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Diabetic foot infections

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https://www.readbyqxmd.com/read/29651304/managing-diabetic-foot-infections-a-survey-of-australasian-infectious-diseases-clinicians
#1
Robert J Commons, Edward Raby, Eugene Athan, Hasan Bhally, Sharon Chen, Stephen Guy, Paul R Ingram, Katy Lai, Chris Lemoh, Lyn-Li Lim, Laurens Manning, Spiros Miyakis, Mary O'Reilly, Adam Roberts, Marjoree Sehu, Adrienne Torda, Mauro Vicaretti, Peter A Lazzarini
Background: Diabetic foot infections (DFI) present a major morbidity, mortality and economic challenge for the tertiary health sector. However, lack of high quality evidence for specific treatment regimens for patients with DFIs may result in inconsistent management. This study aimed to identify DFI caseload proportion and patterns of clinical practice of Infectious Diseases (ID) Physicians and Trainees within Australia and New Zealand. Methods: A cross-sectional online survey of Australian and New Zealand ID Physicians and Trainees was undertaken, to estimate the overall ID caseload devoted to patients with DFIs and assess clinicians' management practices of patients with DFIs...
2018: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29651102/exosomes-from-adipose-derived-stem-cells-overexpressing-nrf2-accelerate-cutaneous-wound-healing-by-promoting-vascularization-in-a-diabetic-foot-ulcer-rat-model
#2
Xue Li, Xiaoyun Xie, Weishuai Lian, Rongfeng Shi, Shilong Han, Haijun Zhang, Ligong Lu, Maoquan Li
Diabetic foot ulcers (DFU) increase the risks of infection and amputation in patients with diabetes mellitus (DM). The impaired function and senescence of endothelial progenitor cells (EPCs) and high glucose-induced ROS likely exacerbate DFUs. We assessed EPCs in 60 patients with DM in a hospital or primary care setting. We also evaluated the therapeutic effects of exosomes secreted from adipose-derived stem cells (ADSCs) on stress-mediated senescence of EPCs induced by high glucose. Additionally, the effects of exosomes and Nrf2 overexpression in ADSCs were investigated in vitro and in vivo in a diabetic rat model...
April 13, 2018: Experimental & Molecular Medicine
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
#3
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
#4
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/29622357/the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-independently-predicts-wound-healing-in-diabetic-foot-ulcers
#5
Caitlin W Hicks, Joseph K Canner, Nestoras Mathioudakis, Ronald Sherman, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Previous studies have reported correlation between the Wound, Ischemia, and foot Infection (WIfI) classification system and wound healing time on unadjusted analyses. However, in the only multivariable analysis to date, WIfI stage was not predictive of wound healing. Our aim was to examine the association between WIfI classification and wound healing after risk adjustment in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. METHODS: All patients presenting to our multidisciplinary DFU clinic from June 2012 to July 2017 were enrolled in a prospective database...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29621304/trends-in-congenital-anomalies-in-europe-from-1980-to-2012
#6
Joan K Morris, Anna L Springett, Ruth Greenlees, Maria Loane, Marie-Claude Addor, Larraitz Arriola, Ingeborg Barisic, Jorieke E H Bergman, Melinda Csaky-Szunyogh, Carlos Dias, Elizabeth S Draper, Ester Garne, Miriam Gatt, Babak Khoshnood, Kari Klungsoyr, Catherine Lynch, Robert McDonnell, Vera Nelen, Amanda J Neville, Mary O'Mahony, Anna Pierini, Annette Queisser-Luft, Hanitra Randrianaivo, Judith Rankin, Anke Rissmann, Jennifer Kurinczuk, David Tucker, Christine Verellen-Dumoulin, Diana Wellesley, Helen Dolk
BACKGROUND: Surveillance of congenital anomalies is important to identify potential teratogens. METHODS: This study analysed the prevalence of 61 congenital anomaly subgroups (excluding chromosomal) in 25 population-based EUROCAT registries (1980-2012). Live births, fetal deaths and terminations of pregnancy for fetal anomaly were analysed with multilevel random-effects Poisson regression models. RESULTS: Seventeen anomaly subgroups had statistically significant trends from 2003-2012; 12 increasing and 5 decreasing...
2018: PloS One
https://www.readbyqxmd.com/read/29617058/multicenter-randomized-controlled-observer-blinded-study-of-a-nitric-oxide-generating-treatment-in-foot-ulcers-of-patients-with-diabetes-pronox1-study
#7
Michael E Edmonds, Harvey J Bodansky, Andrew Jm Boulton, Paul J Chadwick, Cuong N Dang, Ryan D'Costa, Atholl Johnston, Brian Kennon, Graham Leese, Satyan M Rajbhandari, Thomas E Serena, Matthew J Young, Joanne E Stewart, Arthur T Tucker, Marissa J Carter
The aim of this multi-center, prospective, observer-blinded, parallel group, randomized controlled trial was to assess the safety and efficacy of EDX110, a nitric oxide generating medical device, in the treatment of diabetic foot ulcers in a patient group reflecting "real world" clinical practice compared against optimal standard care. Participants were recruited from ten hospital sites in multidisciplinary foot ulcer clinics. The ulcers were full thickness, with an area of 25-2500mm2 and either a palpable pedal pulse or ankle brachial pressure index >0...
April 4, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29611155/managing-the-diabetic-foot-ulcer-how-best-practices-fit-the-real-2018-united-states
#8
Nicole Ilonzo, Munir Patel, John C Lantis
Diabetes Mellitus is a serious systemic illness that has an epidemic-like increasing prevalence in the United States, as well as the rest of the world. With the increasing number of people with diabetes comes the higher incidence of diabetes-related complications. One of these known complications, diabetic foot ulcers (DFU), has an estimated lifetime incidence of 15% in diabetics. Having a DFU increases the risk of infection, amputation, and even death, which is why prompt treatment and surveillance of such ulcers is imperative...
March 29, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29604389/effects-of-sodium-glucose-cotransporter-2-inhibitors-on-cardiovascular-disease-death-and-safety-outcomes-in-type-2-diabetes-a-systematic-review
#9
REVIEW
Karin Rådholm, Jason Hy Wu, Muh Geot Wong, Celine Foote, Gregory Fulcher, Kenneth W Mahaffey, Vlado Perkovic, Bruce Neal
AIM: Sodium glucose co-transporter 2 (SGLT2) inhibitors appear to protect against increased risks of cardiovascular and kidney disease in patients with type 2 diabetes but also cause some harms. Whether effects are comparable across drug class or specific to individual compounds is unclear. This meta-analysis assessed the class and individual compound effects of SGLT2 inhibition versus control on cardiovascular events, death, kidney disease and safety outcomes in patients with type 2 diabetes...
March 28, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29595900/a-perioperative-approach-to-increase-limb-salvage-when-treating-foot-ulcers-in-patients-with-diabetes
#10
Raelina S Howell, Theresa Criscitelli, Jon S Woods, Brian M Gillette, Harold Brem, Scott Gorenstein
Foot ulceration in patients with diabetes increases the risk of lower extremity amputation. Major amputations produce substantial adverse consequences, increase length of hospital stay, diminish quality of life, and increase mortality. In this article, we describe approaches that decrease amputations and improve the quality of life for patients with diabetes and foot ulcers. We highlight the role of the perioperative nurse, who is essential to providing optimal patient care in the perioperative period. Perioperative care of patients with diabetes involves providing optimal surveillance for a break in the skin of the foot, screening for neuropathy, following guidelines for foot ulcer infections, preparing for pathophysiology-based debridement, using adjuvant therapies, and offloading the patient's affected foot...
April 2018: AORN Journal
https://www.readbyqxmd.com/read/29592981/burn-aggravated-infected-wart-in-a-patient-with-type-2-diabetes-a-medical-challenge
#11
Tahseen Ahmed Khan, Mahmood Sheikh, Iqbal Azher, Abdul Khaliq Sheikh
An infectious wart of foot in a patient with diabetics is a medical challenge, and it gets worse when aggravated with burns. We present a case of a 67-year-old Pakistani man, diabetic for 20 years presented at our healthcare centre. While awaiting his culture sensitivity report, he was prescribed an empiric antibiotic therapy. Patient then travelled to Saudi Arabia for pilgrimage 3 days later with growth of Staphylococcus aureus and Proteus species in culture and sensitivity report; during his travel, he walked barefoot and the infected wart aggravated with severe burn...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29580872/molecular-and-culture-based-assessment-of-bacterial-pathogens-in-subjects-with-diabetic-foot-ulcer
#12
Saba Noor, Alok Raghav, Iqbal Parwez, Maaz Ozair, Jamal Ahmad
INTRODUCTION: Expeditious and precise discerning of bacterial pathogens is a fundamental grail, of clinical diagnostic microbiology. Genotypic detection is a budding substitute to recognize phenotypic culture based processes in bacterial identification. AIMS: We report a comparative evaluation of biochemical and genomic-based assays for exploring the commonest bacterial flora of infected diabetic foot ulcers along with clinical variables of subjects enrolled. METHODS: The pathogens selected (i) Staphylococcus aureus ii) Pseudomonas aeruginosa, iii) Escherichia coli and iv) Klebsiella pneumonia, stood for the most frequent isolates of diabetic foot infection in previous studies from Northern India...
March 16, 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/29569418/monitoring-of-ph-and-temperature-of-neuropathic-diabetic-and-non-diabetic-foot-ulcers-for-12-weeks-an-observational-study
#13
G Gethin, G M O'Connor, J Abedin, J Newell, L Flynn, D Watterson, A O'Loughlin
Wound bed assessment is largely reliant on subjective interpretation without recourse to objective tools or biomarkers. The identification of a point of care, reliable biomarker would enhance assessment and ultimately clinical decision-making. Two potentially emerging wound biomarkers exist: surface pH and surface temperature. To date, knowledge of their use has been predominantly in wound prevention, in vitro studies and single time measurements. Our objective was to determine surface pH, size and surface temperature in non-infected, neuropathic foot ulcers at baseline and at 12 weeks...
March 22, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29564946/virulence-factor-genes-in-staphylococcus-aureus-isolated-from-diabetic-foot-soft-tissue-and-bone-infections
#14
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/29561340/validation-of-the-healthy-foot-screen-a-novel-assessment-tool-for-common-clinical-abnormalities
#15
Reneeka Persaud, Patricia M Coutts, Alisa Brandon, Luvneet Verma, James A Elliott, R Gary Sibbald
GENERAL PURPOSE: The purpose of this learning activity is to provide information about the Healthy Foot Screen, a new tool for assessment of common foot abnormalities. 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 completing this continuing education activity, you should be able to:1...
April 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29547034/effects-of-ph-on-the-antibiotic-resistance-of-bacteria-recovered-from-diabetic-foot-ulcer-fluid-an-in-vitro-study
#16
Carla D McArdle, Katie M Lagan, David A McDowell
BACKGROUND: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs...
January 2018: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29544659/cost-of-diabetic-foot-in-france-spain-italy-germany-and-united-kingdom-a-systematic-review
#17
Huidi Tchero, Pauline Kangambega, Lucien Lin, Martin Mukisi-Mukaza, Solenne Brunet-Houdard, Christine Briatte, Gerald Reparate Retali, Emmanuel Rusch
AIM: Cost estimates for diabetic foot are available for developed countries based on cost data for different years. This study aimed to provide a comparison of the cost of diabetic foot in E5 (France, Spain, Italy, Germany, and the United Kingdom) and its characteristics across different conditions. METHODS: PubMed, Central and Embase databases were searched in February 2017 for English language publications. Bibliographies of relevant papers were also searched manually...
March 12, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29525792/new-insights-into-classification-epidemiology-and-microbiology-of-sstis-including-diabetic-foot-infections
#18
Silvano Esposito, Silvana Noviello, Francesco De Caro, Giovanni Boccia
Skin and soft tissue infections (SSTIs) involve a heterogeneous group of entities with different clinical presentations classified according to several specific criteria. Because of their great variability, their incidence and prevalence is difficult to accurately determine. Yet it is generally thought that the rate of SSTIs is globally increasing due to an aging population, strictly associated with the increase in the number of critical and immunocompromised patients. The aetiology of SSTIs is also extremely variable, reflecting the noteworthy heterogeneity of their clinical presentations and their epidemiology...
March 1, 2018: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/29521041/computerized-planimetry-evaluation-of-hyperbaric-oxygen-therapy-in-the-treatment-of-diabetic-foot
#19
Marek Kawecki, Jarosław Pasek, Grzegorz Cieślar, Aleksander Sieroń, Grzegorz Knefel, Mariusz Nowak, Justyna Glik
BACKGROUND: Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. OBJECTIVES: The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. MATERIAL AND METHODS: The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29512223/pseudomonas-aeruginosa-infection-alters-the-macrophage-phenotype-switching-process-during-wound-healing-in-diabetic-mice
#20
Sinuo Chen, Renren Li, Chun Cheng, Jing-Ying Xu, Caixia Jin, Furong Gao, Juan Wang, Jieping Zhang, Jingfa Zhang, Hong Wang, Lixia Lu, Guo-Tong Xu, Haibin Tian
Macrophages play critical roles in wound healing process. They switch from "classically activated" (M1) phenotype in the early inflammatory phase to "alternatively activated" (M2) phenotype in the later healing phase. However, the dynamic process of macrophage phenotype switching in diabetic wounds burdened with bacteria is unclear. In this report, Pseudomonas aeruginosa, frequently detected in diabetic foot ulcers, was inoculated into cutaneous wounds of db/db diabetic mice to mimic bacterium-infected diabetic wound healing...
March 7, 2018: Cell Biology International
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