scholarly journals Phototherapy in the Treatment of Diabetic Foot — A Preliminary Study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zbigniew Mikołajczyk ◽  
Iwona Nowak ◽  
Andrzej Kawiński ◽  
Michał Mik
Keyword(s):  
Diabetic Foot ◽  
Surgical Intervention ◽  
Light Wave ◽  
Early Stage ◽  
Literature Study ◽  
Entire Surface ◽  
Light Waves ◽  
Patients With Diabetes ◽  
Preliminary Study ◽  
Living Organisms

Abstract The first part of the publication presents a substantively insightful literature study on the essence and effects of light waves on wound healing in living organisms, including the use of phototherapy in the treatment of the diabetic foot. A knitted textile dressing was designed and manufactured for phototherapy of patients with diabetes suffering from diabetic foot syndrome (DFS). The proposed solution is intended for the treatment of dermal tissues within the patient's foot affected because of diabetic disease at an early stage. Thus, the use of a knitted dressing with incorporated fiber optic structures and powered by a semiconductor laser emitting a 405 nm light wave from its entire surface would prevent further anomalies of the patient's tissues and help to avoid surgical intervention.

Surgical Off-loading of the Diabetic Foot

2010 ◽  
Vol 100 (5) ◽  
pp. 369-384 ◽  
Author(s):  
Robert G. Frykberg ◽  
Nicholas J. Bevilacqua ◽  
Geoffrey Habershaw
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Foot ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Foot Ulcers ◽  
Foot Surgery ◽  
Patients With Diabetes

Surgical intervention for chronic deformities and ulcerations has become an important component in the management of patients with diabetes mellitus. Such patients are no longer relegated to wearing cumbersome braces or footwear for deformities that might otherwise be easily corrected. Although surgical intervention in these often high-risk individuals is not without risk, the outcomes are fairly predictable when patients are properly selected and evaluated. In this brief review, we discuss the rationale and indications for diabetic foot surgery, focusing on the surgical decompression of deformities that frequently lead to foot ulcers. (J Am Podiatr Med Assoc 100(5): 369–384, 2010)

scholarly journals Surgical Intervention of Early Stage Primary Acquired Cholesteatoma

2016 ◽  
Vol 130 (S3) ◽  
pp. S218-S219
Author(s):  
Tao Pan ◽  
Furong Ma ◽  
Yu Wang ◽  
Ke Zhang ◽  
Jia Ke
Keyword(s):  
Surgical Intervention ◽  
Early Stage ◽  
Acquired Cholesteatoma

scholarly journals A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Rank Test ◽  
Diabetic Patients ◽  
Effective Measure ◽  
Before And After ◽  
Patients With Diabetes ◽  
Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

scholarly journals Changes in the Population Size of Calbindin D-28k-Immunoreactive Enteric Neurons in the Porcine Caecum under the Influence of Bisphenol A: A Preliminary Study

Toxics ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Ignacy Gonkowski ◽  
Slawomir Gonkowski ◽  
Ewa Dzika ◽  
Joanna Wojtkiewicz
Keyword(s):  
Bisphenol A ◽  
Calcium Binding ◽  
Neuronal Cells ◽  
Enteric Neurons ◽  
Toxic Activity ◽  
Protective Properties ◽  
Calcium Buffer ◽  
Preliminary Study ◽  
Living Organisms ◽  
Calbindin D

Calbindin D-28k (CB) is a calcium-binding protein widely distributed in living organisms that may act as a calcium buffer and sensory protein. CB is present in the enteric nervous system (ENS) situated in the gastrointestinal tract, which controls the majority of activities of the stomach and intestine. The influence of various doses of bisphenol A (BPA)—a chemical compound widely used in plastics production—on the number and distribution of CB-positive enteric neuronal cells in the porcine caecum was investigated with an immunofluorescence technique. The obtained results showed that low dosages of BPA resulted in an increase in the number of CB-positive neuronal cells in the myenteric (MP) and inner submucous (ISP) plexuses, whereas it did not alter the number of such neuronal cells in the outer submucous plexus (OSP). High dosages of BPA caused the increase in the amount of CB-positive perikarya in all the above-mentioned kinds of the caecal neuronal plexuses. These observations strongly suggest that CB in the ENS participates in the processes connected with the toxic activity of BPA. Most likely, the changes noted in this experiment result from the adaptive and protective properties of CB.

scholarly journals Glycated Hemoglobin (HbA1c) as a Biomarker for Diabetic Foot Peripheral Neuropathy

Diseases ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Giulia Casadei ◽  
Marta Filippini ◽  
Lorenzo Brognara
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Glycated Hemoglobin ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Glycemic Variability ◽  
Future Research ◽  
Patients With Diabetes ◽  
Axonal Dysfunction ◽  
Biomarker Research

Background: Diabetic peripheral neuropathy (DPN) is known to predict foot ulceration, lower-extremity amputation and mortality. Patients with diabetes mellitus have a predisposition toward developing chronic inflammatory demyelinating polyneuropathy, and this may also facilitate the formation of diabetic foot and cutaneous impairment, which are considered one of the most serious impairments of diabetes mellitus, with a prevalence of 4–10% in this population. Biomarkers research provides opportunities for the early diagnosis of these complications for specific treatments useful to prevent amputation and, therefore, physical inability and mental disturbance. The recent literature has suggested that glycemic levels may be a novel factor in the pathogenesis of diabetic foot complications and is an important mediator of axonal dysfunction. The aim of this systematic literary review is to determine whether hemoglobin A1c (HbA1c) is a positive predictor for diabetic foot peripheral neuropathy and its complications, such as foot cutaneous impairments. There is a lack of consensus regarding the effect of glycemic variability on diabetic foot peripheral neuropathy, unlike other complications such as retinopathy, nephropathy or micro/macrovascular pathology. Methods: Relevant articles were searched in the Medline database using PubMed and Scopus and relevant keywords. The primary search terms used were “glycated hemoglobin” OR “HbA1c” AND “diabetic neuropathies” AND “Foot”. Results: A number of articles (336) were initially identified while searching the scientific literature regarding this topic, and 32 articles were selected and included in this review. Conclusions: This review highlights the role of HbA1c in diabetic foot peripheral neuropathy. Biomarkers play an important role in the decision-making process, and HbA1c levels are extensively used for diabetic foot clinical outcomes and settings, but biomarker research in diabetic foot peripheral neuropathy is in its infancy and will require careful attention to a number of factors and associations, since the consequences of DPN also include neurological alterations. HbA1c is an accurate and easy-to-administer test and can be an effective biomarker in establishing the diagnosis of diabetes, but future research should focus on standardizing the HbA1c level and selecting which DPN value and its correlated complications, such as foot cutaneous impairments, are the most informative.

scholarly journals Quantifying dermal microcirculatory changes of neuropathic and neuroischemic diabetic foot ulcers using spatial frequency domain imaging: a shade of things to come?

2020 ◽  
Vol 8 (2) ◽  
pp. e001815
Author(s):  
Grant A Murphy ◽  
Rajinder P Singh-Moon ◽  
Amaan Mazhar ◽  
David J Cuccia ◽  
Vincent L Rowe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Spatial Frequency ◽  
Oxygen Saturation ◽  
Diabetic Foot ◽  
Clinical Course ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Spatial Frequency Domain Imaging ◽  
Patients With Diabetes ◽  
Spatial Frequency Domain

IntroductionThe use of non-invasive vascular and perfusion diagnostics are an important part of assessing lower extremity ulceration and amputation risk in patients with diabetes mellitus. Methods for detecting impaired microvascular vasodilatory function in patients with diabetes may have the potential to identify sites at risk of ulceration prior to clinically identifiable signs. Spatial frequency domain imaging (SFDI) uses patterned near-infrared and visible light spectroscopy to determine tissue oxygen saturation and hemoglobin distribution within the superficial and deep dermis, showing distinct microcirculatory and oxygenation changes that occur prior to neuropathic and neuroischemic ulceration.Research designs and methods35 patients with diabetes mellitus and a history of diabetic foot ulceration were recruited for monthly imaging with SFDI. Two patients who ulcerated during the year-long longitudinal study were selected for presentation of their clinical course alongside the dermal microcirculation biomarkers from SFDI.ResultsPatient 1 developed a neuropathic ulcer portended by a focal increase in tissue oxygen saturation and decrease in superficial papillary hemoglobin concentration 3 months prior. Patient 2 developed bilateral neuroischemic ulcers showing decreased tissue oxygen saturation and increased superficial papillary and deep dermal reticular hemoglobin concentrations.ConclusionsWounds of different etiology show unique dermal microcirculatory changes prior to gross ulceration. Before predictive models can be developed from SFDI, biomarker data must be correlated with the clinical course of patients who ulcerate while being followed longitudinally.Trial registration numberNCT03341559.

scholarly journals Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene

2021 ◽  
Vol 9 ◽  
pp. 205031212110291
Author(s):  
Targ Elgzyri ◽  
Jan Apelqvist ◽  
Eero Lindholm ◽  
Hedvig Örneholm ◽  
Magdalena Annersten Gershater
Keyword(s):  
Diabetic Foot ◽  
Clinical Characteristics ◽  
Foot Ulcer ◽  
Major Amputation ◽  
Severe Form ◽  
Foot Ulcers ◽  
Vascular Intervention ◽  
Co Morbidity ◽  
Patients With Diabetes

Background: Forefoot gangrene in patients with diabetes is a severe form of foot ulcers with risk of progress and major amputation. No large cohort studies have examined clinical characteristics and outcome of forefoot gangrene in patients with diabetes. The aim was to examine clinical characteristics and outcome of forefoot gangrene in patients with diabetes admitted to a diabetic foot centre. Methods: Patients with diabetes and foot ulcer consecutively presenting were included if they had forefoot gangrene (Wagner grade 4) at initial visit or developed forefoot gangrene during follow-up at diabetic foot centre. Patients were prospectively followed up until final outcome, either healing or death. The median follow-up period until healing was 41 (3–234) weeks. Results: Four hundred and seventy-six patients were included. The median age was 73 (35–95) years and 63% were males. Of the patients, 82% had cardiovascular disease and 16% had diabetic nephropathy. Vascular intervention was performed in 64%. Fifty-one patients (17% of surviving patients) healed after auto-amputation, 150 after minor amputation (48% of surviving patients), 103 had major amputation (33% of surviving patients) and 162 patients deceased unhealed. Ten patients were lost at follow-up. The median time to healing for all surviving patients was 41 (3–234) weeks; for auto-amputated, 48 (10–228) weeks; for minor amputated, 48 (6–234) weeks; and for major amputation, 32 (3–116) weeks. Conclusion: Healing without major amputation is possible in a large proportion of patients with diabetes and forefoot gangrene, despite these patients being elderly and with extensive co-morbidity.

scholarly journals Computer-Generated Hologram Based on Reference Light Multiplexing for Holographic Display

2021 ◽  
Vol 11 (16) ◽  
pp. 7199
Author(s):  
Dapu Pi ◽  
Juan Liu
Keyword(s):  
Image Quality ◽  
Numerical Simulations ◽  
Light Wave ◽  
Information Capacity ◽  
Improve Image Quality ◽  
Multiple Images ◽  
Holographic Display ◽  
Light Waves ◽  
Computer Generated Holograms ◽  
Holographic Displays

In this article, we propose a reference light wave multiplexing scheme to increase the information capacity of computer-generated holograms. The holograms were generated by different reference light waves and superimposed together as a multiplexed hologram. A modified Gerchberg–Saxton algorithm was used to improve image quality, and different images could be reconstructed when the multiplexed hologram was illuminated by corresponding reference light waves. We performed both numerical simulations and optical experiments to demonstrate the feasibility of the proposed scheme. Numerical simulations showed that the proposed method could reconstruct multiple images successfully by a single multiplexed hologram and optical experiments are consistently good with numerical simulations. It is expected that the proposed method has great potential to be widely applied in holographic displays in the future.

Current Concepts in Diabetic Microvascular Dysfunction

2006 ◽  
Vol 96 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Javier La Fontaine ◽  
Lawrence B. Harkless ◽  
Christian E. Davis ◽  
Marque A. Allen ◽  
Paula K. Shireman
Keyword(s):  
Diabetic Foot ◽  
Vascular System ◽  
Microvascular Dysfunction ◽  
Diabetic Macroangiopathy ◽  
Patients With Diabetes ◽  
Foot Problems ◽  
Control Of Diabetes ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Pathologic Processes

Microvascular dysfunction is an important component of the pathologic processes that occur in diabetic foot disease. The endothelial abnormalities observed in patients with diabetes mellitus are poorly understood, and evidence suggests that endothelial dysfunction could be involved in the pathogenesis of diabetic macroangiopathy and microangiopathy. With the advent of insulin replacement in the early 1900s and increased efforts toward metabolic control of diabetes, long-term complications of this disease have become apparent. These late-term complications are primarily disorders of the vascular system. This article reviews the process of microvascular dysfunction and how it may relate to the pathogenesis of diabetic foot problems. (J Am Podiatr Med Assoc 96(3): 245–252, 2006)

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