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    Diagnostic accuracy of various modalities relative to open bone biopsy for detection of long bone posttraumatic osteomyelitis.
    Eur J Orthop Surg Traumatol 2017 May 25. Epub 2017 May 25.
    Department of Orthopaedics, Denver Health Medical Center, School of Medicine, University of Colorado, 777 Bannock Street, Denver, CO, 80204, USA.
    Background: Long bone posttraumatic osteomyelitis (PTOM) is a relatively common complication following surgical fixation of open fractures. There is a lacking consensus on ideal strategies for diagnostic evaluation of long bone PTOM. While open bone biopsy and culture is considered the 'gold diagnostic standard,' its cost and invasiveness are often prohibitive and have prompted the search for alternate diagnostic methods. Read More

    Incidence and risk factors for developing infection in patients presenting with uninfected diabetic foot ulcers.
    PLoS One 2017 17;12(5):e0177916. Epub 2017 May 17.
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
    Objective: There is a paucity of research on patients presenting with uninfected diabetic foot ulcers (DFU) that go on to develop infection. We aimed to investigate the incidence and risk factors for developing infection in a large regional cohort of patients presenting with uninfected DFUs.

    Methods: We performed a secondary analysis of data collected from a validated prospective state-wide clinical diabetic foot database in Queensland (Australia). Read More

    Baroreceptor stimulation in a patient with preexisting subcutaneous implantable cardioverter-defibrillator.
    Pacing Clin Electrophysiol 2017 May 24. Epub 2017 May 24.
    University of Giessen, Department of Internal Medicine I, Division of Cardiology, Germany.
    Background: Many patients with severe heart failure (HF) have an indication for baroreflex activation therapy (BAT) and an ICD. Concerns about device-device interactions were addressed in a study with small sample size that concluded combined BAT and ICD therapy is safe. There are no published data, however, concerning device-device interactions between BAT and a subcutaneous ICD (S-ICD). Read More

    [Total ankle arthroplasty with simultaneous subtalar fusion].
    Oper Orthop Traumatol 2017 May 18. Epub 2017 May 18.
    Fusschirurgie, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Schweiz.
    Objective: Pain free weight bearing ability with orthograde hindfoot position and preserved tibiotalar motion.

    Indications: Symptomatic arthritis of the ankle and subtalar joint, additional subtalar hindfoot malalignment.

    Contraindications: Absolute: acute infection, noncorrectable ligamentous instability or bony defects, restricted perfusion, diabetic foot syndrome. Read More

    Amnion Membrane in Diabetic Foot Wounds: A Meta-analysis.
    Plast Reconstr Surg Glob Open 2017 Apr 25;5(4):e1302. Epub 2017 Apr 25.
    Tulane University School of Medicine, New Orleans, La.; Department of Surgery, Tulane University School of Medicine, New Orleans, La.; Department of Economics, Tulane University, New Orleans, La.; Thayer School of Engineering, Dartmouth College, Hanover, N.H.; and Department of Plastic & Reconstructive Surgery, Weill Cornell Medical College/Houston Methodist Hospital, Houston, Tex.
    Background: Amniotic membrane is tissue obtained from human placenta rich in cytokines, growth factors, and stem cells that possess the ability to inhibit infection, improve healing, and stimulate regeneration.

    Methods: A meta-analysis was performed examining randomized controlled trials comparing amniotic tissue products with standard of care in nonhealing diabetic foot ulcers including PubMed, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews.

    Results: A search of 3 databases identified 596 potentially relevant articles. Read More

    Microbiological pattern of diabetic foot infections at a tertiary care center in a developing country.
    J Pak Med Assoc 2017 May;67(5):665-669
    Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi.
    Objective: To determine the microbiological profile and antibiotic susceptibility patterns of organisms isolated from diabetic foot ulcers in a tertiary care hospital Karachi, Pakistan.

    Methods: This descriptive study was conducted at the Baqai Institute of Diabetology and Endocrinology (BIDE), from January 2013 to March 2014. Bone, pus and tissue samples were collected from 342 patients with diabetic foot infections and inoculated on appropriate media. Read More

    Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients.
    Foot Ankle Spec 2017 May 1:1938640017709907. Epub 2017 May 1.
    Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
    Introduction: Open reduction with external fixation (OREF) utilizing fine wire ringed fixators for correction of Charcot deformity has gained popularity over the past decade. Pin site infections are a well-documented complication of external fixation as well as a driver of escalating health care costs. We aimed to demonstrate the safety and efficacy of a novel method of pin site care utilizing active Leptospermum honey-impregnated dressings (MediHoney) in diabetic patients undergoing deformity correction with OREF. Read More

    Anti-pseudomonal and anti-endotoxic effects of surfactin-stabilized biogenic silver nanocubes ameliorated wound repair in streptozotocin-induced diabetic mice.
    Artif Cells Nanomed Biotechnol 2017 May 14:1-12. Epub 2017 May 14.
    a Department of Microbiology, School of Life Sciences , Bharathidasan University , Tiruchirappalli , Tamil Nadu , India.
    Pseudomonas aeruginosa and its lipopolysaccharides play a key role in the pathogenesis of diabetic foot infection, for which, currently no effective therapeutic agents are available. Hence, newer forms of therapeutic agents are required for treating Pseudomonas aeruginosa infection. In this present study, nanocrystalline silver nanoparticles (AgNPs) were synthesized using culture filtrate of Brevibacillus brevis KN8(2) followed by an investigation of its in vivo anti-pseudomonal and anti-endotoxic properties. Read More

    Hospitalization for Charcot neuroarthropathy in diabetes: A population study in Italy.
    Diabetes Res Clin Pract 2017 Apr 28;129:25-31. Epub 2017 Apr 28.
    Diabetes Unit and Diabetes Foot Unit, San Jacopo Hospital, USL Centro-Toscana, Pistoia, Italy.
    Aims: To provide data on hospitalization and incidence rates of Charcot neuroarthropathy (CN) and its relation to lower limbs' amputations/revascularizations in population with diabetes of Italy as well as of one of its regions (Tuscany).

    Methods: Hospitalizations with CN diagnosis (codes ICD-9-CM: 7130, 7135, 7138) have been recorded in people with diabetes over years 2003-2013 in Italy and 2008-2015 in Tuscany. Amputations, peripheral vascular disease, revascularizations and infections were likewise evaluated. Read More

    Evaluation of diabetic foot infection in nuclear medicine.
    Q J Nucl Med Mol Imaging 2017 May 12. Epub 2017 May 12.
    Nuclear Medicine Division, Radiology Department, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
    Diabetic foot infection is not only the most common cause of hospitalization among diabetic patients, but is also associated with high morbidity, mortality and major utilization of the resources. Managing diabetic patients with suspected foot infection is highly dependent on an early and accurate determination of its presence and location. Medical imaging is often used in the workup of these patients, as clinical diagnosis of osteomyelitis is often difficult, and invasive bone biopsy is infrequently used due to many limitations. Read More

    Renal function in patients with diabetic foot infection; does antibiotherapy affect it?
    J Renal Inj Prev 2017 25;6(2):117-121. Epub 2016 Nov 25.
    Infectious Diseases & Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran.
    Introduction: Antibiotic treatment (antibiotherapy) of diabetic foot ulcers has been proven to have toxic effect on renal function. Objectives: This study aimed to evaluate renal function in patients with diabetic foot infection. Patients and Methods: This cross-sectional retrospective study was performed on 142 patients with diabetic foot ulcers hospitalized in Shahid Yahyanejad hospital of Babol during 2013. Read More

    Health Care Service and Outcomes Among an Estimated 6.7 Million Ambulatory Care Diabetic Foot Cases in the U.S.
    Diabetes Care 2017 May 11. Epub 2017 May 11.
    Department of Surgery, Division of Vascular and Endovascular Surgery, Southern Arizona Limb Salvage Alliance, University of Arizona College of Medicine, Tucson, AZ.
    Objective: To evaluate ambulatory clinical cases of diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs) in the U.S. from 2007 to 2013 and to assess outcomes of emergency department or inpatient (ED/IP) admission, number of clinic visits per year, and physician time spent per visit. Read More

    Clinical outcomes and quality of life in hemodialysis diabetic patients versus non-diabetics.
    J Nephropathol 2017 Mar 14;6(2):81-89. Epub 2016 Dec 14.
    Urology and Nephrology Research Center, Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Background: Diabetes is the leading cause of end stage renal disease (ESRD) worldwide.

    Objectives: We compared the clinical outcomes in diabetic patients on hemodialysis (HD) with non-diabetics.

    Patients And Methods: Adult maintenance HD patients (N= 532) from 9 HD facilities were enrolled to this prospective cohort study in September 2012. Read More

    Osteomyelitis.
    Infect Dis Clin North Am 2017 Jun;31(2):325-338
    Section of Bone and Joint Infections, Department of Infectious Disease, Medicine Institute, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Desk G-21, Cleveland, OH 44195, USA. Electronic address:
    Osteomyelitis is an ancient disease with varied pathophysiology. The several clinical syndromes associated with bone infection have specific clinical presentations and microbiology. Successful recognition and management of the disease requires a knowledge of these mechanisms and the organisms most common in each. Read More

    How Do Preoperative Antibiotics Affect Culture Yield in Diabetic Foot Infections?
    Open Forum Infect Dis 2017 11;4(1):ofx016. Epub 2017 Feb 11.
    Division of Infectious Diseases.
    The impact of preoperative antibiotics on culture of diabetic foot infection samples has not been studied. We found that increasing exposure to preoperative antibiotics was associated with less frequent growth of streptococci and anaerobes and more culture-negative results. In contrast, the yield of Staphylococcus aureus and Gram-negative bacilli was unaffected. Read More

    Using Nuclear Medicine Imaging Wisely in Diagnosing Infectious Diseases.
    Open Forum Infect Dis 2017 3;4(1):ofx011. Epub 2017 Feb 3.
    Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles.
    In recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine's "Choosing Wisely" campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad. This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources. Read More

    A Proposed New Classification of Skin and Soft Tissue Infections Modeled on the Subset of Diabetic Foot Infection.
    Open Forum Infect Dis 2017 7;4(1):ofw255. Epub 2016 Dec 7.
    Roxborough Memorial Hospital, Philadelphia, Pennsylvania.
    Schemes for classifying skin and soft tissue infections (SSTIs) pose limitations for clinicians and regulatory agencies. Diabetic foot infections (DFIs) are a subset of SSTIs. We developed and are proposing a classification to harmonize current schemes for SSTIs and DFIs. Read More

    Outcomes after foot surgery in people with a diabetic foot ulcer and a 12-month follow-up.
    J Wound Care 2017 May;26(5):218-227
    Vascular Surgeon; Wound Expert Clinic, Haaglanden Medical Centre, The Hague, The Netherlands.
    Objective: The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing.

    Method: Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Read More

    Evaluation of skin perfusion pressure to assess refractory foot ulcers.
    J Wound Care 2017 May;26(5):267-270
    Department of Dermatology, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
    Objective: The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. Read More

    ACR Appropriateness Criteria(®) Suspected Osteomyelitis, Septic Arthritis, or Soft Tissue Infection (Excluding Spine and Diabetic Foot).
    J Am Coll Radiol 2017 May;14(5S):S326-S337
    Specialty Chair, Brigham & Women's Hospital, Boston, Massachusetts.
    Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue from osseous infection often determines the appropriate clinical therapeutic course. Radiographs are the recommend initial imaging examination, and although often not diagnostic in acute osteomyelitis, can provide anatomic evaluation and alternative diagnoses influencing subsequent imaging selection and interpretation. Read More

    Microbiological Etiology and Treatment of Complicated Skin and Skin Structure Infections in Diabetic and Nondiabetic Patients in a Population-Based Study.
    Open Forum Infect Dis 2017 10;4(2):ofx044. Epub 2017 Mar 10.
    Department of Infectious Diseases, Inflammation Center, Helsinki University Central Hospital and Helsinki University, Finland; and.
    Background: Diabetes is a major risk factor for skin and skin structure infection (SSSI), and the global burden of diabetics with SSSI is enormous. The more complex microbiology of diabetic foot infection (DFI) is well established, but it is not known whether microbiological etiology differs between diabetics and nondiabetics in other disease entities under the umbrella of complicated SSSI (cSSSI).

    Methods: This retrospective, population-based study included patients with cSSSI, and it was conducted in 2 Nordic cities with a low prevalence of antimicrobial resistance. Read More

    Osteomyelitis in diabetic foot: A comprehensive overview.
    World J Diabetes 2017 Apr;8(4):135-142
    Laura Giurato, Marco Meloni, Valentina Izzo, Luigi Uccioli, Department of Systems Medicine, University of Tor Vergata, 00133 Rome, Italy.
    Foot infection is a well recognized risk factor for major amputation in diabetic patients. The osteomyelitis is one of the most common expression of diabetic foot infection, being present approximately in present in 10%-15% of moderate and in 50% of severe infectious process. An early and accurate diagnosis is required to ensure a targeted treatment and reduce the risk of major amputation. Read More

    Are antibiotic-resistant pathogens more common in subsequent episodes of diabetic foot infection?
    Int J Infect Dis 2017 Apr 24;59:61-64. Epub 2017 Apr 24.
    Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4, rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland; Orthopaedic Surgery Service, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Infection Control Program, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address:
    Background: After antibiotic therapy of an initial diabetic foot infection (DFI), pathogens isolated from subsequent episodes might become more resistant to commonly prescribed antibiotics. If so, this might require a modification of the current recommendations for the selection of empiric antibiotic therapy. This study investigated whether the Infectious Diseases Society of America (IDSA) DFI guideline recommendations should be modified based on the number of past DFI episodes. Read More

    Role of procalcitonin in infected diabetic foot ulcer.
    Diabetes Res Clin Pract 2017 Apr 13;128:51-57. Epub 2017 Apr 13.
    Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeonggi-do 15355, South Korea. Electronic address:
    Aims: Procalcitonin (PCT) has been recently accepted as a marker for diagnosing infection. The aim of the present study was to determine whether PCT levels are associated with infection severity of diabetic foot ulcers and whether PCT levels would be helpful to differentiate infected diabetic foot ulcer (IDFU) from IDFU associated with other infectious diseases (IDFU+O).

    Methods: We prospectively included 123 diabetic patients hospitalized for IDFU. Read More

    A Prospective, Randomized, Blinded, Controlled Trial Comparing Transdermal Continuous Oxygen Delivery to Moist Wound Therapy for the Treatment of Diabetic Foot Ulcers.
    Ostomy Wound Manage 2017 Apr;63(4):12-28
    Worldwide, diabetic foot ulcers (DFUs) continue to exact a major burden on patients and health care providers. Although hyperbaric oxygen therapy is well-known as an adjunct option, less is known about the efficacy of transdermal continuous oxygen therapy (TCOT). A prospective, randomized, blinded, multicenter, parallel study was conducted from October 2009 to November 2012 to evaluate healing time and the proportion of DFUs healed after 12 weeks of moist wound therapy (MWT) with or without TCOT. Read More

    Diagnostic and therapeutic update on diabetic foot osteomyelitis.
    Endocrinol Diabetes Nutr 2017 Feb 10;64(2):100-108. Epub 2017 Feb 10.
    Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España.
    Diabetic foot osteomyelitis (DFO) is the most common infection associated to diabetic foot ulcers (DFU). This review is designed to provide an update on the diagnosis and treatment of DFO based on an analysis of MEDLINE through PubMed using as search criterion "Diabetic Foot Osteomyelitis". Authors have included in this review the most relevant manuscripts regarding diagnosis and treatment of DFO. Read More

    Does Physiological Stress Slow Down Wound Healing in Patients With Diabetes?
    J Diabetes Sci Technol 2017 Apr 1:1932296817705397. Epub 2017 Apr 1.
    1 Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
    Background: Poor healing is an important contributing factor to amputation among patients with diabetic foot ulcers (DFUs). Physiological stress may slow wound healing and increase susceptibility to infection.

    Objectives: The objective was to examine the association between heart rate variability (HRV) as an indicator of physiological stress response and healing speed (HealSpeed) among outpatients with active DFUs. Read More

    Treatment options for diabetic foot osteomyelitis.
    Expert Opin Pharmacother 2017 Jun 19;18(8):759-765. Epub 2017 May 19.
    a Infectious Diseases Department , Gustave Dron Hospital , Tourcoing , France.
    Introduction: Diabetic foot osteomyelitis therapeutical options are based on antibiotic therapy and surgical resection of the infected bone(s). Surgical and medical approaches of patients suffering from a diabetic foot osteomyelitis do not oppose but are complementary and need to be discussed as a tailored manner. Areas covered: The aim of the present article is to discuss data issued from the most recent guidelines of the Infectious Diseases Society of America and the International Working Group on the Diabetic Foot on the management of the diabetic foot infection and from a search in the current literature using the terms diabetic foot osteomyelitis and treatment/therapy/therapeutical in both PubMed and Medline, restricted to the last five years. Read More

    Effect of cadexomer iodine on the microbial load and diversity of chronic non-healing diabetic foot ulcers complicated by biofilm in vivo.
    J Antimicrob Chemother 2017 Apr 10. Epub 2017 Apr 10.
    Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
    Objectives: The performance of cadexomer iodine was determined against microbial populations from chronic non-healing diabetic foot ulcers (DFUs) complicated by biofilm in vivo , using molecular, microscopy and zymography methods.

    Methods: Chronic non-healing DFUs due to suspected biofilm involvement were eligible for enrolment. DNA sequencing and real-time quantitative PCR was used to determine the microbial load and diversity of tissue punch biopsies obtained pre- and post-treatment. Read More

    Long-term Outcomes Following Syme's Amputation.
    Foot Ankle Int 2017 Apr 1:1071100717702462. Epub 2017 Apr 1.
    1 Department of Orthopaedic Surgery and Rehabilitation, Loyola University Health System, Maywood, Illinois, USA.
    Background: The metabolic cost of walking after Syme's ankle disarticulation amputation is minimally more than that for nonamputation. The ability to end weightbearing makes prosthetic fitting relatively simple, and very few patients require extensive rehabilitation or placement in a skilled nursing or rehabilitation facility. In spite of these potential benefits, there is a paucity of objective information on the actual long-term outcomes. Read More

    Antibiotic Use and Kirschner Wire Fixation in Forefoot Surgery: A National Survey.
    Orthopedics 2017 Apr 11:1-4. Epub 2017 Apr 11.
    In foot and ankle patients, the use of Kirschner wires is common, and the population in the typical foot and ankle practice has higher rates of comorbidities associated with infection. This study assessed national trends regarding the use of postoperative prophylactic antibiotic therapy in patients undergoing foot and ankle surgery treated with percutaneous Kirschner wires. Attending physicians at foot and ankle fellowships were mailed a questionnaire that included 3 clinical vignettes containing questions on the use of postoperative antibiotics in patients treated with percutaneous Kirschner wires. Read More

    Communication of Contrast in the Flexor Hallucis Longus Tendon with Other Pedal Tendons at the Master Knot of Henry.
    J Am Podiatr Med Assoc 2017 Mar;107(2):166-170
    It is important to have a full appreciation of lower-extremity anatomical relationships before undertaking diabetic foot surgery. We sought to evaluate the potential for communication of the flexor hallucis longus (FHL) tendon with other pedal tendons and plantar foot compartments at the master knot of Henry and to provide cadaveric images and computed tomographic (CT) scans of such communications. Computed tomography and subsequent anatomical dissection were performed on embalmed cadaveric limbs. Read More

    Characteristics and clinical assessment of antibiotic delivery by chitosan sponge in the high-risk diabetic foot: a case series.
    J Wound Care 2017 Apr;26(sup4):S32-S38
    University of Arizona Southern Arizona Limb Salvage Alliance (SALSA), 1501 N. Campbell Ave, PO box 245018, Tucson, AZ, 85724, US.
    Objective: The local delivery of antimicrobials is attractive for a number of reasons. Chitosan, a biodegradable polysaccharide sponge material, has been proposed as medium to deliver antibiotics directly to wounds. In this report we evaluate the safety and practicality of antimicrobial delivery via chitosan sponge. Read More

    A randomized, open-label, controlled trial to evaluate the antimicrobial and surgical effect of CO2 laser treatment in diabetic infected foot ulcers: DULCIS (diabetic ulcer, CO2 laser, and infections) study.
    J Endocrinol Invest 2017 Apr 4. Epub 2017 Apr 4.
    Diabetic Foot Unit, SOD Diabetologia-Azienda Ospedaliero Universitaria Careggi, Via delle Oblate n. 4, 50141, Florence, Italy.
    Aim: Debridement of fibrin and necrotic tissue from the ulcer surface is an important component of the treatment of diabetic ulcers. A possible alternative to standard lancets is represented by CO2 laser, which vaporizes necrotic tissues together with any pathogen. The present trial is aimed at verifying the effect of a CO2 laser on bacterial load in the debridement of infected diabetic foot ulcers. Read More

    Cutaneous Manifestations of Diabetes Mellitus: A Review.
    Am J Clin Dermatol 2017 Apr 3. Epub 2017 Apr 3.
    Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.
    Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Read More

    Decrease of Staphylococcus aureus Virulence by Helcococcus kunzii in a Caenorhabditis elegans Model.
    Front Cell Infect Microbiol 2017 16;7:77. Epub 2017 Mar 16.
    Institut National de la Santé et de la Recherche Médicale, U1047, UFR de Médecine, Université de MontpellierNîmes, France; Service de Microbiologie, CHU CarémeauNîmes, France.
    Social bacterial interactions are considered essential in numerous infectious diseases, particularly in wounds. Foot ulcers are a common complication in diabetic patients and these ulcers become frequently infected. This infection is usually polymicrobial promoting cell-to-cell communications. Read More

    First report in Africa of two clinical isolates of Proteus mirabilis carrying Salmonella genomic island (SGI1) variants, SGI1-PmABB and SGI1-W.
    Infect Genet Evol 2017 Jul 28;51:132-137. Epub 2017 Mar 28.
    Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima 739-8528, Japan. Electronic address:
    Two Proteus mirabilis strains, designated PmTAN59 and PmKAF126, were isolated from two different Egyptian cities in 2014 and 2015, respectively. PmTAN59 was isolated from a sputum swab from a pneumonia patient in Tanta University Teaching Hospital. PmKAF126 was isolated from a patient with a diabetic foot infection in a hospital in the city of Kafr El-Sheikh. Read More

    Haemolytic differential identification of Arcanobacterium haemolyticum isolated from a patient with diabetic foot ulcers.
    JMM Case Rep 2016 Feb 12;3(1):e005016. Epub 2016 Feb 12.
    Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan , Busan 609-757 , Korea.
    Introduction: Arcanobacterium haemolyticum (formerly known as Corynebacterium haemolyticum) is the causative agent of sore throat and also causes skin and soft tissue infections in diabetes patients. A. haemolyticum is a Gram-positive, catalase-negative, β-haemolytic bacillus. Read More

    Case Report: Diabetic Foot Ulcer Infection Treated with Topical Compounded Medications.
    Int J Pharm Compd 2017 Jan-Feb;21(1):22-27
    Professional Compounding Centers of America, Houston, Texas.
    An adult diabetic male with three toes amputated on his right foot presented with an ulcer infection on his left foot, unresponsive to conventional antifungal oral medication for over two months. The ulcerated foot wound had a large impairment on the patient's quality of life, as determined by the Wound-QoL questionnaire. The compounding pharmacist recommended and the physician prescribed two topical compounded medicines, which were applied twice a day, free of charge at the compounding pharmacy. Read More

    Procalcitonin as a Biomarker for Predicting Amputation Level in Lower Extremity Infections.
    J Foot Ankle Surg 2017 May - Jun;56(3):484-491. Epub 2017 Mar 22.
    Adjunct Faculty, Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH.
    Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Read More

    Evaluation of antibacterial activity of the bark and leaf extracts of Brosimum gaudichaudii Trécul against multidrug resistant strains.
    Nat Prod Res 2017 Mar 22:1-5. Epub 2017 Mar 22.
    e Departamento de Genética e Evolução , Universidade Federal de São Carlos , São Carlos , Brazil.
    Brosimum gaudichaudii Trécul., a plant that belongs to Moraceae family, is found throughout the Brazilian Cerrado. The antimicrobial activities of ethanolic bark and leaf extracts of B. Read More

    Role of biomarkers in predicting diabetes complications with special reference to diabetic foot ulcers.
    Biomark Med 2017 Apr 14;11(4):377-388. Epub 2017 Mar 14.
    V Clinbio labs (P) Ltd, Sri Ramachandra University, Porur, Chennai, India.
    Diabetic foot ulcer (DFU) is one of the major complications of diabetes and about 1% of people with diabetes have to go for lower limb amputation. With better understanding of the pathological basis of DFU, number of biomarkers like atrial natriuretic peptides, galectin-3, and cardiac troponins for diabetic cardiomyopathy, cystatin C for diabetics nephropathy and C-reactive protein for infection and procalcitonin could aid in early and noninvasive diagnosis especially when clinical signs are misleading. Predictive role of novel biomarkers in primary prevention however, requires additional studies considering sex, age and multiple complications in DFU. Read More

    Partial calcanectomy and Ilizarov external fixation may reduce amputation need in severe diabetic calcaneal ulcers.
    Diabet Foot Ankle 2017 20;8(1):1264699. Epub 2017 Jan 20.
    TOBB University, ETÜ Hospital, Department of Orthopaedics , Ankara , Turkey.
    Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers. Read More

    Cell therapy of critical limb ischemia in diabetic patients - State of art.
    Diabetes Res Clin Pract 2017 Apr 27;126:263-271. Epub 2017 Feb 27.
    Diabetes Centre, Tameside Hospital NHS Foundation Trust and University of Manchester, Lancashire, UK.
    In this review we report on the state of cell therapy of critical limb ischemia (CLI) with respect to differences between diabetic and non-diabetic patients mainly from the clinical point of view. CLI is the most severe form of peripheral arterial disease and its diagnosis and treatment in diabetic patients is very difficult. The therapeutic effect of standard methods of CLI treatment is only partial - more than one third of diabetic patients are not eligible for standard revascularization; therefore, new therapeutic techniques such as cell therapy have been studied in clinical trials. Read More

    Can Ratio of Neutrophil-to-Lymphocyte Count and Erythrocyte Sedimentation Rate in Diabetic Foot Infecti on Predict Osteomyelitis and/or Amputation?
    Hematol Rep 2017 Feb 23;9(1):6981. Epub 2017 Feb 23.
    Internal Medicine Clinic, Antalya Education and Research Hospital , Antalya, Turkey.
    The aim of this study was to search for any relations between the neutrophil-to-lymphocyte ratio (NLR) and the development of osteomyelitis and the need for amputation in patients with diabetic foot infection (DFI). All data included DFI patients who were hospitalized in our Infectious Diseases Clinic between 2012 and 2015 and who were classified according to International Classification Disease Code System. 75 patients were analyzed in the study. Read More

    Losing a foot versus losing a dollar; a systematic review of cost studies in diabetic foot complications.
    Expert Rev Pharmacoecon Outcomes Res 2017 Apr 17;17(2):165-180. Epub 2017 Mar 17.
    a National School of Public Health , Health Economics Department , Athens , Greece.
    Introduction: Diabetes mellitus is a chronic disease with high prevalence worldwide and a range of serious related complications. Amongst them, diabetic foot is one of the most disabling, posing a substantial health and economic burden on patients and healthcare systems. Areas covered: According to projections, the expected lower limb morbidity is about to increase - in this light the present review aimed at identifying cost-of-illness studies on the management and treatment of conditions related to the diabetic foot, in an aim to provide a body of evidence for an increasing health care burden. Read More

    The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing but not major amputation in patients with diabetic foot ulcers treated in a multidisciplinary setting.
    J Vasc Surg 2017 Jun 6;65(6):1698-1705.e1. Epub 2017 Mar 6.
    Diabetic Foot and Wound Service, The Johns Hopkins Hospital, Baltimore, Md; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins Hospital, Baltimore, Md. Electronic address:
    Objective: The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation continues to plague the most severe stage 4 WIfI patients, with 1-year amputation rates of 20% to 64%. Our aim was to determine the association between WIfI stage and wound healing and major amputation among patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. Read More

    The Use of a Sea Salt-based Spray for Diabetic Foot Ulcers: A Novel Concept.
    Wounds 2017 Feb;29(2):E5-E9
    Sherman Oaks Hospital, Los Angeles, CA.
    Several patients present to wound healing specialists seeking a natural or alternative medical approach to their wounds. The purpose of this prospective, case-cohort study of 10 patients was to evaluate the use of Oceanzyme Wound Care Spray (Ocean Aid, Inc, Boynton Beach, FL) in improving healing in diabetic foot ulcers during a 12-week period. This product contains water purified by reverse osmosis, coral reef sea salt, lysozyme, and sodium benzoate. Read More

    An Assessment of Intralesional Epidermal Growth Factor for Treating Diabetic Foot WoundsThe First Experiences in Turkey.
    J Am Podiatr Med Assoc 2017 Jan;107(1):17-29
    Background: Intralesional epidermal growth factor (EGF) has been available as a medication in Turkey since 2012. We present the results of our experience using intralesional EGF in Turkey for patients with diabetic foot wounds.

    Methods: A total of 174 patients from 25 Turkish medical centers were evaluated for this retrospective study. Read More

    Detection of diabetic foot hyperthermia by using a regionalization method, based on the plantar angiosomes, on infrared images.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:1389-1392
    Prevention of serious diabetic foot complication like ulceration or infection is an important issue. As the development of thermal graphic technologies, foot temperature-guided avoidance therapy has been recommended. Doctors from Hospital National Dos de Mayo are studying on the risk of the diabetic foot passing from Grade 0 to Grade 1 in the Wagner Scale. Read More

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