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https://www.readbyqxmd.com/read/29785265/a-randomized-controlled-trial-of-the-safety-and-efficacy-of-a-topical-gentamicin-collagen-sponge-in-diabetic-patients-with-a-mild-foot-ulcer-infection
#1
Ilker Uçkay, Benjamin Kressmann, Sébastien Di Tommaso, Marina Portela, Heba Alwan, Hubert Vuagnat, Sophie Maître, Christophe Paoli, Benjamin A Lipsky
Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin-collagen sponge with local care versus local care alone...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29772673/reducing-amputations-in-people-with-diabetes-rapid-evaluation-of-a-new-care-pathway
#2
Sandra MacRury, Kate Stephen, Fiona Main, Jane Gorman, Sandra Jones, David Macfarlane
People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study...
May 16, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29725557/clinico-microbiological-profile-of-septic-diabetic-foot-with-special-reference-to-anaerobic-infection
#3
K Sasikumar, Chellappa Vijayakumar, Sadasivan Jagdish, Dharanipragada Kadambari, Nagarajan Raj Kumar, Rakhi Biswas, Subhash Chandra Parija
Introduction Diabetic foot infections are a major cause of non-traumatic amputations. The role of anaerobes in the prognosis of these infections is particularly unclear. This study was conducted with the aim of correlating microbiological profiles with clinical outcomes in these diabetic foot ulcer patients. Methodology This prospective observational study was done in a tertiary care centre in South India. All patients admitted with diabetic foot ulcers for two years were included in the study. Tissue biopsies were collected from the ulcer for aerobic and anaerobic cultures...
March 1, 2018: Curēus
https://www.readbyqxmd.com/read/29718816/a-post-marketing-surveillance-study-of-chronic-wounds-treated-with-a-native-collagen-calcium-alginate-dressing
#4
Matthew Sabo, Lam Le, Raphael A Yaakov, Marissa Carter, Thomas E Serena
Chronic wounds (ie, wounds that fail to progress through a normal, orderly, timely sequence of repair) continue to pose significant clinical and economic burdens. A prospective, descriptive, 3-week post-marketing surveillance study was conducted across 3 wound care centers in the United States to evaluate the effectiveness of a collagen calcium alginate dressing on chronic wounds in conjunction with standard care (SC) practices (eg, offloading, debridement, compression) to support healing. Eligible participants had to be >18 years of age, have at least 1 chronic wound, and no known sensitivity to collagen...
April 2018: Ostomy/wound Management
https://www.readbyqxmd.com/read/29714456/hand-infection-in-patients-with-diabetes-a-series-of-17-cases-and-a-pooled-analysis-of-the-literature
#5
Anıl Murat Öztürk, Serhat Uysal, Ilgın Yıldırım Şımşır, Hilmi Hüngör, Meltem Işıkgöz Taşbakan
Background/aim: The aim of this study was to report the clinical characteristics and the treatment outcomes of hand infections in diabetic patients and to review the literature. Materials and methods: The medical records of 17 patients with diabetic hand infections admitted to the Diabetic Foot Care Center of two different clinics from January 2012 to October 2017 were reviewed. To perform the pooled analysis, published series (32 studies) were searched in two international databases (www.scopus.com and www...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29713425/follow-up-of-mri-bone-marrow-edema-in-the-treated-diabetic-charcot-foot-a-review-of-patient-charts
#6
Ernst-A Chantelau, Sofia Antoniou, Brigitte Zweck, Patrick Haage
Background : Ill-defined areas of water-like signal on bone magnetic resonance imaging (MRI), characterized as bone marrow edema or edema-equivalent signal-changes (EESC), is a hallmark of active-stage pedal neuro-osteoarthropathy (Charcot foot) in painless diabetic neuropathy, and is accompanied by local soft-tissue edema and hyperthermia. The longitudinal effects on EESC of treating the foot in a walking cast were elucidated by reviewing consecutive cases of a diabetic foot clinic. Study design : Retrospective observational study, chart review Material and methods : Cases with active-stage Charcot foot were considered, in whom written reports on baseline and follow-up MRI studies were available for assessment...
2018: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29700554/platelet-rich-plasma-as-an-additional-therapeutic-option-for-infected-wounds-with-multi-drug-resistant-bacteria-in-vitro-antibacterial-activity-study
#7
Rıza Aytaç Çetinkaya, Ercan Yenilmez, Patrizio Petrone, Soner Yılmaz, Bayhan Bektöre, Berksan Şimsek, Tuğba Kula Atik, Mustafa Özyurt, Aytekin Ünlü
PURPOSE: Infected wounds, such as diabetic foot infections, are mostly polymicrobial and microorganisms have high resistance rates to antimicrobials. Infected wounds in diabetic patients have high cost, morbidity, and mortality rates. Based on these facts, there is a need for supportive localized treatment options such as platelet-rich plasma (PRP) implementations. Demonstrating the in vitro antimicrobial effect, our aim was to lead up to clinical trials of localized PRP implementations in infected wounds such as diabetic foot infections...
April 26, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29696678/barriers-to-foot-care-in-patients-with-diabetes-as-identified-by-healthcare-professionals
#8
C J W Pankhurst, M E Edmonds
AIMS: To seek the views of healthcare professionals as to the barriers to foot care that they perceive as having an impact on clinical outcomes and contributing to the number of amputations. METHODS: The study involved healthcare professionals from the UK attending our 2015 and 2016 Masterclass diabetic foot conferences. Admission to these conferences was open to all members of the multidisciplinary spectrum who provide care of people with diabetes and foot problems...
April 26, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29695061/use-of-leukocyte-platelet-l-prf-rich-fibrin-in-diabetic-foot-ulcer-with-osteomyelitis-three-clinical-cases-report
#9
Alessandro Crisci, Giuseppe Marotta, Anna Licito, Edda Serra, Giulio Benincasa, Michela Crisci
In this study, the use of fibrin rich in leukocytes and platelets (L-PRF) was explored to heal osteomyelitis ulcers in a diabetic foot. The goal was to standardize the utilization of L-PRF in patients with osteomyelitis to direct it for healing. L-PRF was obtained autologously from the peripheral blood of the diabetic patients ( n = 3) having osteomyelitis and skin lesions for at least six months. The L-PRF and supernatant serum were inserted into the skin lesion to the bone after a surgical debridement. The evolution of lesions over time was analyzed...
April 24, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29688043/the-clinical-value-of-diffusion-weighted-magnetic-resonance-imaging-in-diabetic-foot-infection
#10
Mehmet Ali Eren, Ekrem Karakaş, Ayşe Nur Torun, Tevfik Sabuncu
BACKGROUND: Osteomyelitis is a common complication in the diabetic foot which can be concluded with amputation. The purpose of this study was to evaluate the role of diffusion-weighted MRI (DWI) in the diagnosis of osteomyelitis in the diabetic foot ulcer (DFU). METHODS: Thirty patients with type 2 diabetes mellitus having DFU were enrolled. DWI and conventional MRI were obtained. Apparent Diffusion Coefficient (ADC) measurements were made by transferring the images to the workstation...
April 24, 2018: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29685567/minimally-invasive-treatment-of-ankle-fractures-in-patients-at-high-risk-of-soft-tissue-wound-healing-complications
#11
REVIEW
Sherif Mohamed Abdelgaid, Ahmed Fawaz Moursy, Eyad Abd Allah Elgebaly, Aly Mohamed Aboelenien
The complex nature of ankle fractures is magnified when seen in patients at high risk of soft tissue wound healing complications. The major categories include associated soft tissue injury, diabetes, tobacco use, peripheral vascular disease, malnutrition, alcoholism, and corticosteroid use. Because of the potential for wound dehiscence and infection with open reduction and internal fixation of ankle fractures in these patients, minimally invasive procedures have been described. The aims of the present study were to assess the possibility for, and evaluate the results and complications of, minimally invasive techniques for different types of malleolar fractures in high-risk patients...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29683538/effectiveness-of-viable-cryopreserved-placental-membranes-for-management-of-diabetic-foot-ulcers-in-a-real-world-setting
#12
Katherine M Raspovic, Dane K Wukich, Daniel Q Naiman, Lawrence A Lavery, Robert S Kirsner, Paul J Kim, John S Steinberg, Christopher E Attinger, Alla Danilkovitch
In a multicenter randomized controlled trial (RCT), the use of viable cryopreserved placental membrane (vCPM) for chronic diabetic foot ulcers (DFUs) resulted in a higher proportion of wound closure in comparison to good wound care: 62% vs. 21% (p < 0.01). However, patients in RCTs are not representative of daily physician practice. Healthcare databases serve as a valuable tool to evaluate therapy effectiveness and to supplement evidence from RCTs. The objective of this study was to evaluate the effectiveness of vCPM for DFU management using Net Health's WoundExpert® electronic health records (EHR)...
April 23, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29675434/the-role-of-serum-procalcitonin-interleukin-6-and-fibrinogen-levels-in-differential-diagnosis-of-diabetic-foot-ulcer-infection
#13
Pınar Korkmaz, Havva Koçak, Kevser Onbaşı, Polat Biçici, Ahmet Özmen, Cemile Uyar, Duru Mıstanoğlu Özatağ
Aims: We aimed to evaluate the roles of interleukin-6 (IL-6), PCT, and fibrinogen levels in the differential diagnosis of the patients with infected diabetic foot ulcer (IDFU) and noninfected diabetic foot ulcer (NIDFU) and to compare those with C-reactive protein (CRP), white blood cell (WBC), and erythrocyte sedimentation rate (ESR). Methods: Patients over 18 years with a diagnosis of type 2 diabetes mellitus and DFU who were followed up in our hospital between 1 January 2016 and 1 January 2017 were included in the study...
2018: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29651304/managing-diabetic-foot-infections-a-survey-of-australasian-infectious-diseases-clinicians
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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