Blindness, Diabetes, and Amputation: Alleviation of Depression and Pain through Thermal Biofeedback Therapy

1993 ◽  
Vol 87 (9) ◽  
pp. 368-371
Author(s):  
W.E. Needham ◽  
L.S. Eldridge ◽  
B. Harabedian ◽  
D.G. Crawford
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Suicidal Ideation ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Sense Of Self ◽  
Thermal Biofeedback ◽  
Self Control ◽  
Peripheral Vascular ◽  
Biofeedback Therapy

A 39-year-old man who was blind, diabetic, and had a double amputation with chronic renal failure and peripheral vascular disease was treated with thermal biofeedback to reduce his depression through increased self-control, to minimize pain, and to facilitate healing of a pregangrenous hand. His progress was almost immediate, and during treatment he was able to raise the temperature in the affected hand well over three degrees. On his discharge from treatment, his depression and pain were reduced, his suicidal ideation was eliminated, his sense of self-mastery was improved, and there was no further consideration of amputation.

scholarly journals Trends of diabetes-delated preventable hospitalizations in an italian region from 2006 to 2015

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F Cedrone ◽  
P Di Giovanni ◽  
G Di Martino ◽  
F Meo ◽  
P Scampoli ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Failure ◽  
Liver Disease ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Italian Region ◽  
Preventable Hospitalizations ◽  
Uncomplicated Hypertension

Abstract Background Diabetes-related preventable hospitalizations (DRPHs) are indicators of primary care effective services. The aim of this study is to compute the trends of DRPHs, and to assess the risk factors for increased in-hospital length of stay (LOS) and costs in an Italian region. Methods DRPHs were computed following the AHRQ definitions, which include four types: short-term complications (PQI-1), long-term complications (PQI-3), uncontrolled diabetes (PQI-14), lower-extremity amputations (PQI-16). Trends were direct standardized on in-habitants in 2006. Negative binomial regression model was used. Results In the study period PQI-1 increased +426.9 %, PQI-3 +175.5%, PQI-14 +231.7% and PQI-16 decreased -26.2%. Prolonged LOS was related to type 2 diabetes (p < 0.001), peripheral vascular disease (p = 0.045), uncomplicated hypertension (p < 0.001), liver disease (p < 0.001) for PQI-1; type 2 diabetes (p < 0.001), uncomplicated hypertension (p < 0.001), complicated hypertension (p < 0.001) for PQI-3; type 2 diabetes (p < 0.001 ), complicated hypertension (p = 0.001), metastasis (p = 0.042) for PQI-14; female gender (p = 0.001), congestive heart failure (CHF) (p = 0.001), valvulopathy (p = 0.024), BPCO (p = 0.028), renal failure (p < 0.001), liver disease (p = 0.015) for PQI-16.Considerable factors affecting the costs were female gender (p = 0.005), peripheral vascular disease (p = 0.006), renal failure (p = 0.050) for PQI-1; type 2 diabetes (p = 0.002), arrhythmia (p = 0.002), peripheral vascular disease (p < 0.001), BPCO (p < 0.001), renal failure (p < 0.001) for PQI-3; peripheral vascular disease (p = 0.004), uncomplicated hypertension (p = 0.005), BPCO (p = 0.011), renal failure (p = 0.009), liver disease (p < 0.001), psychosis (p = 0.027) for PQI-14; CHF (p = 0.014), arrhythmia (p = 0.001 ), uncomplicated hypertension (p = 0.003), renal failure (p = 0.008), deficiency anemia (p = 0.032) for PQI-16. Conclusions DRPHs has been increasing and some comorbidities need to be better managed in outpatient setting to reduce LOS and costs. Key messages This study addresses the effect of multimorbidity on the burden of diabetes-related preventable hospitalizations using administrative data from an entire italian region over 10 years period. This study uses Prevention Quality Indicators to measure their burden on regional public health and produces useful evidences for the improvement of diabetes management in outpatient setting.

scholarly journals Impact of risk factors and surgical techniques in coronary endarterectomy: a network meta-analysis

2019 ◽  
Vol 29 (3) ◽  
pp. 355-364 ◽  
Author(s):  
Chuan Wang ◽  
Jun Chen ◽  
Chengxiong Gu ◽  
Ruiguo Qiao ◽  
Jingxing Li
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Renal Failure ◽  
Mortality Rate ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Meta Analysis ◽  
Peripheral Vascular ◽  
Coronary Endarterectomy ◽  
Risk Of Mortality

Summary The goal of this network meta-analysis was to compare the early mortality rate of patients who underwent coronary endarterectomy (CE) combined with coronary artery bypass grafting (CABG) with different techniques and with isolated CABG. This analysis also evaluated potential risk factors in patients who undergo CE. Eighteen studies were included, covering 21 752 different patients, among whom 3352 underwent CE + CABG with either open or closed techniques and 18 400 underwent isolated CABG. Patients who had CE + CABG had a statistically significant higher mortality rate [odds ratio (OR) 1.76; P < 0.001]. Subgroup analyses showed that, with closed CE, mortality was 52% (OR 1.52, P = 0.001) more likely to occur, whereas with open CE, mortality was 279% (OR 3.79, P < 0.001) more likely to occur, when both were compared with isolated CABG. A network meta-analysis indicated that both the open and closed methods had poorer results than CABG alone and that the open method had a higher risk of mortality than the closed one. For risk factors, diabetes mellitus (DM), hypertension, prior myocardial infarction, peripheral vascular disease and renal failure were significant contributors to inclusion in the CE group, whereas other risk factors showed no significant difference. However, none of these factors indicated significant correlations with the incidence of mortality between the groups. CE + CABG has a significantly higher risk of death than isolated CABG, and open CE is more risky than closed CE, even though most of the individual studies did not show that CE had a higher risk of mortality. Moreover, DM, hypertension, prior myocardial infarction, peripheral vascular disease and renal failure were more common in the patients who had CE + CABG, but these factors may not necessarily increase the mortality risk of patients who have CE.

Tests for Platelet Changes, Acute Phase Reactants and Serum Lipids in Diabetes mellitus and Peripheral Vascular Disease

1982 ◽  
Vol 48 (03) ◽  
pp. 289-293 ◽  
Author(s):  
B A van Oost ◽  
B F E Veldhuyzen ◽  
H C van Houwelingen ◽  
A P M Timmermans ◽  
J J Sixma
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Acute Phase ◽  
Serum Lipids ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Acute Phase Reactants ◽  
Control Subjects ◽  
And Control

SummaryPlatelets tests, acute phase reactants and serum lipids were measured in patients with diabetes mellitus and patients with peripheral vascular disease. Patients frequently had abnormal platelet tests and significantly increased acute phase reactants and serum lipids, compared to young healthy control subjects. These differences were compared with multidiscriminant analysis. Patients could be separated in part from the control subjects with variables derived from the measurement of acute phase proteins and serum lipids. Platelet test results improved the separation between diabetics and control subjects, but not between patients with peripheral vascular disease and control subjects. Diabetic patients with severe retinopathy frequently had evidence of platelet activation. They also had increased acute phase reactants and serum lipids compared to diabetics with absent or nonproliferative retinopathy. In patients with peripheral vascular disease, only the fibrinogen concentration was related to the degree of vessel damage by arteriography.

Sign in / Sign up

Export Citation Format

Share Document