclear-and-optical-imaging
#12
Alfred O Ankrah, Hans C Klein, Philip H Elsinga
Diabetic foot infections (DFIs) are associated with increased morbidity, an economic burden on patients, their families and healthcare systems and increased mortality. Early diagnosis with prompt, appropriate and adequate treatment of the infected diabetic foot is crucial. The determination of DFIs, however, may be quite perplexing and invasive. Imaging is useful in the evaluation of certain cases of DFIs, especially in suspected instances with no overt clinical features, or in the diagnosis of osteomyelitis...
February 26, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29484982/leukocyte-imaging-of-the-diabetic-foot
#13
Chiara Lauri, Andor W J M Glaudemans, Alberto Signore
BACKGROUND: Diagnosing diabetic foot infection is often difficult, despite several available diagnostic methods. Amongst these, several imaging modalities exist to evaluate the diabetic foot in case of a suspected osteomyelitis. Nuclear Medicine, in particular, offers a variety of radiopharmaceuticals and techniques. Nowadays the gold standard radionuclide procedure, when an osteomyelitis is suspected, is represented by the use of radiolabelled leukocytes with either 99mTc-HMPAO or 111In-oxine...
February 26, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29476898/influence-of-multidrug-resistant-organism-on-the-outcome-of-diabetic-foot-infection
#14
Nese Saltoglu, Onder Ergonul, Necla Tulek, Mucahit Yemisen, Ayten Kadanali, Gul Karagoz, Ayse Batirel, Oznur Ak, Cagla Sonmezer, Haluk Eraksoy, Atahan Cagatay, Serkan Surme, Salih A Nemli, Tuna Demirdal, Omer Coskun, Derya Ozturk, Nurgul Ceran, Filiz Pehlivanoglu, Gonul Sengoz, Turan Aslan, Yasemin Akkoyunlu, Oral Oncul, Hakan Ay, Lutfiye Mulazımoglu, Buket Erturk, Fatma Yilmaz, Gulsen Yoruk, Nuray Uzun, Funda Simsek, Taner Yildirmak, Kadriye Kart Yaşar, Meral Sonmezoglu, Yasar Küçükardali, Nazan Tuna, Oguz Karabay, Nail Ozgunes, Fatma Sargın
OBJECTIVES: We described the clinical outcome of the diabetic patients who had foot infections with multidrug resistant organisms. METHODS: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. RESULTS: In total, 791 patients with DFI were included, 531(67%) was male, median age was 62 (19-90)...
February 21, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29458291/local-antibiotic-delivery-systems-current-and-future-applications-for-diabetic-foot-infections
#15
Konstantinos Markakis, Alan Robert Faris, Hamed Sharaf, Barzo Faris, Sharon Rees, Frank L Bowling
Foot infections are common among diabetic patients with peripheral neuropathy and/or peripheral arterial disease, and it can be the pivotal event leading to a minor or major amputation of the lower extremity. Treatment of diabetic foot infections, especially deep-seated ones, remains challenging, in part because impaired blood perfusion and the presence of biofilms can impair the effectiveness of systemic antibiotics. The local application of antibiotics is an emerging field in the treatment of diabetic foot infections, with demonstrable advantages...
February 1, 2018: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29443819/chronic-osteomyelitis-with-staphylococcus-aureus-deformation-in-submicron-canaliculi-of-osteocytes-a-case-report
#16
Karen L de Mesy Bentley, Ashlee MacDonald, Edward M Schwarz, Irvin Oh
CASE: A patient presenting with an infected diabetic foot ulcer and Staphylococcus aureus chronic osteomyelitis was studied to validate the clinical importance of bacterial colonization of osteocytic-canalicular networks, as we recently reported in a mouse model. We utilized transmission electron microscopy to describe the deformation of S. aureus, from round cocci to rod-shaped bacteria, in the submicron osteocytic-canalicular networks of amputated bone tissue. CONCLUSION: To our knowledge, this is the first evidence of S...
February 14, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29437061/mid-term-follow-up-of-patients-with-hindfoot-arthrodesis-with-retrograde-compression-intramedullary-nail-in-charcot-neuroarthropathy-of-the-hindfoot
#17
M Chraim, S Krenn, H M Alrabai, H-J Trnka, P Bock
AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29350008/-surgical-treatment-for-open-tarsometatarsal-joint-injury
#18
Yang-Hua Tang, Lin-Ru Zeng, Zhen-Shuang Yue, Da-Wei Xin, Zhong-Qing Hu, Can-da Xu
OBJECTIVE: To discuss the surgical method and clinical efficacy for open tarsometatarsal joint injuries. METHODS: From March 2011 to January 2015, 21 patients with open tarsometatarsal joint injuries were treated with stage-surgery method, including 14 males and 7 females with an average age of 45.6 years old ranging from 20 to 75 years. Injury site occurred in the left foot of 13 cases and right foot of 8 cases. Traffic injury was in 5 cases, crush injury in 6 cases, heavy crushing was in 10 cases...
February 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29316689/annual-direct-medical-costs-of-diabetic-foot-disease-in-brazil-a-cost-of-illness-study
#19
Cristiana M Toscano, Tatiana H Sugita, Michelle Q M Rosa, Hermelinda C Pedrosa, Roger Dos S Rosa, Luciana R Bahia
The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1) peripheral neuropathy without ulcer, (2) non-infected foot ulcer, (3) infected foot ulcer, and (4) clinical management of amputated patients...
January 8, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29311091/neutralizing-alpha-toxin-accelerates-healing-of-staphylococcus-aureus-infected-wounds-in-nondiabetic-and-diabetic-mice
#20
Roger V Ortines, Haiyun Liu, Lily I Cheng, Taylor S Cohen, Heather Lawlor, Abhishek Gami, Yu Wang, Carly A Dillen, Nathan K Archer, Robert J Miller, Alyssa G Ashbaugh, Bret L Pinsker, Mark C Marchitto, Christine Tkaczyk, C Kendall Stover, Bret R Sellman, Lloyd S Miller
Staphylococcus aureus wound infections delay healing and result in invasive complications such as osteomyelitis, especially in the setting of diabetic foot ulcers. In preclinical animal models of S. aureus skin infection, antibody neutralization of alpha-toxin (AT), an S. aureus -secreted pore-forming cytolytic toxin, reduces disease severity by inhibiting skin necrosis and restoring effective host immune responses. However, whether therapeutic neutralization of alpha-toxin is effective against S. aureus -infected wounds is unclear...
March 2018: Antimicrobial Agents and Chemotherapy
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