1/75. osteomyelitis associated with peripheral vascular disease secondary to diabetes mellitus.diabetes mellitus and arteriosclerotic vascular disease have been found to be the predisposing factors of osteomyelitis associated with peripheral vascular disease (10). A diabetic person is more susceptible to osteomyelitis because of the microangiopathy, peripheral neuropathy and decreased resistance to infection. In diabetes mellitus there can be microangiopathy which results from the proliferation of the endothelium of the intima and thickening of the basement membrane. This further contributes to a sluggish blood flow. In the patient with arteriosclerotic vascular disease, the lumens of the arterioles and arterioles are compromised by the atheromatous plaques. The anatomic structure of the blood supply to bone along with the pathologic membrane thickening, allows for slowing of blood. This slowing of blood flow causes micro-thrombi and enhances bacterial growth. In diabetes mellitus it has been shown that there is a decreased immunologic response which, along with the above, contributes to the sheltering and proliferation of bacteria in the small bones of the foot.- - - - - - - - - - ranking = 1keywords = diabetic, vascular disease (Clic here for more details about this article) |
2/75. Thermal burns in diabetic feet.Many patients with diabetes can lead a full life without developing diabetic lesions in their feet. This is because these patients have avoided the precipitating factors of which the most important is mechanical trauma and infections. We present five cases of diabetic patients who, out of ignorance, listened to bad advice by using hot therapy to treat their peripheral neuropathy. This resulted in burns and secondary infections. All of them required large surgical debridement and prolonged costly hospital stay to treat their condition. Fortunately, none of them required amputation. This paper hopes to highlight the dangers of self treatment and medication in diabetic foot lesions.- - - - - - - - - - ranking = 4.8054098901557keywords = diabetic (Clic here for more details about this article) |
3/75. Antibiotic beads in the treatment of diabetic pedal osteomyelitis.Antibiotic-impregnated polymethylmethacrylate (PMMA) beads have improved the outcome of osteomyelitis treatment in both experimental models and clinical trials. The primary benefit of antibiotic-impregnated PMMA beads is that they provide high local concentrations of antibiotic while systemic levels of antibiotic remain low. Little has been written about the specific use of antibiotic-impregnated PMMA beads in the treatment of diabetic pedal osteomyelitis. The authors review antibiotic-impregnated PMMA beads and provide examples of their use in the treatment of diabetic pedal osteomyelitis.- - - - - - - - - - ranking = 4.1189227629906keywords = diabetic (Clic here for more details about this article) |
4/75. Fine needle aspiration of tophi for crystal identification in problematic cases of gout. A report of two cases.BACKGROUND: The definitive diagnosis of gout is best established by demonstration of monosodium urate (MSU) crystals in the synovial fluid or biopsy. Fine needle aspiration cytology (FNAC) of tophi can play a crucial role in diagnosis. CASES: A 36-year-old chronic alcoholic male developed subcutaneous nodules on both malleoli without a history of arthropathy and with normal serum uric acid levels. FNAC of the nodules demonstrated stacks and sheaves of needle-shaped crystals of MSU. A 50-year-old diabetic male developed multiple nodules on the feet. He gave a past history of painful athropathy. A roentgenogram of the feet was suspicious for gout; however, joint aspiration failed, and the serum uric acid levels were normal. At this juncture FNAC of the feet tophi clinched the diagnosis of gout. In both cases, polarization of needle washings (wet mount) and the fixed, Papanicolaoustained smears showed negatively birefringent, needle-shaped crystals of MSU, thus confirming the diagnosis of gout. CONCLUSION: FNAC of gouty tophi is an easy alternative to synovial biopsy and joint fluid analysis. It is simpler, easier and less painful. As crystals are preserved in stained smears, they can be employed for polarization and confirmation of gout.- - - - - - - - - - ranking = 0.68648712716511keywords = diabetic (Clic here for more details about this article) |
5/75. Acute Charcot foot changes versus osteomyelitis: does Tc-99m HMPAO labeled leukocytes scan differentiate?osteomyelitis often complicates a diabetic neuropathic foot, leading to amputation, decreased function, and quality of life. Therefore, early detection and treatment are paramount. Furthermore, neuroarthropathic (Charcot) changes in the foot often resemble infection and must be differentiated. Currently, the Tc-99m HMPAO Labeled leukocytes Scan is considered to be the most reliable noninvasive imaging modality of choice in determining Charcot foot changes versus osteomyelitis. The purpose of this article is to alert the clinician that although the Tc-99m HMPAO Labeled leukocytes Scan may be the second most reliable test next to bone biopsy for determining osteomyelitis, false positives do occur.- - - - - - - - - - ranking = 0.68648712716511keywords = diabetic (Clic here for more details about this article) |
6/75. Toxic shock syndrome originating from the foot.The most familiar etiology of toxic shock syndrome (TSS) is that of menstruation and tampon use. Nonmenstrual TSS has been described in all types of wounds including postsurgical, respiratory infection, mucous membrane disruption, burns, and vesicular lesions caused by varicella and shingles. A case of TSS occurring in a diabetic male patient with foot blisters is presented. Early recognition by an infectious disease specialist and appropriate medical management led to complete recovery. There have been no reported cases of staphylococcus aureus TSS originating in the foot to date.- - - - - - - - - - ranking = 0.68648712716511keywords = diabetic (Clic here for more details about this article) |
7/75. Neurogenic positional pedal neuritis. Common pedal manifestations of spinal stenosis.Neurogenic positional pedal neuritis is a presentation of neuritic symptoms in one or both feet usually affected by body position, specifically, the position of the spine. Its etiology is similar to that of neurogenic-induced claudication caused by spinal stenosis in that the symptoms are caused by compression or irritation of nerves of the lower lumbosacral spine, usually the fifth lumbar and first sacral nerve roots. Burning, stabbing, a cold feeling, aching, numbness, paresthesia, or a weak or tired feeling of the feet (during some part of the disease process) depend on spinal position and may occur during standing, walking, or even lying in bed. Symptoms may be severe and are often eliminated by lumbosacral spine flexion, such as by walking with wheeled support such as a grocery cart or walker; less frequently by negative-heel shoe modification, which can change the position of the lumbosacral spine in stance; or by alteration of sleeping position. This condition, which can include loss of protective sensation, is often misdiagnosed as neuropathy (especially in diabetic patients) or less frequently as biomechanical in origin. In diabetic patients, this condition is frequently the cause of failure of monochromatic infrared energy therapy for diabetic peripheral neuropathy. Treatment is aimed at reducing the spinal nerve or nerve root irritation. Clear definition of the pedal symptoms of spinal nerve compression within a single diagnostic category should facilitate identification and treatment.- - - - - - - - - - ranking = 2.0594613814953keywords = diabetic (Clic here for more details about this article) |
8/75. Autoamputation of the foot caused by untreated gas gangrene: a case report.Gas-producing diabetic foot infections are limb-threatening emergencies commonly encountered by foot and ankle surgeons. Appropriate treatment includes aggressive surgical debridement, parenteral antibiotics, and postoperative wound care. The authors present a unique case of a patient who refused treatment for a deep-space gas-producing infection, resulting in autoamputation of the foot. The authors also discuss the confusion surrounding the definition of gas gangrene.- - - - - - - - - - ranking = 0.68648712716511keywords = diabetic (Clic here for more details about this article) |
9/75. Supercharged reverse-flow sural flap: a new modification increasing the reliability of the flap.The management of soft-tissue defects in the lower third of the leg and foot presents a considerable problem because of composite tissue defects, inadequate and tight local tissue for reconstruction, and poor circulation. Although the reverse sural flap is frequently preferred and is fairly reliable, some complications arising from the circulation may be encountered in large flaps or in diabetic patients. In the present study, we developed a new modification by supercharging the sural flap to reduce venous congestion and edema and to increase the reliability of the flap. We treated 3 patients (2 men and 1 woman) by utilizing a supercharged reverse sural flap. All flaps survived and healed uneventfully. We also suggest a new and more distinctive classification for supercharging and turbocharging, which defines the vessel type to be anastomosed and the relationship of the vessel to be anastomosed with the main vessel to the flap.- - - - - - - - - - ranking = 0.68648712716511keywords = diabetic (Clic here for more details about this article) |
10/75. Nonclostridial cellulitis with subcutaneous emphysema.Nonclostridial cellulitis with concomitant gas formation in the plantar tissues of the foot is seldomly reported in the literature. The event itself, however, may actually be relatively common. A review of the literature and a case study involving a diabetic patient is presented, along with a review of the etiology, diagnosis, and treatment.- - - - - - - - - - ranking = 0.68648712716511keywords = diabetic (Clic here for more details about this article) |
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