Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients

2017 ◽  
Vol 11 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Alexander L. Lazarides ◽  
Kamran S. Hamid ◽  
Michael S. Kerzner
Keyword(s):  
External Fixation ◽  
Case Series ◽  
Deformity Correction ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Superficial Infection ◽  
Safety And Efficacy ◽  
Fine Wire ◽  
Pin Site

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. Methods. Twenty-one diabetic patients with Charcot deformities of the lower extremity were prospectively enrolled and followed for pin site complications following OREF for deformity correction. Active Leptospermum honey dressings were applied at metal-cutaneous interfaces at the end of the OREF procedure and replaced weekly for a total of 8 weeks. Patients were monitored for pin site infections from the time of surgery until external fixator removal. Sixteen consecutive patients receiving standard OREF for Charcot deformities were evaluated retrospectively to serve as a control group. Results. Of the 21 enrolled patients, 19 underwent OREF and followed up throughout the study period. Treated patients had a mean age of 58.5 years and mean body mass index measuring 33.3 kg/m2 as documented prior to surgery. The 15 patients with hemoglobin A1c labs drawn in the 3 months preceding surgery averaged 7.5. Fixators were removed at an average of 12.1 weeks after adequate bony healing. Of the 244 pin sites in 19 patients, 3 pin sites (1.2% of pins) in 2 patients (10.5% of patients) showed evidence of superficial infection. All infections resolved with oral antibiotics. Infection rates were significantly reduced when compared to the standard care control group. Conclusions. Pilot data in a prospectively collected case series demonstrate safety and efficacy of active Leptospermum honey–impregnated dressings when used for fine wire ringed fixator pin site care in diabetic Charcot deformity patients. Further investigation in the form of a prospective randomized controlled study is warranted to demonstrate the potential value of this novel intervention. Levels of Evidence: Level IV

Safety of a Protective Funnel in Primary Breast Augmentation: A Retrospective Analysis of 380 Multicenter Cases in the United States

2021 ◽  
Author(s):  
Aldo Lombardo ◽  
Alfred R Antonetti ◽  
Joel Studin ◽  
Frank Stile ◽  
Dudley Giles ◽  
...  
Keyword(s):  
Breast Augmentation ◽  
Case Series ◽  
The United States ◽  
Future Research ◽  
Control Group ◽  
Superficial Infection ◽  
Class 1 ◽  
Median Volume ◽  
Implant Size ◽  
Potential Risk Factors

Abstract Background Protective funnels devices are commonly used to deliver implants in primary breast augmentation (BA) yet there is a paucity of evidence-based data describing their safety in the literature. Objectives The purpose of the study was to assess the safety of protective funnels in primary BA within the first 30-days postoperatively. Methods This multi-center, Level 3 study retrospectively reviewed the surgical records of 380 consecutive patients (760 breasts) who underwent primary BA by nine board-certified plastic surgeons using the iNPLANT Funnel (Proximate Concepts LLC, Allendale, NJ, USA) for implant delivery between November 2019 and December 2020. Data was collected pertaining to demographics, implant information, surgery details, and postoperative complications. Results The mean patient age was 33 years and 76% patients had a BMI < 25. Of this cohort, 11.4% were smokers, 0.8% had diabetes, and 83% were ASA class 1. All patients received smooth implants with a median volume of 375cc. A total of 8 (2.1%) complications were reported including: 3 hematomas (0.79%), 1 seroma (0.26%) and 1 superficial infection (0.26%). No patient required explantation. We identified ASA class, BMI, surgery duration, and implant size as potential risk factors. Conclusions The data suggest that use of protective funnels, such as the iNPLANT Funnel, in primary BA are a safe option when used according to the manufacturer’s IFU. Its use led to a low infection rate (0.26%) and a complication rate (2.1%) consistent with the average reported in the literature (2%-2.5%). 1 Implications for clinical practice are encouraging and future research will include a prospective analysis with a larger case series and potentially a control group.

scholarly journals A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Iman M. Eissa ◽  
Noha M. Khalil ◽  
Heba A. El-Gendy
Keyword(s):  
Anterior Segment ◽  
Tear Film ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Film Stability ◽  
Duration Of Diabetes ◽  
Significant Difference ◽  
Tear Meniscus ◽  
Tear Meniscus Height

Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls.Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted.Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls.Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P=0.002), with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability.Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death

2017 ◽  
Vol 11 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Dane K. Wukich ◽  
Katherine M. Raspovic ◽  
Natalie C. Suder
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Lower Extremity Amputation ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Charcot Neuroarthropathy ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Extremity Amputation

Background. The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. Methods. We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations. The control group (N = 254) was comprised of patients with diabetes who presented with common non–diabetes-related foot pathology. Results. A total of 461 patients were enrolled in this study and included 254 patients without diabetic foot complications and 207 patients with diabetic foot problems. When comparing patients with and without diabetic disease, no significant differences were observed with regard to their fear of blindness, DFI, or ESRD requiring dialysis. Patients with diabetic foot disease (61 of 207, 31.9%) were 136% more likely (odds ratio [OR] = 2.36; 95% CI = 1.51-3.70; P = .002] to rank major LEA as their greatest fear when compared with diabetic patients without foot disease (42 of 254, 16.5%) and were 49% less likely (OR = 0.51; 95% CI = 0.34-0.79; P = .002) to rank death as their greatest fear compared with patients without diabetic foot disease. Conclusion. Patients with diabetic foot pathology fear major LEA more than death, foot infection, or ESRD. Variables that were associated with ranking LEA as the greatest fear were the presence of a diabetic-related foot complication, duration of DM ≥10 years, insulin use, and the presence of peripheral neuropathy. Levels of Evidence: Level II: Prospective, Case controlled study

scholarly journals The Safety and Efficacy of the Interleukin-1 Antagonist Anakinra in Severe Cases of COVID-19- A Systematic Review and Meta-analysis.

2020 ◽  
Author(s):  
Manoj Kumar Reddy Somagutta ◽  
Maria Kezia Lourdes Pormento ◽  
Pousette Hamid ◽  
Alaa Hamdan ◽  
Muhammad Adnan Khan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Interleukin 1 ◽  
Intervention Group ◽  
Case Series ◽  
Cochrane Library ◽  
Control Group ◽  
Safety And Efficacy ◽  
Liver Transaminases ◽  
The Difference ◽  
Enzyme Elevation

Abstract This study aims to assess anakinra's safety and efficacy for treating severe coronavirus disease in 2019 (COVID-19). PubMed, Google Scholar, Cochrane Library, Embase, Scopus, medRxiv, and bioRxiv were searched. Three retrospective studies and five case series involving 3,274 adult patients with severe COVID-19 were included, 621 treated with anakinra (whether administered alone or in combination with other drugs) and 1,565 in the control group arm. All-cause mortality of severe COVID-19 patients among the anakinra group was 20% (16/81), which was lower than that in the control group (65%; 39/60). The difference was statistically significant [hazard ratio (HR) = 0.13, 95% confidence interval (CI) 0.06–0.29, I2= 0%]. The mechanical ventilation requirement with OR 0.57 (0.11-2.84, I2=87%) was not significantly better compared to the control group. For the safety of anakinra, we evaluated thromboembolism risk and liver enzyme elevation. Thromboembolism risk with OR: 1.48 (0.55- 3.99, I2=0%) and elevation in liver transaminases with OR 0.67 (0.11-3.93, I2=66%) were not statistically significant over the control group. However, these non-significant differences between the anakinra and control groups may have been the result of baseline characteristics of the intervention group, and further studies are essential in evaluating anakinra's safety profile.

scholarly journals Impact of Educational Self-Efficacy Enhancement Program on Quality of Life, Pain Management, Self-Efficiency Behaviors and Its Impact of Satisfaction among Adults Diabetic Patients with Peripheral Neuropathy Pain: A Randomized Control Trial

2021 ◽  
Author(s):  
Jawad AHMAD Abu-Shennar ◽  
Nurhan Bayraktar
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Pain Management ◽  
Research Group ◽  
Self Efficacy ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Life Questionnaire

Abstract Background: Peripheral neuropathy pain is common among adult diabetic patients worldwide. Lifestyle behavior modification such as proper diet and exercise, quitting smoking, weight control and regular follow up, as well as enhancement of self-efficacy among adult diabetic patients can be helpful in managing peripheral neuropathy pain and, therefore, improving their quality of life and satisfaction.Aims: This study aims to investigate educational self-efficacy enhancement program's impact on pain management, self-efficiency behaviors, quality of life and satisfaction among adult diabetic patients with peripheral neuropathy pain.Materials and Methods: This randomized controlled study was conducted between October and March 2020 at the Jordanian Ministry of Health settings, where 72 adult diabetic patients with peripheral neuropathy pain were randomly assigned into research group (n = 36) or control group (n = 36), after obtaining ethical approval and informed consents. An educational self-efficacy enhancement program was implemented in the research group only. The instrument used for data collection consisted of Demographic Data Form, Diabetes Pain Intensity Scale, Self-Efficacy Scale, Quality of Life Questionnaire (EQ-5D) and Patient Satisfaction Questionnaire.Results: Statistically significant improvements in pain levels (p = 0.020), self-efficacy score (p = 0.000), quality of life scores (p = 0.000) and best imagined health status (p = 0 .000) were found among research group participants. Furthermore, multiple-linear regression models showed that the implementation of educational self-efficacy enhancement program significantly increased the explained variance of self-efficacy scores (R2 = 0.746, p = 0.000) and quality of life scores (R2 = 0.746, p = 0.000). At the end of implementation, research group participants showed a high overall satisfaction levels (4.33 out of 5). Conclusion: The findings suggest that an educational self-efficacy enhancement program is effective in modifying adult diabetic patients’ lifestyle, enhancing self-efficacy behaviors, managing peripheral neuropathy pain, improving quality of life and satisfaction among adult diabetic patients. It is, therefore, recommended to expand the implementation of this program among adult diabetic patients with peripheral neuropathy pain.

scholarly journals Static monolateral external fixation for the Rolando fracture: a simple solution for a complex fracture

2012 ◽  
Vol 94 (2) ◽  
pp. 112-115 ◽  
Author(s):  
D Marsland ◽  
AP Sanghrajka ◽  
B Goldie
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Case Series ◽  
X Rays ◽  
Site Infection ◽  
Study Support ◽  
Pin Site ◽  
The Mean ◽  
Joint Incongruity ◽  
Mean Time

INTRODUCTION Rolando fractures are often difficult to manage because of their inherent instability. We describe a simple technique for the treatment of this fracture using the principle of ligamentotaxis, with a static, two-pin external fixator spanning the trapeziometacarpal joint, and present the results of a single-surgeon case series. METHODS Eight consecutive patients (mean age: 32.8 years) with Rolando fractures were treated using a Hoffmann II® Micro small bone external fixator using blunt ended 2.0mm half pins, inserted into the trapezium and diaphysis of the first metacarpal. Functional outcome was assessed with the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score at a mean time of 2.7 years following the fracture (range: 4 months – 6.0 years). The mean time to frame removal was 28 days. RESULTS There were three cases of superficial pin site infection. Follow-up x-rays at four months did not demonstrate significant joint incongruity or malunion in any case. The mean QuickDASH score was 7.95 and all patients returned to their previous levels of activity. CONCLUSIONS Although external fixation risks pin site infection, the results of this study support the use of spanning trapeziometacarpal external fixation for Rolando fractures as it reliably gives excellent functional outcomes.

scholarly journals Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Jian Liu ◽  
Miaomiao Zhang ◽  
Bin Li ◽  
Jianrong Wang
Keyword(s):  
Case Series ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Control Group ◽  
Diabetic Patients ◽  
Surgical Success ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

Purpose. To evaluate primary trabeculectomy with adjunctive mitomycin-C (MMC) in diabetic patients without retinopathy with primary angle-closure glaucoma (PACG). Design. This is a retrospective case series comparison. Participants. This retrospective trial compared outcomes of 88 eyes that underwent trabeculectomy in patients with diabetes mellitus (DM) without retinopathy and in 97 patients without DM. Methods. In this study, the intraocular pressure (IOP), visual acuity, visual field, and postoperative complications were compared between the two groups. Qualified surgical success is defined as an IOP between 6 and 18 mmHg with or without topical antiglaucoma medication. Results. After a follow-up of 5 years, the IOP decreased from a mean basal IOP of 27.8±7.3 mmHg to 15.0±5.6 mmHg in the DM group and from 27.3±6.0 mmHg to 12.4±5.3 mmHg in the control group. The mean number of antiglaucoma medications was 3.4±1.3 and 3.3±1.2 preoperatively (P=0.587) whereas it was 1.7±1.5 and 1.1±1.4 at the 5-year follow-up (P=0.049). The 5-year qualified surgical success rates were 42.9% and 65.4% for both groups (P=0.046; log-rank test). Encysted blebs were seen in 21 (23.9%) patients in the DM group and in 12 (12.4%) patients in the control group (P=0.041). Conclusion. PACG patients with DM without retinopathy undergoing primary trabeculectomy with MMC may have a lower long-term surgical survival rate compared with patients without DM.

scholarly journals Homeopathy and Periodontal Treatment in Type II Diabetic Patients: a 1-Year Randomized Clinical Trial

2019 ◽  
Vol 30 (2) ◽  
pp. 139-145 ◽  
Author(s):  
Leila Mourão ◽  
Romeu Carillo Jr ◽  
Sabrina Martins Linares ◽  
Antonio Canabarro ◽  
Ricardo Guimarães Fischer
Keyword(s):  
Glycated Hemoglobin ◽  
Test Group ◽  
Health Condition ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Double Blind ◽  
Mean Glucose ◽  
Improve Health

Abstract Chronic periodontitis (CP) and Diabetes mellitus type 2 (DMII) are chronic diseases usually treated by conventional practices. On the other hand, homeopathy can help to treat many different diseases. The aim of this study was to evaluate the effects of homeopathy (H) as an adjunct for non-surgical periodontal therapy (NSPT) in individuals with DMII and CP. Eighty individuals with CP and DM II, of both sexes and aged between 32 and 70 years, participated in this randomized, double-blind, placebo-controlled study. They were divided into two groups: control group (CG) and the test group (TG), and both groups received the NSPT. TG also received homeopathic therapy, including Berberis, Mercurius solubilis/Belladonna/Hepar sulphur and Pyrogenium, while CG received placebo. Clinical and laboratorial examinations were evaluated at baseline and after 1, 6 and 12 months of treatment. Both groups showed significant improvement throughout the study, for most of the parameters studied, but TG presented significative gain of CAL at 1 and 12 months compared to CG. Mean glucose and glycated hemoglobin significantly decreased in both groups after 6 and 12 months. However, there was a significantly further reduction of these parameters in TG, as compared to CG. In conclusion, homeopathy as supplement of NSPT may further improve health condition, including glycemic control, in DMII patients with CP.

scholarly journals Safety and efficacy of high-dose vitamin B6 for treating antipsychotic-induced hyperprolactinemia in male patients with treatment-resistant schizophrenia

2021 ◽  
Author(s):  
Chuanjun Zhuo ◽  
Yong Xu ◽  
Haibo Wang ◽  
Chunhua Zhou ◽  
Hongjun Tian ◽  
...  
Keyword(s):  
Vitamin B6 ◽  
Serum Prolactin ◽  
Controlled Study ◽  
Psychotic Symptoms ◽  
Control Group ◽  
High Dose ◽  
Treatment Resistant ◽  
Safety And Efficacy ◽  
Male Patients ◽  
High Dose Vitamin

Background and Purpose: This study aimed to investigate the safety and efficacy of high-dose vitamin B6 (vB6) for antipsychotic-induced hyperprolactinemia (AIHP) treatment in male patients with treatment-resistant schizophrenia (TRS). Experimental Approach: In this randomized double-blinded controlled study, patients were randomized (1:1) into a control group given aripiprazole (ARI; 10 mg/day) or an intervention group given vB6 (300 mg/12 h for 16 weeks). Prolactin level, psychotic symptoms [Positive and Negative Syndrome Scale (PANSS)], cognitive function [MATRICS Consensus Cognitive Battery (MCCB)], liver function, kidney function, growth hormone level, micronutrient levels, blood lipids, and adverse secondary effects (ASEs)[Treatment Emergent Symptom Scale (TESS) and Barnes-Akathisia scale] were monitored. Key Results: After a 16-week treatment period, the vB6 group showed a 68.1% reduction in serum prolactin levels (from 95.52 ± 6.30 μg/L to 30.43 ± 18.65 μg/L) while the ARI group showed only a 37.4% reduction (from 89.07 ± 3.59 μg/L to 55.78 ± 7.39 μg/L). During weeks 1–4, both treatments reduced prolactin similarly. Subsequently, the ARI effect plateaued, while the vB6 effect remained robust. AIHP reduction efficacy of vB6 was associated with baseline prolactin and triglyceride levels, total vB6 dosage, and education level. Conclusion and Implications: Compared with the ARI group, TRS patients given vB6 showed better attenuation of AIHP, lower ASE scores, and improvements in clinical symptoms and cognitive impairments. These results support further consideration of vB6 as a putative treatment for AIHP.

scholarly journals Impact of Educational Self-Efficacy Enhancement Program on Quality of Life, Pain Management, Self-Efficiency Behaviors and Its Impact of Satisfaction Among Adults Diabetic Patients with Peripheral Neuropathy Pain: A Randomized Control Trial

2021 ◽  
Author(s):  
Jawad Ahmad Abu-Shennar ◽  
Nurhan Bayraktar
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Pain Management ◽  
Research Group ◽  
Self Efficacy ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Life Questionnaire

Abstract Background: Peripheral neuropathy pain is common among adult diabetic patients worldwide. Lifestyle behavior modification such as proper diet and exercise, quitting smoking, weight control and regular follow up, as well as enhancement of self-efficacy among adult diabetic patients can be helpful in managing peripheral neuropathy pain and, therefore, improving their quality of life and satisfaction.Aims: This study aims to investigate educational self-efficacy enhancement program's impact on pain management, self-efficiency behaviors, quality of life and satisfaction among adult diabetic patients with peripheral neuropathy pain.Materials and Methods: This randomized controlled study was conducted between October and March 2020 at the Jordanian Ministry of Health settings, where 72 adult diabetic patients with peripheral neuropathy pain were randomly assigned into research group (n = 36) or control group (n = 36), after obtaining ethical approval and informed consents. An educational self-efficacy enhancement program was implemented in the research group only. The instrument used for data collection consisted of Demographic Data Form, Diabetes Pain Intensity Scale, Self-Efficacy Scale, Quality of Life Questionnaire (EQ-5D) and Patient Satisfaction Questionnaire.Results: Statistically significant improvements in pain levels (p = 0.020), self-efficacy score (p = 0.000), quality of life scores (p = 0.000) and best imagined health status (p = 0 .000) were found among research group participants. Furthermore, multiple-linear regression models showed that the implementation of educational self-efficacy enhancement program significantly increased the explained variance of self-efficacy scores (R2 = 0.746, p = 0.000) and quality of life scores (R2 = 0.746, p = 0.000). At the end of implementation, research group participants showed a high overall satisfaction levels (4.33 out of 5). Conclusion: The findings suggest that an educational self-efficacy enhancement program is effective in modifying adult diabetic patients’ lifestyle, enhancing self-efficacy behaviors, managing peripheral neuropathy pain, improving quality of life and satisfaction among adult diabetic patients. It is, therefore, recommended to expand the implementation of this program among adult diabetic patients with peripheral neuropathy pain.

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