The aim of this study was to systematically review the evidence for the effectiveness of Buerger’s exercise on the peripheral circulation or diabetic foot ulceration. A systematic search and 18 electronic databases w...The aim of this study was to systematically review the evidence for the effectiveness of Buerger’s exercise on the peripheral circulation or diabetic foot ulceration. A systematic search and 18 electronic databases were conducted. The intervention was predominantly focused on Buerger’s exercise as an outcome. Due to high heterogeneity, data were synthesized in a narrative format rather than by statistical methods. Nine studies that covered 592 participants were selected in the analysis, of which 8 of the 9 found an effect of Buerger’s exercise on peripheral circulation. The positive effects were indicative of improving blood flow, walking ability, reducing necrosis, reducing venous embolism, pain, swelling, cyanosis and the bed-rest times. However, the study design and quality appraisal were limited to Jadad score 2 and the sample size was small. Findings provide some evidence of the beneficial effects of Buerger’s exercises. It was seen as a low cost and low risk physical activity that most diabetic patients could undertake at home. This review highlighted a need for further investigation of standardized procedures of Buerger’s exercises. More high quality studies on the prevention of diabetic foot are required regarding Buerger’s exercises.展开更多
Background: Diabetic foot together with open wounds in distal type peripheral arterial disease constitutes a challenge in therapeutic planning. Ozone therapy may unveil new horizons in management. Case Report: A 67-ye...Background: Diabetic foot together with open wounds in distal type peripheral arterial disease constitutes a challenge in therapeutic planning. Ozone therapy may unveil new horizons in management. Case Report: A 67-year-old woman with diabetes mellitus was applied with open wounds at the bottom of her foot with purulent discharge, with a decision for above ankle amputation. She had had numerous interventions for her wounds including metatarsal amputations due to osteomyelitis and had been on an intense treatment including antibiotics, insulin, antihypertensives and antiaggregants. Angiogram revealed diffuse peripheral arterial disease in lower extremities. All medication but antihypertensives was stopped. She received major medical ozone application as 2000 gamma/session i.v. for 2 weeks, external ozone sac application starting from 60 and dropping to 30 gamma/session for 3 weeks and ozone insuflation 40 gamma/session for 10 sessions. Her purulent discharge ceased after the third session and the atonic debris of the wounds exfoliated, the wounds healed from the base towards the surface of the skin. She was then put on cilostazol and clopidogrel therapy. Conclusion: By being one of the known strongest bactericide, virucide, and fungicide elements, medical ozone therapy stimulates and upregulates the antioxidant system of the body with its hormesis effects. After the cessation of all circulatory system supporting medication (as their interaction with ozone is not clear yet), appropriate ozone therapy may bring new horizons for patients when all classically known methods of treatment have been completed, before assigning the patients for amputation.展开更多
目的探讨欧米诺汗印法对糖尿病足溃疡(DFU)发生风险的预测价值。方法以振动觉阈值(VPT)作为评估DFU发生风险的标准将725例2型糖尿病(T2DM)患者分为DFU高危组和非高危组。利用受试者工作特征(ROC)曲线比较欧米诺汗印法与10 g尼龙单丝(10 ...目的探讨欧米诺汗印法对糖尿病足溃疡(DFU)发生风险的预测价值。方法以振动觉阈值(VPT)作为评估DFU发生风险的标准将725例2型糖尿病(T2DM)患者分为DFU高危组和非高危组。利用受试者工作特征(ROC)曲线比较欧米诺汗印法与10 g尼龙单丝(10 g SWMF)检查对DFU发生风险的预测价值。结果 725例T2DM患者中DFU高危组占6.1%,该组患者的年龄、DM病程、欧米诺颜色完全变化(CCC)时间及10 g SWMF异常率均高于非高危组(P<0.01)。ROC曲线提示欧米诺CCC时间对DFU发生风险的预测作用优于10 g SWMF,前者ROC曲线下面积约0.8,最佳切点为22.25 min。结论欧米诺汗印法能有效预测DFU发生风险,在预防DFU中具有重要应用价值。展开更多
Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence...Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.展开更多
文摘The aim of this study was to systematically review the evidence for the effectiveness of Buerger’s exercise on the peripheral circulation or diabetic foot ulceration. A systematic search and 18 electronic databases were conducted. The intervention was predominantly focused on Buerger’s exercise as an outcome. Due to high heterogeneity, data were synthesized in a narrative format rather than by statistical methods. Nine studies that covered 592 participants were selected in the analysis, of which 8 of the 9 found an effect of Buerger’s exercise on peripheral circulation. The positive effects were indicative of improving blood flow, walking ability, reducing necrosis, reducing venous embolism, pain, swelling, cyanosis and the bed-rest times. However, the study design and quality appraisal were limited to Jadad score 2 and the sample size was small. Findings provide some evidence of the beneficial effects of Buerger’s exercises. It was seen as a low cost and low risk physical activity that most diabetic patients could undertake at home. This review highlighted a need for further investigation of standardized procedures of Buerger’s exercises. More high quality studies on the prevention of diabetic foot are required regarding Buerger’s exercises.
文摘Background: Diabetic foot together with open wounds in distal type peripheral arterial disease constitutes a challenge in therapeutic planning. Ozone therapy may unveil new horizons in management. Case Report: A 67-year-old woman with diabetes mellitus was applied with open wounds at the bottom of her foot with purulent discharge, with a decision for above ankle amputation. She had had numerous interventions for her wounds including metatarsal amputations due to osteomyelitis and had been on an intense treatment including antibiotics, insulin, antihypertensives and antiaggregants. Angiogram revealed diffuse peripheral arterial disease in lower extremities. All medication but antihypertensives was stopped. She received major medical ozone application as 2000 gamma/session i.v. for 2 weeks, external ozone sac application starting from 60 and dropping to 30 gamma/session for 3 weeks and ozone insuflation 40 gamma/session for 10 sessions. Her purulent discharge ceased after the third session and the atonic debris of the wounds exfoliated, the wounds healed from the base towards the surface of the skin. She was then put on cilostazol and clopidogrel therapy. Conclusion: By being one of the known strongest bactericide, virucide, and fungicide elements, medical ozone therapy stimulates and upregulates the antioxidant system of the body with its hormesis effects. After the cessation of all circulatory system supporting medication (as their interaction with ozone is not clear yet), appropriate ozone therapy may bring new horizons for patients when all classically known methods of treatment have been completed, before assigning the patients for amputation.
文摘目的探讨欧米诺汗印法对糖尿病足溃疡(DFU)发生风险的预测价值。方法以振动觉阈值(VPT)作为评估DFU发生风险的标准将725例2型糖尿病(T2DM)患者分为DFU高危组和非高危组。利用受试者工作特征(ROC)曲线比较欧米诺汗印法与10 g尼龙单丝(10 g SWMF)检查对DFU发生风险的预测价值。结果 725例T2DM患者中DFU高危组占6.1%,该组患者的年龄、DM病程、欧米诺颜色完全变化(CCC)时间及10 g SWMF异常率均高于非高危组(P<0.01)。ROC曲线提示欧米诺CCC时间对DFU发生风险的预测作用优于10 g SWMF,前者ROC曲线下面积约0.8,最佳切点为22.25 min。结论欧米诺汗印法能有效预测DFU发生风险,在预防DFU中具有重要应用价值。
基金Supported by Health Research Institute,Diabetes Research Center,Ahvaz Jundishapur University of Medical Sciences,Ahvaz,Iran
文摘Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.
