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https://www.readbyqxmd.com/read/28813728/-amputation-of-the-lower-limb-treatment-and-management
#1
Tim Ramczykowski, Thomas A Schildhauer
Despite modern conservative and surgical procedures, the number of amputations of the lower limb remains at a consistently high level. With the demographic changes and the consequent prevalence of atherosclerosis and diabetes mellitus, there is a steady increase of the risk factors that can lead to an amputation. The cause, which ultimately leads to the loss of the affected limb is therefore a symptom of the underlying disease. Primarily, the purpose of any medical treatment is the prevention of any amputation...
August 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28806350/blood-pressure-variability-is-increasing-from-the-first-to-the-second-day-of-the-interdialytic-interval-in-hemodialysis-patients
#2
Antonios Karpetas, Charalampos Loutradis, Athanasios Bikos, Georgios Tzanis, Georgios Koutroumpas, Antonios A Lazaridis, Konstantinos Mavromatidis, Vassilios Liakopoulos, Aikaterini Papagianni, Pantelis Zebekakis, Luis M Ruilope, Gianfranco Parati, Pantelis A Sarafidis
OBJECTIVES: Patients with end-stage renal-disease under hemodialysis have increased cardiovascular risk and experience severe blood pressure (BP) fluctuations during the dialysis session and the subsequent interdialytic period. BP variability (BPV) may be an additional risk factor for cardiovascular events and preliminary data suggest increased BPV with advancing stages of chronic kidney disease. This is the first study to examine BPV during the whole intradialytic and interdialytic period in hemodialysis patients with ambulatory BP monitoring...
August 12, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28805289/identifying-and-assessing-strategies-for-evaluating-the-impact-of-mobile-eye-health-units-on-health-outcomes
#3
REVIEW
Shiwan Fu, Angus Turner, Irene Tan, Josephine Muir
OBJECTIVE: To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. DESIGN: Systematic literature review. SETTING: Worldwide. PARTICIPANTS: Peer-reviewed journal articles that included the use of a mobile eye health unit. MAIN OUTCOME MEASURE(S): Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes...
August 14, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28804995/assessing-the-need-for-arthritis-training-among-paid-carers-in-uk-residential-care-homes-a-focus-group-and-interview-study
#4
Paul Whybrow, Suzanne Moffatt, Lesley Kay, Ben Thompson, Terry Aspray, Rachel Duncan
OBJECTIVE: The aim of the study was to perform an educational and training needs assessment for arthritis care in residential homes. METHODS: Qualitative data were collected from three purposively selected residential homes: one independent, one in a regional chain and one in a national chain. Three researcher-led focus groups were conducted with paid carers (N = 22) using vignette exercises; interviews were undertaken with 12 residents with joint pain (N = 12), five managerial staff and two general practitioners (GPs)...
August 14, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28804542/significant-association-of-trem-1-with-hmgb1-tlrs-and-rage-in-the-pathogenesis-of-insulin-resistance-in-obese-diabetic-populations
#5
Saravanan Subramanian, Pradeep K Pallati, Poonam Sharma, Devendra K Agrawal, Kalyana C Nandipati
Activated cell surface and intracellular receptors lead to insulin resistance in obesity. Among these receptors, triggering receptors expressed on myeloid cells (TREM)-1, toll like receptors (TLRs), and receptors for advanced glycation end products (RAGE) play a significant role in the induction of inflammatory response in innate immunity. TREM-1 potentially amplifies TLRs and RAGE synergistically with DNA-binding high-mobility group box 1 (HMGB-1). The objective of the study was to analyze the association between TREM-1/DAP12 and HMGB-1, RAGE and TLRs in obesity-induced insulin resistance...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28802699/relationship-between-limited-joint-mobility-of-hand-and-carotid-atherosclerosis-in-patients-with-type-2-diabetes
#6
Yusuke Mineoka, Michiyo Ishii, Yoshitaka Hashimoto, Muhei Tanaka, Naoto Nakamura, Yasukazu Katsumi, Motohide Isono, Michiaki Fukui
AIM: Limited joint mobility (LJM) of hand, which is one of a complication of diabetic hand, has a close association with diabetic microangiopathy. However, it remains to be elucidated about the relationships between LJM of hand and subclinical atherosclerosis in patients with type 2 diabetes. Therefore, we conducted a cross-sectional study to evaluate the relationships between LJM of hand and carotid intima-media thickness (IMT) and plaque score in patients with type 2 diabetes. METHODS: We evaluated the relationships between LJM of hand, and carotid IMT and plaque score, evaluated by carotid ultrasound examination, in 341 consecutive patients with type 2 diabetes...
July 20, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28802220/comparison-of-lower-limb-muscle-strength-between-diabetic-neuropathic-and-healthy-subjects-using-opensim
#7
Alessandra Scarton, Ilse Jonkers, Annamaria Guiotto, Fabiola Spolaor, Gabriella Guarneri, Angelo Avogaro, Claudio Cobelli, Zimi Sawacha
Diabetes neuropathy and vasculopathy are the two major complications of diabetes mellitus, leading to diabetic foot disease, of which the worst consequences are plantar ulcers and amputations. Motor impairments like joint stiffness and loss of balance are distinctive effects of diabetes and they have been extensively explored. However, while altered muscle function has been also assessed through experimentally measured surface electromyography, little is known about muscle forces. The objective of this study was to estimate muscle forces in subjects with diabetes and to use these data to identify differences with respect to a population of healthy subjects matched for age and BMI...
July 31, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28801393/protocol-for-the-mwellcare-trial-a-multicentre-cluster-randomised-12-month-controlled-trial-to-compare-the-effectiveness-of-mwellcare-an-mhealth-system-for-an-integrated-management-of-patients-with-hypertension-and-diabetes-versus-enhanced-usual-care-in-india
#8
Dilip Jha, Priti Gupta, Vamadevan S Ajay, Devraj Jindal, Pablo Perel, David Prieto-Merino, Pramod Jacob, Jonathan Nyong, Vidya Venugopal, Kavita Singh, Shifalika Goenka, Ambuj Roy, Nikhil Tandon, Vikram Patel, Dorairaj Prabhakaran
INTRODUCTION: Rising burden of cardiovascular disease (CVD) and diabetes is a major challenge to the health system in India. Innovative approaches such as mobile phone technology (mHealth) for electronic decision support in delivering evidence-based and integrated care for hypertension, diabetes and comorbid depression have potential to transform the primary healthcare system. METHODS AND ANALYSIS: mWellcare trial is a multicentre, cluster randomised controlled trial evaluating the clinical and cost-effectiveness of a mHealth system and nurse managed care for people with hypertension and diabetes in rural India...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28798347/tonebp-nfat5-haploinsufficiency-attenuates-hippocampal-inflammation-in-high-fat-diet-streptozotocin-induced-diabetic-mice
#9
Jong Youl Lee, Eun Ae Jeong, Kyung Eun Kim, Chin-Ok Yi, Zhen Jin, Jung Eun Lee, Dong Hoon Lee, Hyun Joon Kim, Sang Soo Kang, Gyeong Jae Cho, Wan Sung Choi, Soo Youn Choi, H Moo Kwon, Gu Seob Roh
Recent studies have shown that overexpression of tonicity-responsive enhancer binding protein (TonEBP) is associated with many inflammatory diseases, including diabetes mellitus, which causes neuroinflammation in the hippocampus as well as hepatic steatosis. However, the exact mechanism in diabetic neuroinflammation is unknown. We report that haploinsufficiency of TonEBP inhibits hepatic and hippocampal high-mobility group box-1 (HMGB1) expression in diabetic mice. Here, mice were fed a high-fat diet (HFD) for 16 weeks and received an intraperitoneal injection of 100 mg/kg streptozotocin (STZ) and followed by continued HFD feeding for an additional 4 weeks to induce hyperglycemia and hepatic steatosis...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28795577/understanding-the-emergence-and-development-of-medical-collaboration-across-organizational-boundaries-a-longitudinal-case-study
#10
Nassera Touati, Charo Rodríguez, Marie-Andrée Paquette, Jean-Louis Denis
Our goal in this investigation was to help shed light on the very difficult process of collaboration between family physicians and specialists working at different levels of healthcare delivery. More precisely, and grounded on Giddens' structuration theory, our investigation aims to understand how medical collaboration emerges and develops around chronic patients. This was a longitudinal interpretive case study, the "case" being a continuum-of-care for patients suffering from diabetes, put in place in an urban health center in the Canadian province of Quebec...
August 1, 2017: Health (London)
https://www.readbyqxmd.com/read/28790131/a-team-based-online-game-improves-blood-glucose-control-in-veterans-with-type-2-diabetes-a-randomized-controlled-trial
#11
B Price Kerfoot, David R Gagnon, Graham T McMahon, Jay D Orlander, Katherine E Kurgansky, Paul R Conlin
OBJECTIVE: Rigorous evidence is lacking whether online games can improve patients' longer-term health outcomes. We investigated whether an online team-based game delivering diabetes self-management education (DSME) to patients via e-mail or mobile app can generate longer-term improvements in hemoglobin A1c (HbA1c). RESEARCH DESIGN AND METHODS: Patients (n = 456) on oral diabetes medications with HbA1c ≥58 mmol/mol were randomly assigned between a DSME game (with a civics booklet) and a civics game (with a DSME booklet)...
August 8, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28789654/serum-high-mobility-group-box-1-and-osteoprotegerin-levels-are-associated-with-peripheral-arterial-disease-and-critical-limb-ischemia-in-type-2-diabetic-subjects
#12
Silvia Giovannini, Giovanni Tinelli, Federico Biscetti, Giuseppe Straface, Flavia Angelini, Dario Pitocco, Luciana Mucci, Raffaele Landolfi, Andrea Flex
BACKGROUND: High mobility group box-1 (HMGB-1) is a nuclear protein also acting as inflammatory mediator, whilst osteoprotegerin (OPG), member of tumor necrosis factor receptor superfamily, is indicated as marker of vascular calcification. Peripheral artery disease (PAD) and type 2 diabetes (T2D) are clinical conditions characterized by elevated serum inflammatory markers and vascular calcification enhancement. The aim of this study was to investigate the potential role of HMGB-1, OPG and several inflammatory mediators such as C-reactive protein (HsCRP), tumor necrosis factor-alpha and interleukin-6 (IL-6) on the presence and severity of peripheral artery disease in patients with T2D...
August 8, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28783870/cxcr4-antagonist-delivery-on-decellularized-skin-scaffold-facilitates-impaired-wound-healing-in-diabetic-mice-by-increasing-expression-of-sdf-1-and-enhancing-migration-of-cxcr4-positive-cells
#13
Hao Liu, Hanping Liu, Xiaoyuan Deng, Maosheng Chen, Xue Han, Wenxia Yan, Ning Wang
C-X-C chemokine receptor type 4 (CXCR4) is an alpha-chemokine receptor specific for stromal cell-derived factor 1 (SDF-1 also called CXCL12). The antagonist of CXCR4 can mobilize CD34+ cells and hematopoietic stem cells from bone marrow within several hours, and it has an efficacy on diabetes ulcer through acting on the SDF-1/CXCR4 axis. In this study, we investigated for the first time whether the antagonist of CXCR4 (Plerixafor/AMD3100) delivered on acellular dermal matrix (ADM) may accelerate diabetes-impaired wound healing...
June 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28779822/impairments-in-skin-integrity
#14
REVIEW
Rose W Murphree
Altered skin integrity increases the chance of infection, impaired mobility, and decreased function and may result in the loss of limb or, sometimes, life. Skin is affected by both intrinsic and extrinsic factors. Intrinsic factors can include altered nutritional status, vascular disease issues, and diabetes. Extrinsic factors include falls, accidents, pressure, immobility, and surgical procedures. Ensuring skin integrity in the elderly requires a team approach and includes the individual, caregivers, and clinicians...
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28774253/predictors-of-outcomes-following-fasciectomy-for-dupuytren-s-disease-in-diabetic-and-non-diabetic-patients
#15
Eitan Melamed, Bryan G Beutel, Shaul Goldstein, David Angel
BACKGROUND: The aim of this study was to compare clinical outcomes, and identify predictors thereof, after fasciectomy for Dupuytren's disease in a series of diabetic patients compared with non-diabetic patients. METHODS: Thirty-eight patients were examined following partial palmar and/or digital fasciectomy for Dupuytren's disease (11 diabetics, 27 non-diabetics). Each patient was assessed for degree of pre- and post-operative flexion contractures at the MCP and PIP joints, post-operative Patient Evaluation Measure (PEM) total score, post-operative grip strength, limited joint mobility (LJM), recurrence, extension, and a composite outcomes score based upon grip strength and the degree of joint contractures...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28768935/predictors-of-quality-of-life-improvement-after-2-years-of-coronary-artery-bypass-surgery
#16
Vladan Peric, Radojica Stolic, Aleksandar Jovanovic, Rade Grbic, Bratislav Lazic, Sasa Sovtic, Milorad Borzanovic
PURPOSE: The aim was to examine the predictors of improvement of quality of life after 2 years of coronary artery bypass grafting (CABG). METHODS: In all, 208 patients who underwent the elective CABG at the Institute for Cardiovascular Diseases Dedinje in Belgrade were contacted and examined 2 years after the surgery. All patients completed Nottingham Health Profile Questionnaire part one. RESULTS: Two years after CABG, quality of life (QOL) in patients was significantly improved in all sections compared to preoperative period...
August 1, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28765261/burden-of-child-and-adolescent-obesity-on-health-services-in-england
#17
Russell M Viner, Sanjay Kinra, Dasha Nicholls, Tim Cole, Anthony Kessel, Deborah Christie, Billy White, Helen Croker, Ian C K Wong, Sonia Saxena
OBJECTIVE: To assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England. DESIGN: Pathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data. SETTING: Data on CYP aged 2-18 years from the Health Survey for England 2006 to 2013. MAIN OUTCOME MEASURES: Clinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99...
August 1, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28762209/a-mapping-study-on-mobile-games-for-patients-of-chronic-diseases
#18
Kévin Cardoso de Sá, Márcio Garcia Martins, Cristiano André da Costa, Jorge Luis Victoria Barbosa, Rodrigo da Rosa Righi
There is a growing interest of using technologies to propose solutions for healthcare issues. One of such issues is the incidence of chronic diseases, which are responsible for a considerable proportion of worldwide mortality. It is possible to prevent the development of such diseases using tools and methods that instruct the population. To achieve this, mobile games provide a powerful environment for teaching different subjects to user, without them actively knowing that they are learning new concepts. Despite the growing interest of using mobile games in healthcare, more specifically by patients with chronic diseases, in the best of our knowledge there are no studies that address the current research being published in the area...
September 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28760680/genetic-analysis-of-a-per-2-producing-shewanella-spp-strain-harboring-a-variety-of-mobile-genetic-elements-and-antibiotic-resistant-determinants
#19
Marisa Almuzara, Sabrina Montaña, Terese Lazzaro, Sylvia Uong, Gisela Parmeciano Di Noto, German Traglia, Romina Bakai, Daniela Centrón, Andrés Iriarte, Cecilia Quiroga, Maria Soledad Ramirez
OBJECTIVE: The goal of this work is to investigate the molecular mechanisms that explain the multidrug resistant phenotype found in a novel clinical Shewanella spp. strain (Shew256) recovered from a diabetic patient. METHODS: The whole-genome shotgun sequencing was obtained with Illumina MiSeq-I and Nextera XT DNA library. De novo assembly was performed with SPADES. RAST was used to predict the open reading frames and the predictions were confirmed using BLAST. Further genomic analysis was carried out using average nucleotide identity (ANI), ACT (Artemis), OrthoMCL, ARG-ANNOT, ISFinder, PHAST, tRNAscan-SE, plasmidSPAdes, PlasmidFinder and MAUVE...
July 28, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28760096/collaborative-care-for-mental-health-in-low-and-middle-income-countries-a-who-health-systems-framework-assessment-of-three-programs
#20
Bibhav Acharya, Maria Ekstrand, Pragya Rimal, Mohammed K Ali, Sikhar Swar, Krishnamachari Srinivasan, Viswanathan Mohan, Jürgen Unützer, Lydia A Chwastiak
The collaborative care model is an evidence-based intervention for behavioral and other chronic conditions that has the potential to address the large burden of mental illness globally. Using the World Health Organization Health Systems Framework, the authors present challenges in implementing this model in low- and middle-income countries (LMICs) and discuss strategies to address these challenges based on experiences with three large-scale programs: an implementation research study in a district-level government hospital in rural Nepal, one clinical trial in 50 primary health centers in rural India, and one study in four diabetes clinics in India...
August 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
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