scholarly journals Annual Foot Exams and Incident Amputation

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 224-224
Author(s):  
Latricia Allen ◽  
Anjali Khakharia ◽  
Lawrence Phillips ◽  
Theodore Johnson ◽  
Constance Uphold ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Secondary Analysis ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Fiscal Year ◽  
Administrative Dataset ◽  
High Prevalence ◽  
History Of ◽  
Age Range ◽  
The Relationship

Abstract Diabetes-related lower extremity amputations (LEA) are high cost and high prevalence. Individuals with complications such as neuropathy, foot deformity, history of diabetic foot ulcer or LEA increased morbidity and mortality.1 Current national recommend a foot exam for individuals with diabetes annually or more often depending on risk for LEA.2, The purpose of this pilot study was to examine the relationship between annual foot exams and incident lower extremity amputation in a large Veteran cohort. We conducted a secondary analysis of a national VA Diabetes administrative dataset registry for Veterans with diabetes aged 65 and older during the period of fiscal year 2002-2014 (n=1,544,654; mean age 77.6 years; 97.9 % male). Using logistic regression, we examined the association between annual foot exams and incident LEA. Our analysis was adjusted for demographics, comorbidities, and LEA foot risk. The study included 18,759 (1.21%) Veterans with incident LEA and foot exams, 2,234 (0.14%) Veterans with incident LEA without foot exams. Median age range was 65-75 years old. Gangrene, osteomyelitis, foot ulcers, and neuropathy were the covariates with the highest risk of incident LEA with foot exam. Foot exams did not reduce the risk of LEA when examining Veterans with incident LEA (unadjusted OR of 1.62 (CI 1.56 - 1.69), p<.0001 and adjusted OR was 1.77 (CI 1.69 -1.86), p<.0001. Annual foot exams were not protective for LEA in Veterans with foot exams and incident LEA. Additional research is warranted to examine this relationship considering the effect of early intervention on LEA risk.

scholarly journals Risk Factors for Lower Extremity Amputation in Diabetic Foot Ulcer Patients: A Case-Control Study

2020 ◽  
Vol 11 (2) ◽  
pp. 83
Author(s):  
Gusti Agung Ayu Ira Kencana Dewi ◽  
Sony Wibisono ◽  
I Putu Alit Pawana
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Diabetic Foot ◽  
Medical Records ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Extremity Amputation ◽  
History Of ◽  
Extremity Amputation ◽  
Control Study

Introduction: Diabetes mellitus is a metabolic syndrome that is marked by higher blood glucose. The uncontrolled high blood glucose can lead to complication, such as diabetic foot. Diabetic foot is the most reason why diabetic patients are hospitalized. Diabetic foot that cannot heal may lead to lower extremity amputation. The purpose of this study was to describe the risk factors of lower extremity amputation in diabetic foot ulcer patients.Methods: This study used a case-control study of diabetic foot patients in Dr. Soetomo General Hospital from January 2015 to December 2017. This study used the data from medical records in Inpatient Installation Department of Internal Medicine. Patients with diabetic foot ulcer and lower extremity amputation due to diabetes were included in this study. Incomplete medical records were excluded. Data of samples were divided to two groups, i.e. the amputation group and the non-amputation group with a ratio of 1:1. Risk factors of amputation that were analyzed were male, old age, and the history of ulcer/lower extremity amputation.Results: Based on the data of 36 samples, there were 11 male patients (61.1%) and 7 female patients (38.9%) who experienced lower extremity amputation. The average age of amputation group was 59.61 years old with a range of ages from 39 to 72 years old. This study found the risk factors for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes (OR 5.0, 95% CI 1.065-23.464, p = 0.034). Conclusion: The risk factor for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes. 

scholarly journals Factors Associated with Callus Formation in the Plantar Region through Gait Measurement in Patients with Diabetic Neuropathy: An Observational Case-Control Study

Sensors ◽  
2020 ◽  
Vol 20 (17) ◽  
pp. 4863
Author(s):  
Ayumi Amemiya ◽  
Hiroshi Noguchi ◽  
Makoto Oe ◽  
Kimie Takehara ◽  
Yumiko Ohashi ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Diabetic Neuropathy ◽  
Callus Formation ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Gait Training ◽  
Motion Sensors ◽  
Joint Angles ◽  
Plantar Region ◽  
External Forces

Callus has been identified as a risk factor leading to severe diabetic foot ulcer; thus, it is necessary to prevent its formation. Callus formation under the first, second, and fifth metatarsal heads (MTHs) is associated with external forces (pressure and shear stress) during walking. However, the gait factors increasing the external forces remain undetermined. Thus, this study aims to identify the factors increasing the external forces to prevent callus formation. In 59 patients with diabetic neuropathy wearing their usual shoes, the external forces, and the lower extremity joint angles were measured using MEMS force sensors and motion sensors. The external forces and their relationship with the lower extremity joint angles and footwear size were determined. Risk factors causing high external forces on the first MTH included small flexion of the knee joint (p = 0.015) and large ankle pronation motion (p = 0.034) to obtain propulsion. For the second MTH, wearing excessively long footwear was identified (p = 0.026). For the fifth MTH, high external force was related to tight width footwear (p = 0.005). An effective intervention for preventing callus formation for the first MTH would involve assisting the push-off foot motion using rocker-sole footwear or gait training. For the second and fifth MTHs, wearing appropriate size footwear would be effective.

scholarly journals Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)—Two-Year Follow-Up Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Leila Yazdanpanah ◽  
Hajieh Shahbazian ◽  
Iraj Nazari ◽  
Hamid Reza Arti ◽  
Fatemeh Ahmadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Previous History ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Population Based ◽  
University Hospital ◽  
Foot Deformity ◽  
History Of

Aim/Introduction. This study was carried out to assess the incidence and risk factors of diabetic foot ulcer (DFU). Materials and Methods. In this prospective cohort study in a university hospital, all the participants were examined and followed up for new DFU as final outcome for two years. To analyze the data, the variables were first evaluated with a univariate analysis. Then variables with P value < 0.2 were tested with a multivariate analysis, using backward-elimination multiple logistic regression. Results. Among 605 patients, 39 cases had DFU, so we followed up the remaining 566 patients without any present or history of DFU. A two-year cumulative incidence of diabetic foot ulcer was 5.62% (95% CI 3.89–8.02). After analysis, previous history of DFU or amputation [OR = 9.65, 95% CI (2.13–43.78), P value = 0.003], insulin usage [OR = 5.78, 95% CI (2.37–14.07), P value < 0.01], gender [OR = 3.23, 95% CI (1.33–7.83), P value = 0.01], distal neuropathy [OR = 3.37, 95% CI (1.40–8.09), P value = 0.007], and foot deformity [OR = 3.02, 95% CI (1.10–8.29), P value = 0.032] had a statistically significant relationship with DFU incidence. Conclusion. Our data showed that the average annual DFU incidence is about 2.8%. Independent risk factors of DFU development were previous history of DFU or amputation, insulin consumption, gender, distal neuropathy, and foot deformity. These findings provide support for a multifactorial etiology for DFU.

Lower-extremity arterial revascularization: Is there any evidence for diabetic foot ulcer-healing?

2016 ◽  
Vol 42 (1) ◽  
pp. 4-15 ◽  
Author(s):  
J. Vouillarmet ◽  
O. Bourron ◽  
J. Gaudric ◽  
P. Lermusiaux ◽  
A. Millon ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Ulcer Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Revascularization

scholarly journals Flourishing Despite Migraines: A Nationally Representative Portrait of Resilience and Mental Health among Canadians

2021 ◽  
Author(s):  
Esme Fuller-Thomson
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Secondary Analysis ◽  
Well Being ◽  
Care Providers ◽  
Physical And Mental Health ◽  
History Of ◽  
Nationally Representative ◽  
The Relationship

Objective 1) To examine the relationship between migraine status and complete mental health (CMH) among a nationally representative sample of Canadians; 2) To identify significant correlates of CMH among those with migraine. Methods Secondary analysis of the nationally representative Canadian Community Health Survey – Mental Health (CCHS-MH) (N=21,108). Bivariate analyses and a series of logistic regression models were performed to identify the association between migraine status and CMH. Significant correlates of CMH were identified in the sample of those with migraine (N=2,186). Results Individuals without a history of migraine had 72% higher odds of being in CMH (OR=1.72; 95% CI=1.57, 1.89) when compared with those with a history of migraine. After accounting for physical health and mental health problems, the relationship between migraine status and CMH was reduced to non-significance, with both groups having an approximately equal likelihood of achieving CMH (OR=1.03; 05% CI=(0.92, 1.15). Among those with migraine, factors that were strongly associated with CMH were a lack of a history of depression, having a confidant, and having an income of $80,000 or more. Conclusion Clinicians and health care providers should also address co-occurring physical and mental health issues to support the overall well-being of migraineurs.

scholarly journals Extracellular matrix and cellular senescence in venous leg ulcers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Debbie X. E. Lim ◽  
Toby Richards ◽  
Muholan Kanapathy ◽  
Thankiah Sudhaharan ◽  
Graham D. Wright ◽  
...  
Keyword(s):  
Cellular Senescence ◽  
Chronic Wounds ◽  
Second Harmonic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Venous Leg Ulcer ◽  
Non Invasive ◽  
Wound Assessment ◽  
High Prevalence ◽  
Invasive Method

AbstractHigh prevalence of non-healing chronic wounds contributes to a huge healthcare burden across the world. Early treatment interventions for non-healing wounds are vital. It was previously shown that accumulation of 15% or more of senescent cells in a chronic wound edge is an indicator that the wound is unlikely to heal. However, determining the presence of senescent cells would require invasive procedures such as tissue biopsies to be taken. In this study, we found a strong correlation between decreased collagen area and presence of senescent cells in human chronic wounds i.e. venous leg ulcer (VLU), diabetic foot ulcer (DFU) and pressure ulcer (PRU). We also report that the lowest collagen levels were found in VLU patients less than 60 years of age, with a persistent wound of > 24 months. Elevated levels of senescent cells were also found in VLU of males. Second harmonic imaging of collagen at the edge of chronic wounds with a handheld multiphoton device could be used to predict the number of senescent cells, indicating if the wound is on a healing trajectory or not. Our data support the use of collagen imaging in cutaneous wound assessment for a faster and non-invasive method to predict cellular senescence and determining wound trajectory of healing.

The Relationship Between Injury-Related Fear and Visuomotor Reaction Time in Individuals With a History of Anterior Cruciate Ligament Reconstruction

2020 ◽  
pp. 1-7
Author(s):  
Francesca Genoese ◽  
Shelby E. Baez ◽  
Nicholas Heebner ◽  
Matthew C. Hoch ◽  
Johanna M. Hoch
Keyword(s):  
Anterior Cruciate Ligament ◽  
Reaction Time ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Fear Avoidance ◽  
Injured Limb ◽  
History Of ◽  
Anterior Cruciate ◽  
The Relationship

Context: Deficits in reaction time, decreased self-reported knee function, and elevated levels of injury-related fear have been observed in individuals who sustain anterior cruciate ligament injury. Understanding the relationship between these variables may provide the impetus to further investigate effective intervention strategies to address these deficits in individuals after anterior cruciate ligament reconstruction (ACLR). Objective: To examine the relationship between injury-related fear and lower-extremity visuomotor reaction time (VMRT) in individuals with a history of ACLR. A secondary purpose was to determine the relationship between self-reported knee function and lower-extremity VMRT in individuals with a history of ACLR. Design: Cross-sectional study. Setting: Laboratory. Participants: Twenty participants between the ages of 18–35 years, with history of unilateral ACLR within the last 10 years, who injured their knee playing or training for organized or recreational sports. Main Outcome Measures: Scores on the athlete fear avoidance questionnaire, the fear-avoidance beliefs questionnaire (FABQ), the knee injury and osteoarthritis outcome score, and reaction time (in seconds) on the lower-extremity VMRT task using the FitLight Trainer™, bilaterally. Spearman Rho correlations examined the relationship between the dependent variables. Results: There was a moderate positive correlation between VMRT and FABQ-total (r = .62, P < .01), FABQ-sport (r = .56, P = .01), and FABQ-physical activity (r = .64, P < .01) for the injured limb. Correlations between FABQ scores and VMRT for the uninjured limb were weak positive correlations (r = .36–.41, P > .05). Weak correlations between the osteoarthritis outcome score subscales, athlete fear avoidance questionnaire, and VMRT were observed for the injured limb (P > .05). Conclusions: Individuals with a history of ACLR who exhibited elevated levels of injury-related fear demonstrated slower VMRT. There were no relationships between self-reported knee function and VMRT. Future research should explore interventions to address injury-related fear and VMRT in individuals after ACLR.

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