scholarly journals MON-683 Assessment of Features Associated with Diabetic Foot Risk in General Hospital in Lima-Peru

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Marlon Augusto Yovera-Aldana ◽  
Sonia Helen Perez-Cavero ◽  
Candy Ivoone Sipiran ◽  
Haydee Barrios ◽  
Eduardo Callacna ◽  
...  
Keyword(s):  
At Risk ◽  
Peripheral Neuropathy ◽  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Working Group ◽  
Arterial Disease ◽  
Older Age ◽  
International Working Group ◽  
History Of ◽  
Peripheral Arterial

Abstract Objectives: To determine the frequency of diabetic foot risk of ulceration and associated factors in patients with type 2 diabetes mellitus. Methods and materials: We used a cross-sectional descriptive design. Data collection was performed in the foot at risk office at Maria Auxiliadora hospital over a period of 3 years, dating from the october 2016 to september 2019. Foot risk assessment was based on the International Working Group of Diabetic Foot (IWGDF) system, which evaluates peripheral neuropathy (with monofilament or tuning fork), biomechanical deformity, peripheral arterial disease (altered pulse or ankle branchial index) or a history of foot ulcer1,2. Foot risk frequency was found according to epidemiological characteristics, and the prevalence ratios with 95% confidence interval were calculated to association analysis, we perform bivariate and multivariate analysis using a generalized linear model. This study has the approval of the María Auxiliadora HospitaĹs Ethics Committee. Results: a total of 402 subjects were included in this study, 63.3% were women, average age 62 yo and diabetes duration <10 years in 56%. 76.6% presented risk to develop ulcer, of which 54.7% presented biomechanical deformation, 37.3% Peripheral Neuropathy (NP), 35.4% Peripheral Arterial Disease (PAD), and 12.7% history of foot ulcer. Patients with foot at risk were associated with older age (RP 1,006, 95% CI 1,001-1.01), and with a score> 5 with respect to <5 in the Total Symptom Score (RP 1.26, 95% CI 1.05-1.51). Conclusions: 3 of 4 patients have a foot at risk of ulceration, predominantly due to biomechanical deformation and peripheral neuropathy, and this risk was associated with older age and greater pain symptomatology. References 1. Bakker K, Apelqvist J, Schaper NC. Practical Guidelines on the management and prevention of the diabetic foot 2011. International Working Group on the Diabetic Foot Guidelines. Diabetes Metab Res Rev. 2012; 28(1):225-231 2. Peters E, Lavery L. Effectiveness of the Diabetic Foot Risk Classification System of the International Working Group on the Diabetic Foot. Diabetes Care. 2001 24:1442–7.

scholarly journals Prospective observational study evaluating association of sociodemographic parameters, Wagner’s grading, peripheral arterial disease and diabetic peripheral neuropathy with the outcomes of diabetic foot ulcers

2020 ◽  
Vol 7 (7) ◽  
pp. 2129
Author(s):  
Vishnu S. Ravidas ◽  
Samadarsi P. ◽  
Ajayan G.
Keyword(s):  
Peripheral Neuropathy ◽  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Diabetic Peripheral Neuropathy ◽  
Arterial Disease ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
The Mean ◽  
Peripheral Arterial

Background: The present study was conducted to determine the association of sociodemographic parameters, comorbid conditions and complications of diabetes mellitus (DM) with the treatment outcomes of diabetic foot ulcers.Methods: The present prospective observational study enrolled 105 participants aged 30-85 years with diabetic foot ulcers presenting to general surgery department during a period of 18 months. Participants who were terminally ill, who had trophic ulcers of Hansen’s disease and filariasis and its sequelae were excluded. The study was approved by institutional ethics committee and written informed consent was obtained from all study participants. Data was analyzed using R and the test of significance was chi square test, p<0.05 was considered statistically significant.Results: Higher proportion of male participants and those aged between 50-69 years were encountered. Male participants were of higher age and the mean duration of DM in participants with diabetic foot ulcer was 8 years. The mean HbA1C of study participants was 8.1%, 38.1% participants had high plasma glucose. Food deformity was observed in 41% participants. 62.9% and 66.7% participants had diabetic peripheral neuropathy and peripheral arterial disease respectively. The mean time required for healing among participants with diabetic foot ulcers was 45.8 Significant association of major amputation with diabetic peripheral neuropathy (p=0.02), Wagner’s grading (p<0.001) and peripheral arterial disease (PAD) (p=0.006) was observed.Conclusions: The presence of diabetic peripheral neuropathy and PAD were risk factors for major amputations in diabetic foot ulcers. Lower Wagner’s grading was associated with lower chances of major amputation.

Activation Products of the Haemostatic System in Coronary, Cerebrovascular and Peripheral Arterial Disease

2001 ◽  
Vol 85 (02) ◽  
pp. 234-239 ◽  
Author(s):  
M. L. Bots ◽  
F. Haverkate ◽  
P. Meijer ◽  
A. Hofman ◽  
C. Kluft ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Transient Ischemic Attack ◽  
Pressure Ratio ◽  
Arterial Disease ◽  
Population Based ◽  
Control Subjects ◽  
History Of ◽  
Ischemic Attack ◽  
Peripheral Arterial ◽  
D Dimer

SummaryTo determine the presence of a ‘hypercoagulable state’ as assessed by indices of thrombin and plasmin generation and of the amount of fibrin that is lysed, in patients with stable coronary, cerebral and peripheral arterial disease a population-based cross-sectional study was performed. From a population-based cohort comprising 7983 men and women aged 55 years and over, we randomly selected 127 subjects with a history of myocardial infarction, 124 with a history of stroke and/or transient ischemic attack, 131 patients with peripheral arterial disease and 263 control subjects in the same age group without arterial disease. Subjects using anticoagulant drugs were not selected. F1+2, TAT, and PAP were not associated with a history of cardiovascular events, nor with peripheral arterial disease. In contrast, positive associations were found for D-Dimer. Mean D-Dimer level was 40 μg/l (95% CI 35,44) in control subjects; 53 μg/l (47, 61) in those with a history of myocar-dial infarction and 51 μg/l (45, 58) in those with a history of stroke and or transient ischemic attack. D-Dimer increased gradually with increasing severity of peripheral atherosclerosis; a decrease in ankle/arm systolic blood pressure ratio of 0.1 was associated with an increase in D-Dimer of 3.9 μg/l (p<0.01). This was more pronounced in subjects with higher F1+2, TAT and PAP concentration. In conclusion, the markers of onset of coagulation F1+2, TAT and PAP are not associated with the presence of arterial disease, but increased levels of these markers are necessary for the positive association between D-Dimer and arterial disease.

scholarly journals Case Report: ENDOVASCULAR STENTING IN PERIPHERAL ARTERIAL DISEASE OF LOWER EXTREMITY

2017 ◽  
Vol 52 (2) ◽  
pp. 140
Author(s):  
Yudi Her Oktaviono
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Transluminal Angioplasty ◽  
Focal Lesions ◽  
First Choice ◽  
History Of ◽  
Arterial Insufficiency ◽  
Artery Disease ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for simple focal lesions to multimodality techniques that enable treatment of severe arterial insufficiency. Especially for high-grade stenoses or short arterial occlusions, percutaneous transluminal angioplasty (PTA) should be the method of first choice followed by the best surgical procedure later on. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures and risk factor control is mandatory.

scholarly journals O48 Incongruous trends in peripheral arterial disease and amputation in Australia

2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
R J Goodall ◽  
W R M Hughes ◽  
J D Salciccioli ◽  
D Marshall ◽  
J Shalhoub
Keyword(s):  
At Risk ◽  
Peripheral Arterial Disease ◽  
Health Expenditure ◽  
Disease Process ◽  
Arterial Disease ◽  
Developed Country ◽  
True Incidence ◽  
Incidence Trends ◽  
Risk Patients ◽  
Peripheral Arterial

Abstract Introduction We aimed to compare the incidence trends for peripheral arterial disease (PAD) and lower extremity amputation (LEA) in Australia with European Union (EU) 15+ countries. Method For the years 1990–2017, we extracted PAOD and LEA incidence data from the Global Burden of Disease (GBD) Study and compared trends across EU15+ countries (19 countries with similar health expenditure—including Australia, the US and the UK). Result In 2017, the age-standardised incidence rate (ASIR) for PAOD was lower in Australia than any other EU15+ country for males (90.0/100,000) and third lowest in females (99.9/100,000) (only females in Norway and Spain had lower 2017 ASIRs for PAD). However for LEA, the 2017 ASIRs were higher in Australia for both sexes than in any other EU15+ country (male 119.8/100,000, female 78.0/100,000). Furthermore, contrasting and anomalous time trends in the incidence of PAOD and LEA were observed in Australia between 1990–2017. The PAOD ASIR decreased over the 28-year period for both males (-16.5%) and females (-17.4%), whereas the LEA ASIR increased over the same time period for both sexes (males +12.5%, females +10.3%). Given the frequency with which LEAs are precipitated by PAOD, these divergent trends were unexpected, especially within a developed country such as Australia. Conclusion Our data raises the concern that the true incidence of PAOD in Australia is under-diagnosed, with at-risk patients potentially being recognised late in the disease-process, manifesting as high amputation rates relative to countries with similar health expenditure. Take-home Message Australia has anomalous trends in amputation and peripheral arterial disease when compared with other countries with similar health expenditure. Our data raises the concern that the true incidence of PAOD in Australia is under-diagnosed, with at-risk patients potentially being recognised late in the disease-process, manifesting as high amputation rates relative to countries with similar health expenditure.

scholarly journals SKRINING KAKI DIABTES UNTUK DETEKSI DINI LUKA KAKI DIABETES PADA PASIEN DIABETES

2020 ◽  
Vol 6 (2) ◽  
pp. 192-198
Author(s):  
Juhelnita Bubun ◽  
Saldy Yusuf ◽  
Yuliana Syam ◽  
Wahyu Hidayat ◽  
Suharno Usman
Keyword(s):  
Peripheral Arterial Disease ◽  
Scoping Review ◽  
Diabetic Foot ◽  
Full Text ◽  
Arterial Disease ◽  
Key Word ◽  
Diabetic Foot Screening ◽  
Peripheral Arterial

Latar Belakang: Prognosis LKD yang tidak dirawat dengan baik akan berdampak buruk yaitu amputasi bahkan kematian sehingga dibutuhkan tindakan pencegahan yaitu skrining kaki diabetes. Tujuan dari review ini, untuk mengetahui metode skrining kaki diabetes untuk mencegah terjadi luka kaki diabetes (LKD). Metode database yang digunakan pada pencarian artikel yaitu pubmed, wiley dan science direct. Hasil: kata kunci yang digunakan diabetic foot screening OR diabetes foot screening jumlah artikel yang didapatkan   39 artikel dari tiga database dan artikel yang menjadi kriteria inklusi artikel, artikel tahun 2013-2018, merupakan hasil penelitian, sesuai tema  scoping review dan artikel full text, sehingga terdapat empat artikel yang terinklusi. Dari artikel tersebut dua artikel yang membahas metode skrining kaki diabetes untuk mendeteksi neuropati dan dua artikel yang membahas metode skrining kaki diabetes untuk mendeteksi angiopati. Skrining kaki diabetes untuk mendeteksi neuropati dapat menggunakan metode sudoscan yang dapat mendeteksi 34% tidak ada neuropati, tanpa gejala 69% dan dengan gejala 61,7%. Metode Ipswich touch test (IpTT) dapat digunakan oleh tenaga non professional di rumah dan klinik dalam mendeteksi neuropati dengan sensitivitas 78,3% dan 81,2%, spesifitas 93,9% dan 96,4%. Metode dalam mendeteksi angiopati adalah ankle brachialis index (ABI). Kombinasi hasil palpasi nadi yang lemah /hilang dan ABI yang abnormal menghasilkan sensitivitas dan nilai prediksi negatif tertinggi (92,3 % dan 89,8%) penyebab peripheral arterial disease (PAD). Kesimpulan: metode skrining kaki diabetes untuk mendeteksi neuropati terdiri atas beberapa metode yang aman untuk digunakan. ABI dapat digunakan mendeteksi PAD. Key word: skrining kaki diabetes, neuropati, angiopati

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