Society vs the Wheelchair

PEDIATRICS ◽  
1979 ◽  
Vol 63 (4) ◽  
pp. 576-579
Author(s):  
Rose Marie MacElman
Keyword(s):  
Diabetes Mellitus ◽  
High School ◽  
Young Lady ◽  
Lower Limbs ◽  
Unknown Etiology ◽  
Cerebellar Disease ◽  
Childhood Illnesses ◽  
Unsteady Gait ◽  
Ecg Abnormalities ◽  
Tendon Reflexes

Rose Marie became a patient of mine at the age of 2½, just one month after I began practicing pediatrics in July of 1962. She had typical childhood illnesses and seemed otherwise normal until March of 1965, when on her preschool physical exam I picked up mild ataxia and a positive Romberg's sign. This showed slow but steady progression, so a year later I referred her to a neurologist. He felt she had a progressive degenerative cerebellar disease of unknown etiology. At that time, her only problems were an unsteady gait and "shaky" handwriting. In 1971 her sister, five years younger, was noted to have an identical disability. By 1972, Rose Marie had ECG abnormalities consistent with Friedreich's ataxia. By that time she was confined to a wheelchair, had slurred speech, and a progressive scoliosis. In five more years she had developed diabetes mellitus (felt to be unrelated), occasional choking spells, and marked weakness and ataxia of her upper as well as lower limbs, distally more than proximally. She has absent deep tendon reflexes and loss of position and vibratory sensation in the lower limbs. Despite her problems, Rose Marie is a B student and a very personable young lady. In the spring of 1978, a few months before she was to graduate from high school, I was sent a form from the state vocational rehabilitation director regarding her potential and prognosis. Although I felt I knew Rose Marie as well as any of my patients, my immediate reaction was, "Rehabilitation?

Experience of using atraumatic ointment bandages based on peruvian balsam in the complex treatment of patients with chronic wound defects of the lower limbs

2020 ◽  
pp. 43-57
Author(s):  
Anna Tabuika
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Local Treatment ◽  
Lower Limbs ◽  
Complex Treatment ◽  
Average Area ◽  
Arterial Insufficiency ◽  
Significant Activation

The article reflects the results of a retrospective non-comparative study, the objects of which were 34 outpatient comorbid patients (15 of which are over 60 years old) with chronic wounds of the lower limbs developed against the background of varicosity, post-thrombotic disease, chronic arterial insufficiency of the lower limbs, diabetes mellitus or their combination. Their local treatment was carried out using atraumatic ointment dressing «Branolind N» containing Peruvian balsam. There were 23 women (67.6 %) and 11 men (32.4 %). In microbiological study prior to the beginning of treatment in 31 patients the growth of a pathogen of wound infection was revealed; in 19 patients — Staphylococcus aureus in monoculture and in various associations, in 6 patients — Pseudomonas aeruginosa in monoculture, in other cases — other pathogens. In 3 patients the pathogen was not detected. The average wound size was 34 cm2 . The phase of the wound process was additionally confirmed by cytological studies. After treatment the average area of the wound defect decreased by 10 cm2 and made 24 cm2 on average. Full healing of the wound defect occurred in 11 patients, the others had granulation and active marginal epithelization. There was also a decrease in bacterial semination of wounds, a change in composition of infection agents to less aggressive monoflora, and cytologically — a decrease in signs of inflammation against the background of significant activation of reparative processes.

scholarly journals The Prevalence of Diabetes Mellitus Among High School and University Teachers in Mogadishu, Somalia

2020 ◽  
Vol 4 (2) ◽  
pp. 94
Author(s):  
Mohamed Elmi Ibrahim ◽  
Recep Erçin Sönmez ◽  
Ahmed Yusuf Guleid ◽  
Orhan Alimoğlu
Keyword(s):  
Diabetes Mellitus ◽  
High School ◽  
High School Teachers ◽  
Primary Objective ◽  
University Teachers ◽  
Screening Programs ◽  
Research Survey ◽  
Multiple Variables ◽  
Public Environment ◽  
Prevalence Of Diabetes Mellitus

Background: Primary objective of the present study is to describe the main risk factorsof diabetes mellitus (DM) and to determine its prevelance among high school and university teachers in Mogadishu, Somalia.Materials and Methods: Current study is designated as a research survey in an attempt to collect data from members of a certain population in order to determine the actual status of diabetes mellitus (DM) in respect to multiple variables (risk factors, awareness, prevelance). The study populationhad beenselected fromhigh school and university teachers who reside and work in Mogadishu, Somalia.Results:A total of 222 (M/F (135/87)) respondents were included in the study of whom mostly were university teachers (n=128 (57.7%)), and less were high school teachers (n=94 (42.3%)). Majority of the population had been consisted of those graduated with degree (n=100 (45%)), and less were the ones with diploma (n=51 (23%)), secondary certificate (n=40 (18%)), master degree (n=29 (13.1%)) and PhD (n=2 (0.9%)) in decreasing frequency. Most of respondents were less than 60 years of age (n=196 (89.2%)) that the majority were within 30-40 years interval (n=74 (33.3%)). Prevelance of diabetes mellitus (DM) was found as 36.5% (n=81). Though, only 15 (18.5%) patients had prior knowledge of which type of DM (1 or 2) they had.Conclusion:Interactional educational programs should be conducted both in public environment as well as in schools to improve knowledge and awareness of the community about clinical outcomes of diabetes mellitus (DM) on common health. Establishment of new screening programs will aid in prevention of adverse effects related to diabetes mellitus (DM).International Journal of Human and Health Sciences Vol. 04 No. 02 April’20 Page : 94-97

scholarly journals Study of the influence of vacuum therapy on the wound process in patients with diabetic foot syndrome

2019 ◽  
Vol 74 (4) ◽  
pp. 283-288
Author(s):  
Petr A. Gerasimchuk ◽  
Alexander V. Shidlovskyi ◽  
Dmitriy B. Fira ◽  
Andrey V. Pavlyshyn
Keyword(s):  
Diabetes Mellitus ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Chronic Wound ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Vacuum Therapy ◽  
Social Significance ◽  
Number Of Patients ◽  
Bed Days

Background: According to the International Diabetes Federation (IDF), the number of patients on diabetes mellitus is now more than 415 million people on Earth, until 2030 it will increase to 439 million, and by 2035 ― will reach 592 million. Throughout life, 4.625% of patients with diabetes mellitus develops a diabetic foot syndrome with the formation of wounds, whose treatment, can not yet be considered satisfactory, since in 1525% of patients are the direct cause of high amputations of the lower limbs. This requires finding new effective methods for treating wound defects in patients with diabetic foot syndrome, one of which can be vacuum wound therapy. Aims: To study the effectiveness of vacuum therapy in the treatment of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenetic form of the lesion. Materials and methods: The effect of vacuum therapy on the course of acute and chronic wound process in 231 patients with neuropathic and ischemic form of diabetic foot syndrome was studied during 20142017. Evaluation of the dynamics of the wound process was carried out on the basis of clinical, planimetric, microbiological, morphological methods, as well as microcirculation indices in the area round the wound. Results: Vacuum therapy of acute and chronic wounds in patients with different pathogenetic forms of diabetic foot syndrome, allows to stabilize the course of wound process, stimulate regenerative processes in the wound, improve local microcirculation (p0.05). This, in turn, allows a shorter time to prepare a wound for closure by one of the methods of plastic surgery or create favorable conditions for its independent epithelization. In patients with ischemic lesions (chronic arterial insufficiency of the third degree), the carrying out of vacuum therapy by standard method leads to an intensification of the pain syndrome. This causes the need to apply an initial negative pressure in the system in the range of 7080 mm Hg, which makes it possible to stop pain during the day. At 23 days of the postoperative period, negative pressure is established at standard values. Conclusions: Vacuum therapy of wounds in patients with diabetic foot syndrome is an effective method of treatment that allows the doctor to reduces the duration of treatment of patients in hospital with a neuropathic form of diabetic foot syndrome on average (4.31.7) bed-days, and patients with ischemic form ― on average (4.11.9) bed-days, which has both medical and social significance.

scholarly journals Caso Clínico: Cirugía Reconstructiva de Tobillo

2018 ◽  
Vol 10 (2) ◽  
pp. 170-174
Author(s):  
Fulvio Enrique Zuñiga Cabrera ◽  
Jaime Santiago Clavijo Jaramillo ◽  
Adriana Abigail Guzmán Villa
Keyword(s):  
Diabetes Mellitus ◽  
Reverse Flow ◽  
Public Health Problem ◽  
Lower Limbs ◽  
World Health ◽  
Major Public Health Problem ◽  
Sural Flap ◽  
Advantages And Disadvantages ◽  
Left Ankle ◽  
Osteosynthesis Material

BACKGROUND: Diabetes mellitus is a major public health problem, according to the World Health Organization, 422 million adults worldwide in 2014. In 2012, it caused 1.5 million deaths worldwide. Diabetes is the leading cause of non-traumatic amputation in lower limbs and foot infections occur with high frequency in poorly controlled patients. This case shows the reconstruction of soft tissue defects in the lower third leg, heel, malleoli and foot through the description of the reverse sural flap. In this study the advantages and disadvantages of the use of this technique are discussed. CASE REPORT: A 56-year-old female patient with a poorly controlled history of Diabetes Mellitus type 2, who suffered a fracture of the left ankle treated with osteosynthesis, and who during the postoperative period attended emergency orthopedics and traumatology, due to severe pain in the left ankle, fever, dehiscence of surgical wound, accompanied by serous secretion. EVOLUTION: The patient, after several surgical cleanings and changes in closure therapy assisted by negative pressure, manages to control the infection, with persistence of the bone coverage defect and the osteosynthesis material. There were additional complications such as joint stiffness, muscle atrophy; it was decided to reconstruct the distal third of the foot using a reverse flow sural fasciocutaneous flap, which evolved satisfactorily, managing to cover the defect with biological tissue. CONCLUSIONS: The sural flap of reverse flow is a reproducible technique that allows to cover coverage defects in the distal third of the leg and ankle; shorten hospitalization times, especially when there is bone exposure or osteosynthesis material.

scholarly journals Stiff Man Syndrome: A Diagnostic Dilemma in a Young Female with Diabetes Mellitus and Thyroiditis

2014 ◽  
Vol 7 ◽  
pp. CCRep.S16941 ◽  
Author(s):  
Hilary Enuh ◽  
Michael Park ◽  
Arjun Ghodasara ◽  
Edward Arsura ◽  
Jay Nfonoyim
Keyword(s):  
Diabetes Mellitus ◽  
Young Female ◽  
Leg Pain ◽  
Stiff Person Syndrome ◽  
Diagnostic Dilemma ◽  
Lower Extremity Weakness ◽  
Unsteady Gait ◽  
Unusual Occurrence ◽  
Stiff Man Syndrome

Stiff Person Syndrome (SPS), is a very rare neuroimmunologic disorder characterized by progressive muscle pain, rigidity, stiffness, and spasms. It can be very debilitating if misdiagnosed or not recognized in time. Herein we discuss a case of a female in her 20s who presented with an unsteady gait, lower extremity weakness, persistent leg pain, and stiffness few weeks after uncomplicated childbirth. She has type 1 diabetes mellitus (DM) and was diagnosed with thyroiditis in the course of her illness. The triad of thyroiditis, DM, and stiffness with normal neuroimaging in a young female patient is an unusual occurrence.

scholarly journals Disulfiram-induced polyneurophaty

2012 ◽  
Vol 69 (5) ◽  
pp. 453-475
Author(s):  
Slavica Vujisic ◽  
Ljiljana Radulovic ◽  
Sladjana Knezevic-Apostolski ◽  
Stevan Petkovic ◽  
Filip Vukmirovic ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Laboratory ◽  
Chronic Alcoholism ◽  
Lower Limbs ◽  
Sensory Impairment ◽  
Treatment Cessation ◽  
Below The Knee ◽  
Toxic Neuropathy ◽  
Soles Of The Feet ◽  
Tendon Reflexes

Introduction. Disulfiram is used in the treatment of chronic alcoholism, because of the unpleasant symptoms produced after ethanol intake. Although it is well tolerated in most patients, one in 15,000 patients will develop peripheral neuropathy every year, which is frequently misdiagnosed as alcoholic neuropathy. Case report. We report clinical, laboratory, electrophysiological and histopathological features in a 19-year-old patient who developed an acute distal sensorymotor neuropathy during the treatment of alcoholism. At the end of 4-month treatment with disulfiram 250 mg/day, the patient complained of weakness in distal segments of the lower limbs associated with burning dysesthesias, numbness and pain in the soles of the feet and the legs below the knees; reduction in foot strength, the absence of ankle jerk tendon reflexes, and tactile stocking pin-pick and vibratory sensory impairment in the lower limbs below the knee. Recovery was successful after treatment cessation. Conclusion. The significance of toxic neuropathy is shown by the fact that the recognition of clinical picture, identifying etiological factors and its elimination may prevent the evolution of polyneuropathy. This allows for more effective treatment of these neuropathies as apposite to idiopathic ones which can be treated only symptomatically. Our case report indicates the possibilities during a period with no serious damage to the axons manifested.

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