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Foot Complications (foot + complications)
Selected AbstractsEthnic differences in plantar pressures in diabetic patients with peripheral neuropathyDIABETIC MEDICINE, Issue 4 2008M. P. Solano Abstract Aims To compare plantar foot pressures between Caucasian and Hispanic diabetic patients with peripheral neuropathy (PN) without a history of foot ulceration and between Caucasian and Hispanic non-diabetic individuals. Methods Forty-four Hispanic diabetic patients with PN (HDPN), 35 Caucasian diabetic patients with PN (CDPN), 41 non-diabetic Hispanic subjects and 33 non-diabetic Caucasian subjects participated. Total and regional peak plantar pressures (PPs) and pressure time integrals (PTIs) were assessed using the EMED-SF-4 plantar pressure system. Results Hispanic diabetic patients with PN had significantly lower peak PP than Caucasian diabetic patients with PN in the entire foot (552.4 ± 227.9 vs. 810.1 ± 274.6 kPa; P < 0.001), forefoot (464.1 ± 222.6 vs. 699.6 ± 323.1 kPa; P < 0.001), hindfoot (296.3.4 + 101.8 vs. 398.1 + 178.3 kPa; P < 0.01) and at the fifth metatarsal head (MTH5; 204.3 ± 143.2 vs. 388.2 ± 273.9 kPa; P < 0.001). The PTI in the entire foot, forefoot and MTH5 were also lower in HDPN than in CDPN. The ethnic differences between the diabetic groups with PN for the entire foot, forefoot and MTH5 remained significant after adjusting for the effect of age, gender, weight and duration of diabetes. There were no significant differences in peak PP and PTI among non-diabetic individuals, except for a lower peak PP at the MTH5 in Hispanic compared with Caucasian subjects. Conclusions Despite a well-known higher incidence of foot complications in diabetic Hispanic subjects, dynamic plantar pressures are lower in Hispanic diabetic patients with PN when compared with their Caucasian counterparts, suggesting that differences in other risk factors exist between these two ethnic groups. [source] Diabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapyJOURNAL OF CLINICAL NURSING, Issue 14 2009Hjelm Katarina Aim., To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber. Background., To our knowledge there are no patients' evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given. Design., Explorative study. Participants., Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44,83 years (median 70), with diabetic foot ulcers, participated. Method., Focus-group interviews by an external evaluator. Results., Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation. Conclusions and relevance to clinical practice., From patients' perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease. [source] Deficiencies in nutritional intake in patients admitted with diabetes-related foot complicationsNUTRITION & DIETETICS, Issue 3 2007Sarah PITT Abstract Aim:, Adequate nutritional intake is an essential component for timely wound healing. The present research aimed to identify the frequency of inadequate dietary intake, including the specific nutritional elements most frequently lacking, in a group of patients admitted with diabetes-related foot complications. Methods:, Consecutive patients admitted to a diabetic foot unit underwent a dietary assessment, which included the retrospective collection of a seven-day food history for the period just prior to admission. The collected data were entered into FoodWorks, and comparisons were made with recommendations made by national guidelines. Results:, Thirty-five patients underwent nutritional assessment, 74% male and 26% having impaired renal function. Protein consumption was in excess of daily recommended intake, and although the overall fat intake as a percentage of total calories consumed was in keeping with national guidelines, the intake of saturated fat was inappropriately high. Of the 12 micronutrients assessed, niacin and vitamin C were appropriately consumed by all; average intake of potassium, phosphorus and thiamine approached recommended levels, while the intake of magnesium, calcium, zinc, riboflavin, folate and vitamin A all fell short of recommended daily requirements. No dietary differences were identified between individuals with normal and abnormal renal function, but deficiencies in calcium and iron were identified only in women. Conclusion:, Dietary deficiencies of macronutrients were not identified in individuals admitted with diabetes-related foot complications, but many patients were found to be consuming well below the daily recommended daily intake of one or more of the micronutrients deemed necessary for normal wound healing. [source] | ||||||||||