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Diabetic foot infections

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https://www.readbyqxmd.com/read/27902390/virulence-determinants-in-clinical-staphylococcus-aureus-from-monomicrobial-and-polymicrobial-infections-of-diabetic-foot-ulcers
#1
Kavitha Shettigar, Spoorthi Jain, Deepika V Bhat, Raviraj Acharya, Lingadakai Ramachandra, Kapaettu Satyamoorthy, T S Murali
Antibiotic resistance in Staphylococcus aureus is a major public health concern and Methicillin Resistant S. aureus has emerged as an important pathogen. We characterized S. aureus isolates from monomicrobial and polymicrobial wound infections from 200 diabetic individuals with foot ulcers to understand their underlying diversity and pathogenicity. Staphylococcal Cassette Chromosome mec typing was performed and genes coding for production of biofilm, Panton-Valentine Leukocidin, Toxic Shock Syndrome Toxin, Leukotoxins DE and M were screened...
October 19, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27898266/methicillin-resistant-staphylococcus-aureus-in-foot-osteomyelitis
#2
Chester N Ashong, Shazia A Raheem, Andrew S Hunter, Cezarina Mindru, Neal R Barshes
BACKGROUND: Conflicting studies exist regarding the impact of methicillin-resistant Staphylococcus aureus (MRSA) on increased time to wound healing, future need for surgical procedures, and likelihood of treatment failure in patients with diabetic foot osteomyelitis. The purpose of this study is to determine the overall significance of MRSA in predicting treatment failure in bone infections of the foot and to determine an appropriate pre-operative and empiric post-operative antibiotic regimen...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27894749/the-microbiology-of-diabetic-foot-infections-in-patients-recently-treated-with-antibiotic-therapy-a-prospective-study-from-india
#3
Ashu Rastogi, Suja Sukumar, Abhishek Hajela, Soham Mukherjee, Pinaki Dutta, Sanjay Kumar Bhadada, Anil Bhansali
AIM: Clinicians often treat clinically infected diabetic foot ulcers without information from cultures of the wound. The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously treated patients with a clinically infected DFU. RESEARCH DESIGN AND METHODS: 293 consecutive patients with clinically infected DFU on prior antimicrobial treatment within the immediate past few days for a duration greater than one week were evaluated for microbial etiology, antibiotic sensitivity and final outcomes...
November 9, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27888847/mr-imaging-of-the-diabetic-foot
#4
REVIEW
Eoghan McCarthy, William B Morrison, Adam C Zoga
Abnormalities of the peripheral nervous, vascular, and immune systems contribute to the development of numerous foot and ankle pathologies in the diabetic population. Although radiographs remain the most practical first-line imaging tool, magnetic resonance (MR) is the tertiary imaging modality of choice, allowing for optimal assessment of bone and soft tissue abnormalities. MR allows for the accurate distinction between osteomyelitis/septic arthritis and neuropathic osteoarthropathy. Furthermore, it provides an excellent presurgical anatomic road map of involved tissues and devitalized skin to ensure successful limited amputations when required...
February 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/27888790/complication-assessment-and-prevention-strategies-using-midfoot-fusion-bolt-for-medial-column-stabilization-in-charcot-s-osteoarthropathy
#5
Alexander T Mehlhorn, Markus Walther, Niklas Iblher, Norbert P Südkamp, Hagen Schmal
In Charcot's osteoarthropathy stabilization of the medial column of the foot was introduced in order to establish a stable foot and reduce the risk for amputation. This study was performed to analyze postoperative complications, define risk factors for those and develop strategies for prevention. Since bolt dislocation takes place frequently, it was aimed to predict an appropriate time point for bolt removal under the condition that osseous healing has occurred. Fourteen consecutive patients with neuroosteoarthropathy of the foot and arch collapse were treated with open reduction and stabilization using midfoot fusion bolt and lateral lag screws...
November 4, 2016: Foot
https://www.readbyqxmd.com/read/27887858/predictive-value-of-neutrophil-to-lymphocyte-ratio-in-diabetic-wound-healing
#6
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Robert B McLafferty, Nabil J Alkayed, Gregory L Moneta, Amir F Azarbal
OBJECTIVE: The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds. METHODS: The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27865317/revisional-surgery-of-the-diabetic-charcot-foot-and-ankle
#7
REVIEW
Patrick R Burns, Spencer J Monaco
Charcot neuroarthropathy (CN) is a difficult problem for the foot and ankle surgeon. If surgery is required, little is known or available regarding the best methods and timing. When the initial attempt of reconstruction fails, revision of CN is even more demanding. One must take in to account all aspects, including nutrition, vascular status, infection control, short- and long-term blood glucose management, as well as other factors requiring laboratory monitoring and consult services. Once optimized, the biomechanics of the deformity can be addressed and decisions can be made on fixation devices...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865314/surgical-treatment-options-for-the-diabetic-charcot-midfoot-deformity
#8
REVIEW
Yousef Alrashidi, Thomas Hügle, Martin Wiewiorski, Mario Herrera-Perez, Victor Valderrabano
Management of diabetic Charcot midfoot deformity is one of the most demanding aspects of foot and ankle surgery. Its treatment should aim at reducing the rate of complications, including foot and ankle amputations or limb loss. Attempting reconstruction at Eichenholtz stages I and II carries the risk of infection and loss of fixation. It is advisable to limit surgical reconstruction to Eichenholtz stage III in the absence of any evidence of infection or vascular insufficiency. Achilles lengthening or gastrocnemius-soleus release is an essential initial step in surgery...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27846299/hyperglycemia-induces-skin-barrier-dysfunctions-with-impairment-of-epidermal-integrity-in-non-wounded-skin-of-type-1-diabetic-mice
#9
Junko Okano, Hideto Kojima, Miwako Katagi, Takahiko Nakagawa, Yuki Nakae, Tomoya Terashima, Takeshi Kurakane, Mamoru Kubota, Hiroshi Maegawa, Jun Udagawa
Diabetes causes skin complications, including xerosis and foot ulcers. Ulcers complicated by infections exacerbate skin conditions, and in severe cases, limb/toe amputations are required to prevent the development of sepsis. Here, we hypothesize that hyperglycemia induces skin barrier dysfunction with alterations of epidermal integrity. The effects of hyperglycemia on the epidermis were examined in streptozotocin-induced diabetic mice with/without insulin therapy. The results showed that dye leakages were prominent, and transepidermal water loss after tape stripping was exacerbated in diabetic mice...
2016: PloS One
https://www.readbyqxmd.com/read/27831638/aescin-based-topical-formulation-to-prevent-foot-wounds-and-ulcerations-in-diabetic-microangiopathy
#10
S Hu, G Belcaro, M Dugall, M Hosoi, S Togni, G Maramaldi, L Giacomelli
OBJECTIVE: Impairment of the peripheral microcirculation in diabetic patients often leads to severe complications in the lower extremities, such as foot infections and ulcerations. In this study, a novel aescin-based formulation has been evaluated as a potential approach to prevent skin breaks and ulcerations by improving the peripheral microcirculation and skin hydration. PATIENTS AND METHODS: In this registry study, 63 patients with moderate diabetic microangiopathy were recruited...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27827300/concordance-in-diabetic-foot-ulceration-a-cross-sectional-study-of-agreement-between-wound-swabbing-and-tissue-sampling-in-infected-ulcers
#11
E Andrea Nelson, Alexandra Wright-Hughes, Sarah Brown, Benjamin A Lipsky, Michael Backhouse, Moninder Bhogal, Mwidimi Ndosi, Catherine Reynolds, Gill Sykes, Christopher Dowson, Michael Edmonds, Peter Vowden, Edward B Jude, Tom Dickie, Jane Nixon
BACKGROUND: There is inadequate evidence to advise clinicians on the relative merits of swabbing versus tissue sampling of infected diabetic foot ulcers (DFUs). OBJECTIVES: To determine (1) concordance between culture results from wound swabs and tissue samples from the same ulcer; (2) whether or not differences in bacterial profiles from swabs and tissue samples are clinically relevant; (3) concordance between results from conventional culture versus polymerase chain reaction (PCR); and (4) prognosis for patients with an infected DFU at 12 months' follow-up...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27822727/handcrafted-vacuum-assisted-device-for-skin-ulcers-treatment-versus-traditional-therapy-randomized-controlled-trial
#12
Israel Gonzalez Gonzalez, Medina Andrade Luis Angel, Maria Valeria Jimenez Baez, Brenda Ruiz Flores, Maria de Los Angeles Martinez Ferretiz, Stephanny Vanestty Woolf, Israel López, Luis Sandoval-Jurado, Fany Guadalupe Pat-Espadas, Alan Alejandro Reyes Cruz, Arsenio Torres Delgado
BACKGROUND: Chronic lower limb ulcers constitute a public health problem, with important socioeconomic implications and high attention cost. This trial evaluates handcrafted vacuum-assisted therapy versus traditional treatment effectiveness for lower limbs ulcers. MATERIALS AND METHODS: It was a prospective randomized clinical trial conducted over 144 patients with lower limbs ulcers. Patients were randomized into two groups of 72 patients: Experimental group were treated with debridement, cure and a handcrafted vacuum-assisted device that was changed every 72 h...
November 7, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27821407/role-of-type-2-diabetes-in-determining-retinal-renal-and-cardiovascular-outcomes-in-women-with-previous-gestational-diabetes-mellitus
#13
Ravi Retnakaran, Baiju R Shah
OBJECTIVE: Women who have gestational diabetes mellitus (GDM) have elevated lifetime risks for the development of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), compared with their peers. However, it is not known whether their risk of CVD is dependent upon the development of T2DM. Thus, we sought to evaluate the role of T2DM in determining vascular outcomes in women with previous GDM. RESEARCH DESIGN AND METHODS: All women in Ontario, Canada, with a live-birth pregnancy between April 1994 and March 2014 (n = 1,515,079) were stratified into the following four groups: women with GDM in whom T2DM subsequently developed (n = 15,585, median age 32 years); those with GDM in whom T2DM did not develop (n = 41,299; median age 32 years); women who did not have GDM but in whom T2DM developed (n = 49,397; median age 31 years); and those with neither GDM nor T2DM (n = 1,408,798; median age 30 years)...
November 7, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27813064/factors-influencing-cure-rates-of-non-dermatophyte-mold-and-candida-onychomycosis-analysis-of-outcomes-in-81-patients-who-completed-treatment
#14
Ranthilaka R Ranawaka, S H Padmal de Silva
OBJECTIVES: Onychomycosis shows a poor response to current topical, oral, or device-related antifungal therapies. The aim of this study was to identify factors influencing the cure rates of non-dermatophyte mold and Candida onychomycosis. METHODS: Eighty-one patients who completed treatments were divided into "cured" and "non-cured" groups. The statistical significance of differences between the two groups was studied. RESULTS: Male gender (P < 0...
November 4, 2016: International Journal of Dermatology
https://www.readbyqxmd.com/read/27812455/kinetics-and-kinematics-of-diabetic-foot-in-type-2-diabetes-mellitus-with-and-without-peripheral-neuropathy-a-systematic-review-and-meta-analysis
#15
REVIEW
Animesh Hazari, Arun G Maiya, K N Shivashankara, Ioannis Agouris, Ashma Monteiro, Radhika Jadhav, Sampath Kumar, C G Shashi Kumar, Shreemathi S Mayya
BACKGROUND: Diabetes mellitus patients are at increased risk of developing diabetic foot with peripheral neuropathy, vascular and musculoskeletal complications. Therefore they are prone to develop frequent and often foot problems with a relative high risk of infection, gangrene and amputation. In addition, altered plantar pressure distribution is an important etiopathogenic risk factor for the development of foot ulcers. Thus the review on study of foot kinematic and kinetic in type 2 diabetes mellitus to understand the biomechanical changes is important...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27806820/purple-urine-bag-syndrome
#16
Luma Khalid, Iftikhar Ali, Khatira Wahid, Aziz Ullah Khan, Saima Fawad
Purple Urine Bag Syndrome (PUBS) refers to the purple discoloration of urine and is commonly observed in bed ridden patients with long-term urinary catheters. Although typically benign, the purple discoloration is alarming to both the patients and their attendants. This case report presents an uncommon case of PUBS in a 60-year-old lady with hypertension, type II diabetes, and chronic kidney disease stage 5, who presented to the emergency room with bilateral diabetic foot ulcers of 3 months duration, dry gangrene of ring finger and infected middle and little fingers with abscess over the palmar aspect of right hand of 20 days duration...
October 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27790114/bilateral-necrotizing-fasciitis-of-the-foot-associated-with-group-b-streptococcus
#17
Keitaro Fukuda, Misao Ryujin, Reiko Sakio, Satoshi Fukuzumi, Takanori Omae, Kazuhito Hayakawa
Necrotizing fasciitis (NF) is a severe bacterial infection involving fascia and subcutaneous tissue. It generally affects upper or lower extremities unilaterally, and there are few reports of bilateral-extremity NF. Here, we report a case of a 43-year-old male with type 1 diabetes who had NF on the left foot and subsequently developed NF on the other foot 1 week later. The patient survived with antimicrobial therapy and bilateral below-knee amputation. As group B streptococcus (GBS) was isolated by blood culture and culture of excised tissues of both feet, bilateral GBS NF of the foot was diagnosed...
September 2016: Case Reports in Dermatology
https://www.readbyqxmd.com/read/27770835/localization-of-human-adipose-derived-stem-cells-and-their-effect-in-repair-of-diabetic-foot-ulcers-in-rats
#18
Rongfeng Shi, Yinpeng Jin, Chuanwu Cao, Shilong Han, Xiaowen Shao, Lingyu Meng, Jie Cheng, Meiling Zhang, Jiayi Zheng, Jun Xu, Maoquan Li
BACKGROUND: Diabetic foot ulcer (DFU) is an intractable diabetic complication. Patients suffering from diabetes mellitus (DM) frequently present with infected DFUs. In this study, a wound healing model on diabetic rat foot was established to mimic the pathophysiology of clinical patients who suffer from DFUs. Our study aimed to explore the localization of human adipose-derived stem cells (hADSCs) and the role of these cells in the repair of foot ulcerated tissue in diabetic rats, and thus to estimate the possibilities of adipose-derived stem cells for diabetic wound therapy...
October 22, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/27755049/fabrication-of-waterproof-breathable-composite-liquid-dressing-and-its-application-in-diabetic-skin-ulcer-repair
#19
Dong-Lin Xia, Yan-Pei Chen, Yu-Fei Wang, Xiao-Dong Li, Ning Bao, Hong He, Hai-Ying Gu
OBJECTIVES: Diabetic patients are at increased risk of severe skin infections. Covering the wound as early as possible can prevent infection and shorten the course of treatment. In this study, the authors fabricated a waterproof and breathable composite liquid dressing (CLD) that formed a barrier to bacteria and shortened healing time of diabetic rat skin ulcers. METHODS: The CLD was prepared in a formulation that, on evaporation of the liquid carrier, acts as a waterproof, breathable coating on injured skin...
November 2016: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/27753002/clinical-determinants-of-target-non-attainment-of-linezolid-in-plasma-and-interstitial-space-fluid-a-pooled-population-pharmacokinetic-analysis-with-focus-on-critically-ill-patients
#20
Iris K Minichmayr, André Schaeftlein, Joseph L Kuti, Markus Zeitlinger, Charlotte Kloft
OBJECTIVES: We aimed to assess linezolid pharmacokinetics in the plasma and interstitial space fluid (ISF) of patients with sepsis, diabetic foot infections or cystic fibrosis and healthy volunteers. The impacts of joint characteristics and disease on plasma and target-site exposure were to be identified together with the benefit of dose intensification in critically ill patients. METHODS: Rich plasma (n = 1598) and ISF concentrations in subcutaneous adipose (n = 1430) and muscle tissue (n = 1089) measured by microdialysis were pooled from three clinical trials with 51 individuals receiving 600 mg of intravenous and oral linezolid...
October 17, 2016: Clinical Pharmacokinetics
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