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Diabetic foot infections

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https://www.readbyqxmd.com/read/28817962/patients-with-diabetic-foot-disease-fear-major-lower-extremity-amputation-more-than-death
#1
Dane K Wukich, Katherine M Raspovic, Natalie C Suder
BACKGROUND: The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. METHODS: We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations...
February 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28802182/inflammatory-markers-as-risk-factors-for-infection-with-multidrug-resistant-microbes-in-diabetic-foot-subjects
#2
Saba Noor, Abhijit Girish Borse, Maaz Ozair, Alok Raghav, Iqbal Parwez, Jamal Ahmad
BACKGROUND: Diabetic foot ulcers (DFUs), a dreadful microvascular complication of diabetes is responsible for substantial increase in morbidity and mortality. Infection, not a cause, but a consequence in DFUs that accounts for minor or major limb loss. The current study aimed to evaluate the microbial etiology of infected diabetic foot ulcers in northern tertiary care hospital, assessment of risk factors and role of inflammatory markers involved in colonization of multidrug-resistant organisms (MDROs) and their impact on the outcome...
May 3, 2017: Foot
https://www.readbyqxmd.com/read/28765981/-anatomic-stabilization-of-chronic-lateral-instability-of-the-ankle-gold-technique
#3
REVIEW
T Diermeier, B Scheiderer, L Lacheta, A B Imhoff
OBJECTIVES: Anatomical reconstruction of the lateral ligament complex in the ankle. INDICATIONS: Chronic lateral ankle instability. CONTRAINDICATIONS: Severe osteoarthritis, obesity, hindfoot varus, general contraindications (infection, circulatory disorders, diabetic foot syndrome). SURGICAL TECHNIQUE: Anatomical V‑shaped reconstruction of the lateral ligament complex with half of the peroneus brevis tendon and additional retinaculum stabilization...
August 1, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28765052/predictors-of-lower-extremity-amputation-and-reamputation-in-the-diabetic-foot
#4
Erdinc Acar, Burkay Kutluhan Kacıra
In the present study, we aimed to identify the comorbidities that would be predictive of requiring lower extremity amputation or reamputation for diabetic foot wounds. We performed a retrospective review of 132 consecutive patients who had undergone lower extremity amputations (110 patients) or reamputations (22 patients) for diabetic wounds from January 2013 to March 2016. We used multivariate logistic regression to calculate the odds ratios (ORs) for amputation and reamputation for various comorbidities. The ORs of undergoing amputation were greatest for adult males (OR 5...
July 29, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28762948/previous-atorvastatin-treatment-and-risk-of-diabetic-foot-infection-in-adult-patients-a-case-control-study
#5
Mohammad Nassaji, Raheb Ghorbani, Hanieh Saboori Shkofte
OBJECTIVE: In addition to their lipid-lowering abilities, statins have anti-inflammatory and immunomodulatory properties. Increasing recent evidence suggests the possible role of pretreatment with statins in preventing or decreasing morbidity and mortality from infection. Diabetic foot infection (DFI) is a common complication of diabetes mellitus. The aim of this study was to determine whether previous atorvastatin use is associated with reduced risk of DFI and better outcomes of these infections...
July 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28756043/impact-of-angiosome-and-non-angiosome-targeted-peroneal-bypass-on-limb-salvage-and-healing-in-patients-with-chronic-limb-threatening-ischemia
#6
Jean-Baptiste Ricco, Mauro Gargiulo, Andrea Stella, Mohammad Abualhin, Enrico Gallitto, Mathieu Desvergnes, Romain Belmonte, Fabrice Schneider
BACKGROUND: Direct (DIR) or indirect (IND) revascularization of pedal angiosomes in patients with chronic limb-threatening ischemia (CLTI) has an unclear impact on limb salvage and healing. The aim of this study was to evaluate the outcomes of DIR and IND revascularization in patients with a peroneal bypass and tissue loss. METHODS: We conducted a retrospective study of a prospectively maintained database in two European university centers from 2004 to 2015. We extracted from this database all patients with CLTI and tissue loss who had received a bypass to the peroneal artery...
July 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28754091/-visually-impaired-elderly-patient-ingests-pill-desiccant-leading-to-acute-hypoxic-respiratory-failure-requiring-intubation
#7
Wendy Gerstein, Ziyang Liu
BACKGROUND: A significant percentage of elderly patients suffer from both polypharmacy and visual impairment. This combination can increase the risk of an adverse event related to medication. This case highlights an unusual, but potentially deadly, medication adverse event. CASE PRESENTATION: A 77-year-old male, visually impaired, ingested a pill desiccant, believing it was the ampicillin/sulbactam tablet he was prescribed for an infected diabetic foot ulcer. He presented to the emergency room with inability to swallow, and imaging revealed the pill desiccant lodged in his upper esophagus...
July 28, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28740749/a-longitudinal-study-of-the-diabetic-skin-and-wound-microbiome
#8
Melissa Gardiner, Mauro Vicaretti, Jill Sparks, Sunaina Bansal, Stephen Bush, Michael Liu, Aaron Darling, Elizabeth Harry, Catherine M Burke
BACKGROUND: Type II diabetes is a chronic health condition which is associated with skin conditions including chronic foot ulcers and an increased incidence of skin infections. The skin microbiome is thought to play important roles in skin defence and immune functioning. Diabetes affects the skin environment, and this may perturb skin microbiome with possible implications for skin infections and wound healing. This study examines the skin and wound microbiome in type II diabetes. METHODS: Eight type II diabetic subjects with chronic foot ulcers were followed over a time course of 10 weeks, sampling from both foot skin (swabs) and wounds (swabs and debrided tissue) every two weeks...
2017: PeerJ
https://www.readbyqxmd.com/read/28736121/potential-of-circulatory-procalcitonin-as-a-biomarker-reflecting-inflammation-among-south-indian-diabetic-foot-ulcers
#9
Dhamodharan Umapathy, Sireesh Dornadula, Arvind Rajagopalan, Narayana Murthy, Vairamani Mariappanadar, Rajesh Kesavan, Ramkumar Kunka Mohanram
OBJECTIVE: Diabetic foot ulcer (DFU), the major complication associated with diabetes mellitus, has been shown to precede amputation in up to 90% of cases. Recent data reveal that procalcitonin (PCT) is a valid marker for the diagnosis of bacterial infections compared with traditional markers like white blood cell count, C-reactive protein levels, and erythrocyte sedimentation rate in DFU patients. Furthermore, cytokines are proposed to act as modulators and mediators for the expression and release of PCT into the circulation...
July 20, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28734103/levels-of-wound-calprotectin-and-other-inflammatory-biomarkers-aid-in-deciding-which-patients-with-a-diabetic-foot-ulcer-need-antibiotic-therapy-induce-study
#10
J R Ingram, S Cawley, E Coulman, C Gregory, E Thomas-Jones, T Pickles, R Cannings-John, N A Francis, K Harding, K Hood, V Piguet
AIMS: Deciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point-of-care tests. Four inflammatory biomarkers were investigated to develop a composite algorithm for mildly infected diabetic foot ulcers: venous white cell count, C-reactive protein (CRP) and procalcitonin, and a novel wound exudate calprotectin assay. Calprotectin is a marker of neutrophilic inflammation. METHODS: In a prospective study, people with uninfected or mildly infected diabetic foot ulcers who had not received oral antibiotics in the preceding 2 weeks were recruited from community podiatry clinics for measurement of inflammatory biomarkers...
July 22, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28733376/detection-of-osteomyelitis-in-the-diabetic-foot-by-imaging-techniques-a-systematic-review-and-meta-analysis-comparing-mri-white-blood-cell-scintigraphy-and-fdg-pet
#11
REVIEW
Chiara Lauri, Menno Tamminga, Andor W J M Glaudemans, Luis Eduardo Juárez Orozco, Paola A Erba, Paul C Jutte, Benjamin A Lipsky, Maarten J IJzerman, Alberto Signore, Riemer H J A Slart
OBJECTIVE: Diagnosing bone infection in the diabetic foot is challenging and often requires several diagnostic procedures, including advanced imaging. We compared the diagnostic performances of MRI, radiolabeled white blood cell (WBC) scintigraphy (either with (99m)Tc-hexamethylpropyleneamineoxime [HMPAO] or (111)In-oxine), and [(18)F]fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET)/computed tomography. RESEARCH DESIGN AND METHODS: We searched Medline and Embase as of August 2016 for studies of diagnostic tests on patients known or suspected to have diabetes and a foot infection...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28722354/risk-factors-for-amputation-in-patients-with-diabetic-foot-infection-a-prospective-study
#12
Serhat Uysal, Bilgin Arda, Meltem I Taşbakan, Şevki Çetinkalp, Ilgın Y Şimşir, Anıl M Öztürk, Ayşe Uysal, İlgen Ertam
There is a variety of diagnostic and therapeutic algorithms for diabetic foot infections (DFIs). Some of them are too difficult to be applied in routine clinical approach. In the routine clinical approach, it is necessary to find new risk factors and end up with a quick and easy assessment of DFIs. In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI...
July 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28718238/bacteriology-of-diabetic-foot-in-tertiary-care-hospital-frequency-antibiotic-susceptibility-and-risk-factors
#13
Syeda Sadia Amjad, Jamal Zafar, Nadia Shams
BACKGROUND: Diabetic foot being one of the frequent and disabling complications of diabetes. In view of widespread regional variation in causative organisms and antimicrobial susceptibility, the current study aimed to determine frequency of causative organisms, their antimicrobial susceptibility and associated risk factors. METHODS: This descriptive cross-sectional study was conducted in 6 months' duration at dept. of Medicine; PIMS Hospital Islamabad. Type 2 Diabetes mellitus patients with diabetic foot ulcer were enrolled after informed consent...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28716100/quality-of-life-and-clinical-radiological-long-term-results-after-implant-associated-infections-in-patients-with-ankle-fracture-a-retrospective-matched-pair-study
#14
Patrick Ziegler, Donat Schlemer, Ingo Flesch, Sonja Bahrs, Ulrich Stoeckle, Sebastian Werner, Christian Bahrs
BACKGROUND: Ankle fractures are frequently occurring injuries. Despite the relatively simple operative technique, patients often suffer from postoperative complications. Little is known about postoperative treatment of implant-associated infections of the ankle. Therefore, this study shows and evaluates a treatment algorithm in long- and short-term outcomes compared to infection-free patients. METHODS: Data from patients of over 20 years of a level 1 trauma center and university hospital was retrospectively analyzed including age, gender, comorbidities, smoking status, fracture classification, number of revisions, length of in-patient stay due to fracture and infection, and results of microbiological specimen with the length of antibiotic treatment...
July 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28715342/quantitative-evaluation-of-rehabilitation-effect-on-peripheral-circulation-of-diabetic-foot
#15
Yao-Kuang Huang, Chang-Cheng Chang, Pin-Xing Lin, Bor-Shyh Lin
Diabetics may encounter different foot problems, which easily lead to infection, ulcers, and increased risk of amputation due to nerve or vascular injury. In order to reduce the risk of amputation, Buerger's exercise is one of the frequently used rehabilitation to improve the blood circulation in the lower limbs. However, it is difficult to evaluate the rehabilitation efficiency of Buerger's exercise objectively. In this study, a novel non-invasively optical system was developed to non-invasively monitor the change of the foot blood circulation before and after long-term Buerger's exercise...
July 13, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28704149/amputation-predictors-in-diabetic-foot-ulcers-treated-with-hyperbaric-oxygen
#16
S T Kaplan, D Hemsinli, S Kaplan, A Arslan
OBJECTIVE: Although hyperbaric oxygen therapy (HBOT) has long been used for diabetic foot ulcers (DFUs), its effectiveness is still controversial. The aim of this study was to investigate the efficacy of HBOT in the management of DFUs and identify amputation predictors. METHOD: Patients with chronic DFUs (Wanger grade 2-5) were included in the study, which took place between January 2010 and December 2012. HBOT, 100% oxygen, 2.4 atmosphere absolute (ATA) for 120 minutes, was administered to all patients in addition to standard treatment...
July 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28697694/midterm-outcomes-from-a-pilot-study-of-percutaneous-deep-vein-arterialization-for-the-treatment-of-no-option-critical-limb-ischemia
#17
Steven Kum, Yih Kai Tan, Michiel A Schreve, Roberto Ferraresi, Ramon L Varcoe, Andrej Schmidt, Dierk Scheinert, Jihad A Mustapha, Darryl M Lim, Derek Ho, Tjun Y Tang, Vlad-Adrian Alexandrescu, Pramook Mutirangura
PURPOSE: To report the initial clinical experience with percutaneous deep vein arterialization (PDVA) to treat critical limb ischemia (CLI) via the creation of an arteriovenous fistula. METHODS: Seven patients (median age 85 years; 5 women) with CLI and no traditional endovascular or surgical revascularization options (no-option CLI) were recruited in a pilot study to determine the safety of PDVA. All patients were diabetic; 4 had Rutherford category 6 ischemia...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28696850/advanced-mr-imaging-techniques-for-differentiation-of-neuropathic-arthropathy-and-osteomyelitis-in-the-diabetic-foot
#18
Teodoro Martín Noguerol, Antonio Luna Alcalá, Luis S Beltrán, Marta Gómez Cabrera, Jordi Broncano Cabrero, Joan C Vilanova
Diagnosis and treatment of foot disease in patients with diabetes is a common clinical-radiologic challenge, particularly the differentiation of neuropathic arthropathy from osteomyelitis. Conventional clinical tests and imaging techniques have limited accuracy for evaluation of the diabetic foot. The introduction of morphologic magnetic resonance (MR) imaging in these patients has provided a qualitative leap in diagnosis. The characteristics of soft-tissue and bone marrow edema and their patterns of distribution throughout the foot allow discrimination between both entities...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28696493/total-contact-cast-system-to-heal-diabetic-foot-ulcers
#19
Brock Liden
Off-loadinga diabetic foot ulcer is a cornerstone of quality wound care for diabetic patients to allow cellular growth in the wound bed. While total contact casts (TCC) have been described as the gold standard for off-loading the wound, the complexity of application and the time commitment for both application and drying have discouraged health professionals from using them. This retrospective case series, conducted in a podiatric practice, evaluated using a TCC system that helps address the three components in which guidelines should be addressed when caring for a diabetic foot: V - vascular management, I - infection management and prevention, and P - pressure relief...
July 25, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28689936/results-of-one-stage-or-staged-amputations-of-lower-limbs-consequent-to-critical-limb-ischemia-and-infection
#20
Leandro Ramos Silva, Giordano Masini Fernandes, Natacha Ueda Morales, Marcone Lima Sobreira, Regina Moura, Matheus Bertanha, Winston Bonetti Yoshida
BACKGROUND: Amputations of lower limbs can be conducted as one-stage (OSA) or staged procedures (SA). OBJECTIVE: To analyze technical success and mortality rates of both techniques, as well as factors that might influence outcomes in patients with critical limb ischemia (CLI). METHODS: Retrospective study of 185 consecutive patients with CLI who underwent amputations in the period 2004-2011. Primary endpoints were rates of technical success (healing without dehiscence or reintervention), and mortality...
July 6, 2017: Annals of Vascular Surgery
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