Analysis of experience of feet functions perfection in rhythmic gymnastic exercises

Directory of Open Access Journals (Sweden)

Nesterova T.V.

2009-10-01

Full Text Available Trainers and gymnasts take the problem of the special preparation feet and developments of method of its perfection to the number of the actual. The results of the pedagogical testing are shown that basic (basic, pushed, amortisation and specific (aesthetic, manipulation, integral functions feet have a different degree of display. They will be realized in exercises on all of the stages of long-term preparation of sportswomen. Most dynamic perfection of functions feet gymnasts take place on the stages of initial and preliminary base preparation.

A New Mobile Application for Standardizing Diabetic Foot Images.

Science.gov (United States)

Yap, Moi Hoon; Chatwin, Katie E; Ng, Choon-Ching; Abbott, Caroline A; Bowling, Frank L; Rajbhandari, Satyan; Boulton, Andrew J M; Reeves, Neil D

2018-01-01

We describe the development of a new mobile app called "FootSnap," to standardize photographs of diabetic feet and test its reliability on different occasions and between different operators. FootSnap was developed by a multidisciplinary team for use with the iPad. The plantar surface of 30 diabetic feet and 30 nondiabetic control feet were imaged using FootSnap on two separate occasions by two different operators. Reproducibility of foot images was determined using the Jaccard similarity index (JSI). High intra- and interoperator reliability was demonstrated with JSI values of 0.89-0.91 for diabetic feet and 0.93-0.94 for control feet. Similarly high reliability between groups indicates FootSnap is appropriate for longitudinal follow-ups in diabetic feet, with potential for monitoring pathology.

Burning Feet

Science.gov (United States)

... be accompanied by a pins and needles sensation (paresthesia) or numbness, or both. Burning feet may also be referred to as tingling feet or paresthesia. While fatigue or a skin infection can cause ...

Tissue Oxygenation and Negative-Pressure Wound Therapy When Applied to the Feet of Persons With Diabetes Mellitus: An Observational Study.

Science.gov (United States)

Lee, Ye-Na; Lee, Jong Seok; Han, Seung-Kyu; Jung, Hye-Kyung

Our group has reported that negative-pressure wound therapy (NPWT) decreases tissue oxygenation by 84% in the foot of diabetic patients because the pad of the connecting drainage tube and foam sponge of the NPWT system compress the wound bed. The purpose of this study was to determine whether an NPWT modified dressing application reduces tissue oxygenation in the feet of persons with diabetes mellitus. A prospective, clinical, observational study. We enrolled 30 patients with diabetic mellitus; their mean age was 63.9 ± 11.2 years (mean ± standard deviation). All were cared for at the diabetic wound center at an academic tertiary medical center in South Korea between 2014 and January 2015. Transcutaneous partial oxygen pressures (TcpO2) were measured to determine tissue oxygenation levels beneath modified NPWT dressings. A TcpO2 sensor was fixed at the tarsometatarsal area of the contralateral unwounded foot. A negative pressure of -125 mm Hg was applied until TcpO2 reached a plateau state; values were measured before, during, and after the modified NPWT. The Wilcoxon' and Mann-Whitney U tests were used to compare differences between these measurements. TcpO2 levels decreased by 26% during the modified NPWT. Mean TcpO2 values before, during, and after turning off the therapy were 54.3 ± 15.3 mm Hg, 41.6 ± 16.3 mm Hg, and 53.3 ± 15.6 mm Hg (P drainage tube significantly reduces the amount of tissue oxygenation loss beneath foam dressings on the skin of the foot dorsum in diabetic patients.

MRI spectrum of bone changes in the diabetic foot

International Nuclear Information System (INIS)

Roug, Inger K.; Pierre-Jerome, Claude

2012-01-01

Purposes: (1) To assess the prevalence of bone marrow changes in the diabetic foot and (2) to discuss the clinical significance of these changes. Methods: 85 patients with radiographic and magnetic resonance imaging (MRI) foot examinations were selected. Inclusion criteria were clinical diagnosis of diabetes and bone changes on radiographs and MRI. The material was selected from the image storage (PACS) system. We searched for vascular (infarct and necrosis), traumatic (bruise and occult fractures), destruction and debris, dislocation, osteochondritis, osteomyelitis. Five patients had bilateral examinations. A total of 90 feet were evaluated. Results: From 90 feet, 17 (18.9%) presented with vascular changes, from them, 11 feet had infarct and 6 feet had necrosis. Twenty (22.2%) feet had traumatic changes; of them, 10 (50%) had edema on MRI. Five (25%) cases had occult fracture on MRI; and 5 (25%) had visible fracture on both X-ray and MRI. Bone destruction was detected in 8 (8.9%) feet. Bony debris was visualized in three of them. Bone dislocation was visualized in 11 (12.2%) feet. There was evidence of osteochondritis in twenty-four (26.7%) feet. Osteomyelitis was diagnosed in ten (11.1%) feet. Conclusion: Diabetic foot is a challenge for both clinicians and radiologists due to its complexity. The bone derangements inherent to the diabetic foot can be evaluated with high accuracy with MRI.

Diabetes Complications

Science.gov (United States)

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can cause problems with other body ... as your kidneys, nerves, feet, and eyes. Having diabetes can also put you at a higher risk ...

Diabetes: Good Diabetes Management and Regular Foot Care Help Prevent Severe Foot Sores

Science.gov (United States)

Amputation and diabetes: How to protect your feet Good diabetes management and regular foot care help prevent severe foot sores that ... and may require amputation. By Mayo Clinic Staff Diabetes complications can include nerve damage and poor blood ...

Knowledge about feet care of the diabetic client

OpenAIRE

Barbui, Elaine Cristina; Cocco, Maria Inês Monteiro

2002-01-01

Esta pesquisa tem por objetivo avaliar o conhecimento dos clientes que freqüentam um Ambulatório de Diabetes, em relação à sua doença e cuidados com os pés. Na amostra estudada - diabéticos tipo 2 - houve predominância da faixa etária acima de cinqüenta anos e 71,8% tinham diabetes há menos de dez anos. Concluiu-se que os clientes sabem que os cuidados adequados com os pés são necessários para evitar as complicações, porém o autocuidado não é realizado corretamente. Para que isso seja incorpo...

Diabetes Diet, Eating, & Physical Activity

Science.gov (United States)

... Sexual, & Bladder Problems Clinical Trials Diabetes Diet, Eating, & Physical Activity Nutrition and physical activity are important parts of ... feet before, during, and after physical activity. What physical activities should I do if I have diabetes? Most ...

A Complex Approach to Noninvasive Estimation of Microcirculatory Tissue Impairments in Feet of Patients with Diabetes Mellitus using Spectroscopy

Science.gov (United States)

Potapova, E. V.; Dremin, V. V.; Zherebtsov, E. A.; Makovik, I. N.; Zharkikh, E. V.; Dunaev, A. V.; Pilipenko, O. V.; Sidorov, V. V.; Krupatkin, A. I.

2017-12-01

The possibility of a complex approach for studying changes in the system of blood microcirculation and metabolic processes in the biotissue of lower extremities using optical noninvasive methods of laser doppler flowmetry (LDF), fluorescence spectroscopy, and diffuse reflectance spectroscopy in combination with different modes of heating tests has been assessed. Seventy-six patients with type 2 diabetes mellitus, with 14 patients having visible trophic foot impairments, and 48 healthy volunteers have been examined. The parameters of LDF signals and spectra of fluorescence intensity and diffuse reflectance for foot skin have been analyzed. Statistically significant differences in the recorded parameters between the groups under study have been found. It has been concluded that combined application of noninvasive methods of spectroscopy could be used for diagnostics of complications both upon the occurrence of preliminary symptoms of diabetes, when pathological changes are still reversible, and in the presence of impairments to prevent aggravation of the disease and select an adequate correction of the treatment.

Renal echo-3D and microalbuminuria in children of diabetic mothers: a preliminary study.

Science.gov (United States)

Cappuccini, B; Torlone, E; Ferri, C; Arnone, S; Troiani, S; Bini, V; Bellomo, G; Barboni, G; Di Renzo, G

2013-08-01

Maternal diabetes has assumed epidemic relevance in recent years and animal studies have provided some evidence that it may cause abnormalities in renal development and a reduction in nephron endowment in the offspring; however, human data are lacking. The renal cortex contains ∼95% of the glomeruli and its volume could be taken as a surrogate measure of glomerular number; based on this assumption, we measured renal cortex volume and in addition, microalbuminuria in a homogeneous sample of 42 children of diabetic (pregestational, n = 13, and gestational, n = 29) mothers, compared with 21 healthy children born of non-diabetic mothers. The offspring of diabetic mothers showed a significant reduction of renal cortex volume and higher albumin excretion compared with controls, possibly attributable to a reduction in the number of nephrons and the difference was statistically significant (P < 0.001). Although further studies on a larger sample are necessary, our preliminary findings suggest that maternal diabetes may affect renal development with sequelae later in life, requiring closer monitoring and follow-up. Furthermore, the importance of strict maternal diabetes management and control must be emphasized.

Diabetic Foot Australia guideline on footwear for people with diabetes.

Science.gov (United States)

van Netten, Jaap J; Lazzarini, Peter A; Armstrong, David G; Bus, Sicco A; Fitridge, Robert; Harding, Keith; Kinnear, Ewan; Malone, Matthew; Menz, Hylton B; Perrin, Byron M; Postema, Klaas; Prentice, Jenny; Schott, Karl-Heinz; Wraight, Paul R

2018-01-01

The aim of this paper was to create an updated Australian guideline on footwear for people with diabetes. We reviewed new footwear publications, (inter)national guidelines, and consensus expert opinion alongside the 2013 Australian footwear guideline to formulate updated recommendations. We recommend health professionals managing people with diabetes should: (1) Advise people with diabetes to wear footwear that fits, protects and accommodates the shape of their feet. (2) Advise people with diabetes to always wear socks within their footwear, in order to reduce shear and friction. (3) Educate people with diabetes, their relatives and caregivers on the importance of wearing appropriate footwear to prevent foot ulceration. (4) Instruct people with diabetes at intermediate- or high-risk of foot ulceration to obtain footwear from an appropriately trained professional to ensure it fits, protects and accommodates the shape of their feet. (5) Motivate people with diabetes at intermediate- or high-risk of foot ulceration to wear their footwear at all times, both indoors and outdoors. (6) Motivate people with diabetes at intermediate- or high-risk of foot ulceration (or their relatives and caregivers) to check their footwear, each time before wearing, to ensure that there are no foreign objects in, or penetrating, the footwear; and check their feet, each time their footwear is removed, to ensure there are no signs of abnormal pressure, trauma or ulceration. (7) For people with a foot deformity or pre-ulcerative lesion, consider prescribing medical grade footwear, which may include custom-made in-shoe orthoses or insoles. (8) For people with a healed plantar foot ulcer, prescribe medical grade footwear with custom-made in-shoe orthoses or insoles with a demonstrated plantar pressure relieving effect at high-risk areas. (9) Review prescribed footwear every three months to ensure it still fits adequately, protects, and supports the foot. (10) For people with a plantar diabetic

Healthy Feet are Happy Feet

Centers for Disease Control (CDC) Podcasts

2007-10-05

This podcast offers tips for people with diabetes on foot care to prevent complications, such as foot ulcers and amputation.  Created: 10/5/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health.   Date Released: 12/2/2007.

Radiological residua of healed diabetic arthropathies

Energy Technology Data Exchange (ETDEWEB)

Reinhardt, K.

1981-12-01

Diabetic arthropathy is a relatively rare manifestation of neuropathic disease, occurring in fewer than 5% of cases. Abnormalities of this type are confined largely to the small joints of the feet, although the larger joints of the lower limbs and the spine occasionally are affected. Some lesions, particularly in the feet, repair spontaneously, leaving radiological residua sufficiently characteristic to prompt suspicion of an unrecognised diabetic state. These include deformity of the head of the second metatarsal (akin to a Freiberg lesion), shortening of the great toe, painless deforming arthrosis of the knee, and ankylosis of interphalangeal joints. In the presence of these signs the patient should be interrogated concerning diabetes and blood sugar estimates, with provocation if necessary, obtained. Should such a diagnosis be sustained, appropriate protective measures may be undertaken to avoid a relapse of the arthropathy.

Conhecimento do cliente diabético em relação os cuidados com os pés Conocimiento de los diabéticos sobre los cuidados con los pies Knowledge about feet care of the diabetic client

Directory of Open Access Journals (Sweden)

Elaine Cristina Barbui

2002-03-01

Full Text Available Esta pesquisa tem por objetivo avaliar o conhecimento dos clientes que freqüentam um Ambulatório de Diabetes, em relação à sua doença e cuidados com os pés. Na amostra estudada - diabéticos tipo 2 - houve predominância da faixa etária acima de cinqüenta anos e 71,8% tinham diabetes há menos de dez anos. Concluiu-se que os clientes sabem que os cuidados adequados com os pés são necessários para evitar as complicações, porém o autocuidado não é realizado corretamente. Para que isso seja incorporado em seu cotidiano, é fundamental que tenham acesso às informações sobre diabetes, participação da família, além de habilidade e motivação.Este estudio tuvo por objetivo evaluar el conocimiento de los diabeticos tipo 2 atendidos en uno Ambulatorio de Diabetes en relación a su enfermedad y los cuidados con los pies. La major faja de edad fue más de cincuenta años y 71,8% teniam diabetes ha mas de diet años. Los resultados no permitieron concluir que los diabeticos saben que los cuidados adecuados con los pies son necesarios hacia evitar las complicaciónes, pero el atuocuidado no es realizado correctamente. Para incorporar esto en su cotidiano es fundamental que los diabeticos tengam acceso a las informaciones sobre diabetes, allende la participación de la familia, habilidad y motivación.The objective of this research is to evaluate how much the clients that frequently went to the Diabetes Ambulatory, knew about their own ill, and the feet care. In the sample - diabetes type 2 - the majority were people with more than fifty years old and 71.8% were diabetics for more than ten years. So the conclusion that could be taken is that the clients knew about the care that they must have with their feet to don't have complications, but the "own care" is not well done. To insert it in the rightly on their day-by-day they must have acess to the information about diabetes, participation of the family, motivation and their own

Patient education for preventing diabetic foot ulceration

NARCIS (Netherlands)

Dorresteijn, J.A.; Kriegsman, D.M.; Assendelft, W.J.; Valk, G.D.

2014-01-01

BACKGROUND: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS: We

Patient education for preventing diabetic foot ulceration

NARCIS (Netherlands)

Dorresteijn, J.A.; Kriegsman, D.M.; Assendelft, W.J.J.; Valk, G.D.

2012-01-01

BACKGROUND: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus. OBJECTIVES: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus. SEARCH METHODS:

The radiological residua of healed diabetic arthropathies

International Nuclear Information System (INIS)

Reinhardt, K.

1981-01-01

Diabetic arthropathy is a relatively rare manifestation of neuropathic disease, occurring in fewer than 5% of cases. Abnormalities of this type are confined largely to the small joints of the feet, although the larger joints of the lower limbs and the spine occasionally are affected. Some lesions, particularly in the feet, repair spontaneously, leaving radiological residua sufficiently characteristic to prompt suspicion of an unrecognised diabetic state. These include deformity of the head of the second metatarsal (akin to a Freiberg lesion), shortening of the great toe, painless deforming arthrosis of the knee, and ankylosis of interphalangeal joints. In the presence of these signs the patient should be interrogated concerning diabetes and blood sugar estimates, with provocation if necessary, obtained. Should such a diagnosis be sustained, appropriate protective measures may be undertaken to avoid a relapse of the arthropathy. (orig.)

Sweaty Feet (Hyperhidrosis)

Science.gov (United States)

... RAC) Information OIG Opioid and Chronic Pain Management OSHA Off-Label Use Physician Payment Sunshine Act (Open ... prescription medications, often anticholinergics, can be used. Severe cases of sweaty feet may be treated with a ...

Does PGE₁ vasodilator prevent orthopaedic implant-related infection in diabetes? Preliminary results in a mouse model.

Science.gov (United States)

Lovati, Arianna B; Romanò, Carlo L; Monti, Lorenzo; Vassena, Christian; Previdi, Sara; Drago, Lorenzo

2014-01-01

Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE₁ vasodilator on the incidence of surgical infections in diabetic mice was investigated. A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE₁ vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses. The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE₁ and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment. The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model.

Functional assessment of feet of patients with type II diabetes

Directory of Open Access Journals (Sweden)

Vinicius Saura Cardoso

2014-09-01

Full Text Available Objective: To evaluate the incidence of functional changes and risk of developing ulcers in type II diabetic patients seen in Primary Healthcare Units (Unidades Básicas de Saúde- UBS. Methods: A cross-sectional, quantitative and descriptive study comprising 80patients with type II diabetes mellitus (DM aged between 41 to 85 years and attended inthe UBS in the city of Parnaíba-PI. Volunteers responded to the identification form and theMichigan Neuropathy Screening Instrument (MNSI, followed by an evaluation of the lowerlimbs, as follows: achilles and patellar reflex, palpation of arterial pulses (dorsalis pedis and posterior tibial, tactile sensitivity (Monofilament 10g and vibration sensitivity (128Hz tuning fork; identification of the presence of changes such as ingrown toenails, calluses,claw toes and hair loss. Finally, using the information acquired from the assessment, subjects were classified according to the risk of developing wounds. Results: The sample consisted of 76 diabetic patients, with average age of 63.8 ± 10.4 years, 63 (82.8% were female, mean diagnostic time 8.8 ± 7.2 years, average body mass index (BMI 28.2 ± 5.4 kg/m2, with 15.7% of the sample being smokers. The myotatic reflexes and arterial pulses were reduced. Tactile sensitivity was identified in 81.5% and 13.1% did not feel the vibration of the tuning fork. The most dominant changes identified were calluses, 76.3% (n = 58. Risk level 2 of developing ulcers stood out, 52.6% (n = 40. Conclusion: Functional changes were detected in the sample and a classification of risk 2 for developing wounds was found in more than 50% of the assessed patients. doi:http://dx.doi.org/10.5020/18061230.2013.p563

Care Management Medical Home Center Model: Preliminary Results of a Patient-Centered Approach to Improving Care Quality for Diabetic Patients.

Science.gov (United States)

Page, Timothy F; Amofah, St Anthony; McCann, Shelia; Rivo, Julie; Varghese, Asha; James, Terisa; Rivo, Marc; Williams, Mark L

2015-07-01

This article presents preliminary findings of the impact of an innovative care management model for diabetic patients. The model was implemented by seven Federally Qualified Health Centers serving 10,000 diabetic patients in Miami-Dade County. A primary intervention of this model is a centralized care management team that makes previsit phone calls to diabetic patients who have scheduled appointments. These previsit phone calls optimize patient knowledge and self-management goals, and provide patient care coordinators with relevant clinical information to optimize the office visit and help to ensure completion of recommended diabetic preventive and chronic care services. Data suggest that following the implementation of this care management model, more diabetic patients are receiving regular care, and compliance with recommended tests and screenings has improved. © 2015 Society for Public Health Education.

Electrochemical skin conductance to detect sudomotor dysfunction, peripheral neuropathy and the risk of foot ulceration among Saudi patients with diabetes mellitus.

Science.gov (United States)

Sheshah, Eman; Madanat, Amal; Al-Greesheh, Fahad; Al-Qaisi, Dalal; Al-Harbi, Mohammad; Aman, Reem; Al-Ghamdi, Abdul Aziz; Al-Madani, Khaled

2015-01-01

Sudomotor dysfunction is manifested clinically as abnormal sweating leading to dryness of feet skin and increased risk of foot ulceration. The aim of this study was to test the performance of foot electrochemical skin conductance (ESC) to detect diabetic peripheral neuropathy and the risk of foot ulceration against traditional methods in Saudi patients with diabetes mellitus. This cross-sectional study was conducted on 296 Saudi patients with diabetes mellitus. Painful neuropathic symptoms were evaluated using the neuropathy symptom score (NSS). The risk of foot ulceration and diabetic peripheral neuropathy were determined using the neuropathy disability score (NDS). Vibration perception threshold (VPT) was assessed using neurothesiometer. Neurophysiological assessment of the right and left sural, peroneal and tibial nerves was performed in 222 participants. Diabetic peripheral neuropathy was defined according to the definition of the American Academy of Neurology. ESC was measured with Sudoscan. Feet-ESC decreased as the scores of sensory and motor function tests increased. Feet-ESC decreased as the NSS, NDS and severity of diabetic peripheral neuropathy increased. Sensitivity of feet-ESC peripheral neuropathy assessed by VPT ≥ 25 V, NDS ≥ 3, NDS ≥ 6 was 90.1, 61 and 63.8 % respectively and specificity 77, 85 and 81.9 % respectively. Sensitivity of feet-ESC peripheral neuropathy assessed by VPT ≥ 25 V, NDS ≥ 3, NDS ≥ 6 was 100, 80.6 and 80.9 % respectively. Sensitivity and specificity of feet-ESC peripheral neuropathy were 67.5 and 58.9 % respectively. Sudoscan a simple and objective tool can be used to detect diabetic peripheral neuropathy and the risk of foot ulceration among patients with diabetes mellitus. Prospective studies to confirm our results are warranted.

Relative sensory sparing in the diabetic foot implied through vibration testing

Directory of Open Access Journals (Sweden)

Todd O'Brien

2013-09-01

Full Text Available Background: The dorsal aspect of the hallux is often cited as the anatomic location of choice for vibration testing in the feet of diabetic patients. To validate this preference, vibration tests were performed and compared at the hallux and 5th metatarsal head in diabetic patients with established neuropathy. Methods: Twenty-eight neuropathic, diabetic patients and 17 non-neuropathic, non-diabetic patients underwent timed vibration testing (TVT with a novel 128 Hz electronic tuning fork (ETF at the hallux and 5th metatarsal head. Results: TVT values in the feet of diabetic patients were found to be reduced at both locations compared to controls. Unexpectedly, these values were significantly lower at the hallux (P < 0.001 compared to the 5th metatarsal head. Conclusion: This study confirms the hallux as the most appropriate location for vibration testing and implies relative sensory sparing at the 5th metatarsal head, a finding not previously reported in diabetic patients.

The design of hands and feet contamination monitor

International Nuclear Information System (INIS)

Song Jiangxue; Shen Yang; Deng Changming; Zhang Jia; Hou Lei; Meng Dan

2011-01-01

In order to protect the hands and feet of personnel engaged in nuclear, draw on advanced hands and feet contamination monitor, we design a new radiation protection instrumentation. It describes the composition of the hands and feet contamination monitor, and software program design. It describes the hardware monitor software, firmware and computer programming techniques. If device found your hand and foot surface is contamination, it will prompt you to decontamination, to protect your hands and feet of safety. (authors)

Does PGE₁ vasodilator prevent orthopaedic implant-related infection in diabetes? Preliminary results in a mouse model.

Directory of Open Access Journals (Sweden)

Arianna B Lovati

Full Text Available BACKGROUND: Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE₁ vasodilator on the incidence of surgical infections in diabetic mice was investigated. METHODOLOGY: A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE₁ vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses. RESULTS: The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE₁ and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment. CONCLUSIONS: The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model.

Prevalence and risk factors of diabetes mellitus foot syndrome ...

African Journals Online (AJOL)

Background: Diabetic foot problems are common throughout the world, resulting in major economic consequences for the patients, their families, and thesociety. Diabetic foot ulcers are largely preventable by identifying people at risk of ulceration throughexamination of the feet, education and frequent follow-up of these ...

Diabetes and Orientation and Mobility Training: An Added Challenge.

Science.gov (United States)

Kozel, B.

1995-01-01

Issues related to promoting orientation and mobility training for individuals with visual impairments and diabetes are discussed, including effects of insulin, hypoglycemia and hyperglycemia, the timing of training, complications to the feet, and fluctuations in vision. Major lifestyle changes required by diabetes are stressed. (Author/SW)

Comparing Arc-shaped Feet and Rigid Ankles with Flat Feet and Compliant Ankles for a Dynamic Walker

DEFF Research Database (Denmark)

Kuhlemann, Ilyas; Matthias Braun, Jan; Wörgötter, Florentin

2014-01-01

In this paper we show that exchanging curved feet and rigid ankles by at feet and compliant ankles improves the range of gait parameters for a bipedal dynamic walker. The new lower legs were designed such that they t to the old set-up, allowing for a direct and quantitative comparison. The dynamic...

The management of diabetic foot ulcers in Danish hospitals is not optimal

DEFF Research Database (Denmark)

Kirketerp-Møller, Klaus; Svendsen, Ole Lander; Jansen, Rasmus Bo

2015-01-01

INTRODUCTION: The diabetic foot is a complicated health issue which ideally involves several different specialists to ensure the most effective treatment. The Danish Health and Medicines Authority recently published a national guideline to address the implementation of multidisciplinary teams...... in the treatment. The objective of this study was to describe the treatment practices at the time the guidelines were launched. METHODS: A questionnaire-based survey was conducted among Danish hospital departments working with diabetic feet. All public departments were invited by e-mail to participate......) were mostly orthopaedic surgeons. A classification system of the diabetic foot was rarely or never used, and eight respondents (42%) reported having a multidisciplinary team in accordance with the national guidelines. 73% of the respondents performed some form of surgical intervention on diabetic feet...

Evaluation of "care of the foot" as a risk factor for diabetic foot ulceration: the role of internal physicians.

Science.gov (United States)

Oguejiofor, O C; Oli, J M; Odenigbo, C U

2009-03-01

Several risk factors predispose the diabetic patient to foot ulceration, including "inadequate care of the foot". This risk factor for foot ulceration has not been previously evaluated among Nigeria diabetic patients and is the objective of this study. One hundred and twenty (120) diabetic patients with and without symptoms of peripheral neuropathy receiving care at the medical outpatient department (MOPD) and the diabetic clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi were recruited consecutively as they presented. They were administered structured questionnaires to assess some variables concerning care of their feet as provided to them by their physicians. Among the 120 diabetic participants, 83 (69.2%) had neuropathic symptoms (the symptomatic participants) while 37 (30.8%) were asymptomatic (the asymptomatic participants). Eighty (80; 96.4%) of the symptomatic vs 36 (97.3%) of the asymptomatic participants had never had their feet examined by their physician. Also, 26 (31.3%) of the symptomatic vs 12 (32.4%) of the asymptomatic participants had never received any form of advice on how to take special care of their feet by their physician, and 26 (31.3%) of the symptomatic vs 6 (16.2%) of the asymptomatic participants walked unshod most times in their immediate surroundings. Physicians do not provide adequate care to the feet of their diabetic patients irrespective of the presence or absence of neuropathic symptoms, making this variable a critical risk factor for diabetic foot ulceration and amputation. Continuing medical education to health care providers emphasizing adequate "care of the foot" of the diabetic patient, will reduce avoidable loss of limbs to diabetes.

A review of thermal methods and technologies for diabetic foot assessment.

Science.gov (United States)

Sousa, Paula; Felizardo, Virginie; Oliveira, Daniel; Couto, Rafael; Garcia, Nuno M

2015-07-01

Temperature analysis has been considered as a complementary method in medical evaluation and diagnosis. Several studies demonstrated that monitoring the temperature variations of the feet of diabetic patients can be helpful in the early identification of diabetic foot manifestations, and also in changing behaviors, which may contribute to reducing its incidence. In this review, several and most used techniques for assessing the temperature of the feet are presented, along with original published work on specific applications in diabetic foot complications. A review of solutions and equipment that operate according to the temperature assessment techniques is also presented. Finally, a comparison between the various technologies is presented, and the authors share their perspective on what will be the state of affairs in 5 years.

The role of foot morphology on foot function in diabetic subjects with or without neuropathy.

Science.gov (United States)

Guiotto, Annamaria; Sawacha, Zimi; Guarneri, Gabriella; Cristoferi, Giuseppe; Avogaro, Angelo; Cobelli, Claudio

2013-04-01

The aim of this study was to investigate the role of foot morphology, related with respect to diabetes and peripheral neuropathy in altering foot kinematics and plantar pressure during gait. Healthy and diabetic subjects with or without neuropathy with different foot types were analyzed. Three dimensional multisegment foot kinematics and plantar pressures were assessed on 120 feet: 40 feet (24 cavus, 20 with valgus heel and 11 with hallux valgus) in the control group, 80 feet in the diabetic (25 cavus 13 with valgus heel and 13 with hallux valgus) and the neuropathic groups (28 cavus, 24 with valgus heel and 18 with hallux valgus). Subjects were classified according to their foot morphology allowing further comparisons among the subgroups with the same foot morphology. When comparing neuropathic subjects with cavus foot, valgus heel with controls with the same foot morphology, important differences were noticed: increased dorsiflexion and peak plantar pressure on the forefoot (Pfoot morphology in altering both kinematics and plantar pressure in diabetic subjects, diabetes appeared to further contribute in altering foot biomechanics. Surprisingly, all the diabetic subjects with normal foot arch or with valgus hallux were no more likely to display significant differences in biomechanics parameters than controls. This data could be considered a valuable support for future research on diabetic foot function, and in planning preventive interventions. Copyright © 2012 Elsevier B.V. All rights reserved.

Does PGE1 Vasodilator Prevent Orthopaedic Implant-Related Infection in Diabetes? Preliminary Results in a Mouse Model

Science.gov (United States)

Lovati, Arianna B.; Romanò, Carlo L.; Monti, Lorenzo; Vassena, Christian; Previdi, Sara; Drago, Lorenzo

2014-01-01

Background Implant-related infections are characterized by bacterial colonization and biofilm formation on the prosthesis. Diabetes represents one of the risk factors that increase the chances of prosthetic infections because of related severe peripheral vascular disease. Vasodilatation can be a therapeutic option to overcome diabetic vascular damages and increase the local blood supply. In this study, the effect of a PGE1 vasodilator on the incidence of surgical infections in diabetic mice was investigated. Methodology A S. aureus implant-related infection was induced in femurs of diabetic mice, then differently treated with a third generation cephalosporin alone or associated with a PGE1 vasodilator. Variations in mouse body weight were evaluated as index of animal welfare. The femurs were harvested after 28 days and underwent both qualitative and quantitative analysis as micro-CT, histological and microbiological analyses. Results The analysis performed in this study demonstrated the increased host response to implant-related infection in diabetic mice treated with the combination of a PGE1 and antibiotic. In this group, restrained signs of infections were identified by micro-CT and histological analysis. On the other hand, the diabetic mice treated with the antibiotic alone showed a severe infection and inability to successfully respond to the standard antimicrobial treatment. Conclusions The present study revealed interesting preliminary results in the use of a drug combination of antibiotic and vasodilator to prevent implant-related Staphylococcus aureus infections in a diabetic mouse model. PMID:24718359

Automatic detection of diabetic foot complications with infrared thermography by asymmetric analysis

Science.gov (United States)

Liu, Chanjuan; van Netten, Jaap J.; van Baal, Jeff G.; Bus, Sicco A.; van der Heijden, Ferdi

2015-02-01

Early identification of diabetic foot complications and their precursors is essential in preventing their devastating consequences, such as foot infection and amputation. Frequent, automatic risk assessment by an intelligent telemedicine system might be feasible and cost effective. Infrared thermography is a promising modality for such a system. The temperature differences between corresponding areas on contralateral feet are the clinically significant parameters. This asymmetric analysis is hindered by (1) foot segmentation errors, especially when the foot temperature and the ambient temperature are comparable, and by (2) different shapes and sizes between contralateral feet due to deformities or minor amputations. To circumvent the first problem, we used a color image and a thermal image acquired synchronously. Foot regions, detected in the color image, were rigidly registered to the thermal image. This resulted in 97.8%±1.1% sensitivity and 98.4%±0.5% specificity over 76 high-risk diabetic patients with manual annotation as a reference. Nonrigid landmark-based registration with B-splines solved the second problem. Corresponding points in the two feet could be found regardless of the shapes and sizes of the feet. With that, the temperature difference of the left and right feet could be obtained.

A preliminary study of patient-specific mechanical properties of diabetic and healthy plantar soft tissue from gated magnetic resonance imaging.

Science.gov (United States)

Williams, Evan D; Stebbins, Michael J; Cavanagh, Peter R; Haynor, David R; Chu, Baocheng; Fassbind, Michael J; Isvilanonda, Vara; Ledoux, William R

2017-07-01

Foot loading rate, load magnitude, and the presence of diseases such as diabetes can all affect the mechanical properties of the plantar soft tissues of the human foot. The hydraulic plantar soft tissue reducer instrument was designed to gain insight into which variables are the most significant in determining these properties. It was used with gated magnetic resonance imaging to capture three-dimensional images of feet under dynamic loading conditions. Custom electronics controlled by LabVIEW software simultaneously recorded system pressure, which was then translated to applied force values based on calibration curves. Data were collected for two subjects, one without diabetes (Subject A) and one with diabetes (Subject B). For a 0.2-Hz loading rate, and strains 0.16, 0.18, 0.20, and 0.22, Subject A's average tangential heel pad stiffness was 10 N/mm and Subject B's was 24 N/mm. Maximum test loads were approximately 200 N. Loading rate and load magnitude limitations (both were lower than physiologic values) will continue to be addressed in the next version of the instrument. However, the current hydraulic plantar soft tissue reducer did produce a data set for healthy versus diabetic tissue stiffness that agrees with previous trends. These data are also being used to improve finite element analysis models of the foot as part of a related project.

Nociception at the diabetic foot, an uncharted territory

Science.gov (United States)

Chantelau, Ernst A

2015-01-01

The diabetic foot is characterised by painless foot ulceration and/or arthropathy; it is a typical complication of painless diabetic neuropathy. Neuropathy depletes the foot skin of intraepidermal nerve fibre endings of the afferent A-delta and C-fibres, which are mostly nociceptors and excitable by noxious stimuli only. However, some of them are cold or warm receptors whose functions in diabetic neuropathy have frequently been reported. Hence, it is well established by quantitative sensory testing that thermal detection thresholds at the foot skin increase during the course of painless diabetic neuropathy. Pain perception (nociception), by contrast, has rarely been studied. Recent pilot studies of pinprick pain at plantar digital skinfolds showed that the perception threshold was always above the upper limit of measurement of 512 mN (equivalent to 51.2 g) at the diabetic foot. However, deep pressure pain perception threshold at musculus abductor hallucis was beyond 1400 kPa (equivalent to 14 kg; limit of measurement) only in every fifth case. These discrepancies of pain perception between forefoot and hindfoot, and between skin and muscle, demand further study. Measuring nociception at the feet in diabetes opens promising clinical perspectives. A critical nociception threshold may be quantified (probably corresponding to a critical number of intraepidermal nerve fibre endings), beyond which the individual risk of a diabetic foot rises appreciably. Staging of diabetic neuropathy according to nociception thresholds at the feet is highly desirable as guidance to an individualised injury prevention strategy. PMID:25897350

Preliminary results of hydrologic testing of the Umtanum Basalt Fracture Zone at borehole RRL-2 (3,781 to 3,827 ft)

International Nuclear Information System (INIS)

Strait, S.R.; Spane, F.A. Jr.

1983-02-01

This report presents preliminary results and description of hydrologic test activities for the Umtanum Basalt Fracture Zone at Borehole RRL-2, within the test interval 3,781 to 3,827 feet. Hydrologic tests conducted include two short-term, constant discharge pumping tests and two slug tests. Preliminary results indicate an observed hydraulic head for the test interval of 406.7 feet above mean sea level. Transmissivity values determined from hydrologic tests performed range between 205 and 881 ft 2 /day. The best estimate of equivalent hydraulic conductivity, based on an effective test thickness of 6 feet, is 147 ft/day. 8 refs., 6 figs., 3 tabs

Sympathetic neuropathy in diabetes mellitus patients does not elicit Charcot osteoarthropathy

DEFF Research Database (Denmark)

Christensen, Tomas M; Simonsen, Lene; Holstein, Per E

2011-01-01

AIM: The aim of the study was to determine the degree of neuropathy (autonomic and somatic) in patients with diabetes mellitus with or without Charcot osteoarthropathy (CA). METHODS: Forty-nine patients with diabetes mellitus type 1 or 2 were investigated. The patient population of interest...... with first toe amputation (n=5), a high-risk group for development of CA, and two control groups consisting of diabetes patients with (n=9) or without somatic neuropathy (n=11) were investigated. Regional blood flow in the feet was measured by venous occlusion plethysmography. Quantitation of somatic...... neuropathy was done by the Neuropathy Disability Score and modified Neuropathy Symptom Score. Quantitation of autonomic neuropathy was done by measurements of local venoarteriolar sympathetic axon reflex in the feet and of heart rate variability during deep breathing and orthostatic challenge. RESULTS...

Description and preliminary evaluation of a diabetes technology simulation course.

Science.gov (United States)

Wilson, Rebecca D; Bailey, Marilyn; Boyle, Mary E; Seifert, Karen M; Cortez, Karla Y; Baker, Leslie J; Hovan, Michael J; Stepanek, Jan; Cook, Curtiss B

2013-11-01

We aim to provide data on a diabetes technology simulation course (DTSC) that instructs internal medicine residents in the use of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring system (CGMS) devices. The DTSC was implemented during calendar year 2012 and conducted in the institution's simulation center. It consisted of a set of prerequisites, a practicum, and completion of a web-based inpatient CSII-ordering simulation. DTSC participants included only those residents in the outpatient endocrinology rotation. Questionnaires were used to determine whether course objectives were met and to assess the satisfaction of residents with the course. Questionnaires were also administered before and after the endocrine rotation to gauge improvement in familiarity with CSII and CGMS technologies. During the first year, 12 of 12 residents in the outpatient endocrinology rotation completed the DTSC. Residents reported that the course objectives were fully met. The mean satisfaction score with the course ranged from 4.0 to 4.9 (maximum, 5), with most variables rated above 4.5. Self-reported familiarity with the operation of CSII and CGMS devices increased significantly in the postrotation survey compared with that on the prerotation survey (both p technologies. In light of these preliminary findings, the course will continue to be offered, with further data accrual. Future work will involve piloting the DTSC approach among other types of providers, such as residents in other specialties or inpatient nursing staff. © 2013 Diabetes Technology Society.

Why Do Feet Stink?

Science.gov (United States)

... Oooh, boy — your feet have been in those sneakers a long time! On the car ride home, ... shoes or insoles. Some insoles or shoes, especially sneakers, may be washable — a great way to kill ...

Isolation and Characterization of Collagen from Chicken Feet

OpenAIRE

P. Hashim; M. S. Mohd Ridzwan; J. Bakar

2014-01-01

Collagen was isolated from chicken feet by using papain and pepsin enzymes in acetic acid solution at 4°C for 24h with a yield of 18.16% and 22.94% by dry weight, respectively. Chemical composition and characteristics of chicken feet collagen such as amino acid composition, SDS-PAGE patterns, FTIR spectra and thermal properties were evaluated. The chicken feet collagen is rich in the amino acids glycine, glutamic acid, proline and hydroxyproline. Electrophoresis pattern demonstrated two disti...

Evaluation of TCOM/HBOT practice guideline for the treatment of foot burns occurring in diabetic patients.

Science.gov (United States)

Jones, Larry M; Rubadue, Christopher; Brown, Nicole V; Khandelwal, Sorabh; Coffey, Rebecca A

2015-05-01

A multidisciplinary team developed an evidence-based guideline for the management of foot burns occurring in diabetic patients that included transcutaneous oxygen measurements (TCOM) and application of hyperbaric oxygen therapy (HBOT) to selected patients. This report represents an evaluation of preliminary TCOM/HBOT data. This is a retrospective review of patients with diabetes mellitus (DM) who were admitted to a single American Burn Association (ABA) verified burn center for the treatment of foot burns. Patients were treated via the guideline if they were over the age of 16, admitted for the initial care of burns involving the feet between 4/01/2012 and 7/22/2013, and had a known or new diagnosis of DM. Eighteen patients were treated according to the guideline, 14 men and 4 women. Average age was 54 years+14.78. Average BMI was 30.63+6.34. Median burn size was 0.88% TBSA (median partial thickness of 1% and median full thickness of 0.5%). The average HbA1c was 9.08+2.42. Seven patients received pre-operative HBOT, two received post-operative HBOT and three patients healed their wounds with HBOT alone. Average hospital length of stay was 13.39 days+9.94 and was significantly longer for the group receiving HBOT. Admission HbA1c was not a predictor of the need for HBOT. While TCOM/HBOT therapy has not been widely applied to the management of diabetic foot burns, the use of an evidence-based guideline incorporating TCOM/HBOT can provide a systematic way to evaluate the patients' microcirculation and ability to heal burns of the foot. The incorporation of TCOM determination and application of HBOT in selected patients with DM and burns of the feet warrant continued study. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Practical Recommendations for the Preliminary Design Analysis of ...

African Journals Online (AJOL)

Interior-to-exterior shear ratios for equal and unequal bay frames, as well as column inflection points were obtained to serve as practical aids for preliminary analysis/design of fixed-feet multistory sway frames. Equal and unequal bay five story frames were analysed to show the validity of the recommended design ...

The thermoregulation of healthy individuals, overweight-obese, and diabetic from the plantar skin thermogram: a clue to predict the diabetic foot.

Science.gov (United States)

Renero-C, Francisco-J

2017-01-01

Background : Thermoregulation is a complex autonomic process to keep or to dissipate heat in the human body. Methods : In this work, by means of the thermogram of the plantar skin, the thermoregulation of healthy individuals, overweight-obese, and diabetic is discussed. Results : The thermograms of the plantar skin, for the healthy individuals, are: (1) symmetrical, the temperature distribution of the right foot being a mirror image of that of the left foot ; (2) the thermograms of women, on average, are 3°C colder than those of the men; and (3) the temperature distributions decrease distally from the medial longitudinal arch. The plantar skin thermograms of overweight-obese individuals show: (1) increased average temperature of both feet and for both genders; (2) no symmetry between the left and right feet thermograms; and (3) the temperature distribution is still decreasing from the medial longitudinal arch to the periphery of the foot. However, the standard deviation, for each averaged temperature of the angiosomes, shows greater uncertainty. Most thermograms of diabetic individuals show temperature increase on the plantar skin, and are mostly symmetric between left and right feet. Conclusions: An asymmetric thermogram of the plantar skin of diabetic individuals, where one foot is hotter than the other, may mean that the coldest foot is losing the capacity to communicate properly with the central nervous system and/or that vasoconstriction/vasodilatation is having problems in regulating the passing of blood through the vessels. Thus, the asymmetric thermograms of diabetic patients, and particularly those coldest regions of foot are of interest, because of the reduction of the local autonomic sensing and the lack of achieving properly the passing of the blood.

Relationship between patient satisfactions with diabetes care and ...

African Journals Online (AJOL)

2013-08-05

Aug 5, 2013 ... Bener, et al.: Patients satisfaction evaluation and management of diabetes care. 219 ... socioeconomic status (SES), females and the elderly.[5‑8] .... the subject was standing bare feet and with normal straight posture. Weight ...

Diabetes Mellitus and the Musculoskeletal System

International Nuclear Information System (INIS)

Monu, Johnny V.J.

2015-01-01

Diabetes mellitus is a metabolic disease with systemic manifestations. Occurrence is increasing worldwide from 153m to 347m from 1980 to 2011. Traditionally there are two main types: Insulin dependent or juvenile diabetes and non-insulin dependent or Maturity onset or insulin resistant diabetes. Gestational diabetes the second type of diabetes is increasingly seen in young patients and it evolves into insulin dependence. Obesity is causally related to type II diabetes. Diabetes Mellitus affects appendicular and peripheral structures more commonly – ankle and feet. Diabetes in the MSK System effects manifested as congenital problems, Peripheral neuropathy, Peripheral vasculopathy Infections and Connective tissue changes. The disease target Structures like Cardio-vascular system, Central nervous system (brain, eyes) and peripheral nerves, Reticulo-endothelial system, Kidneys and Musculoskeletal system. Osteomyelitis fractures including fragmentation of bones and disorganization of joints – neuropathic changes. Diabetic Myopathy occurs predominantly in long-standing, poorly controlled type 1 diabetics often have other vascular or end organ complications. Etiology related to microvascular disease leads to muscle ischemia and infarction eventual muscle atrophy

IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes

NARCIS (Netherlands)

Bus, S. A.; van Netten, J. J.; Lavery, L. A.; Monteiro-Soares, M.; Rasmussen, A.; Jubiz, Y.; Price, P. E.

2016-01-01

Recommendations To identify a person with diabetes at risk for foot ulceration, examine the feet annually to seek evidence for signs or symptoms of peripheral neuropathy and peripheral artery disease. (GRADE strength of recommendation: strong; Quality of evidence: low) In a person with diabetes who

Risk Factors of Treatment Failure in Diabetic Foot Ulcer Patients

Directory of Open Access Journals (Sweden)

Kyung Mook Lee

2013-03-01

Full Text Available BackgroundSome diabetic feet heal without complication, but others undergo amputation due to progressive wounds. This study investigates the risk factors for amputation of diabetic feet.MethodsA total of 55 patients who visited our institution from 2008 to 2012 were included in the study. The patients with abnormal fasting blood sugar levels, lower leg vascularity, and poor nutrition were excluded from the study group, and the wound states were unified. The patients were categorized into a treatment success group (n=47 and a treatment failure group (n=8, and their hemoglobin A1C (HgA1C, C-reactive protein (CRP, white blood cell count (WBC, and serum creatinine levels were analyzed.ResultsThe initial CRP, WBC, and serum creatinine levels in the treatment failure group were significantly higher than that of the treatment success group, and the initial HgA1C level was significantly higher in the treatment success group. The CRP and WBC levels of both groups changed significantly as time passed, but their serum creatinine levels did not.ConclusionsThe initial CRP, WBC, and serum creatinine levels were considered to be risk factors for amputation. Among them, the serum creatinine level was found to be the most important predictive risk factor. Because serum creatinine represents the renal function, thorough care is needed for the feet of diabetic patients with renal impairment.

Impact Response for Two Designs of Athletic Prosthetic Feet

Directory of Open Access Journals (Sweden)

Mohsin N. Hamzah

2018-03-01

Full Text Available The present work evaluated the differences in mechanical properties of two athletic prosthetic feet samples when subjected to impact while running. Two feet samples designated as design A and B were manufactured using layers of different orientations of woven glass fiber reinforced with unsaturated polyester resin as bonding epoxy. The samples’ layers were fabricated with hand lay-up method. A theoretical study was carried out to calculate the mechanical properties of the composite material used in feet manufacturing, then experimental load-deflection test was applied at 0 degree position and 25 degree dorsiflexion feet position and impact test were applied for both feet designs to observe the behavior of the feet under static and impact loading and compare properties like stiffness, efficiency, rigidity, and shock absorption at different drop angles range from 25 degrees to 60 degrees which perform the foot positions while running. The load-deflection test result shows that the maximum deflection of the proposed design B was 32.2 mm at 0° and 38.45mm at 25°. While it was 41mm at 0˚ and 39mm at 25˚ for design A. Impact test result shows that design B foot gives peak load of 128 .7 kg with a peak time of 0.06 sec, while design Afoot gives 125.32 kg peak load with a time of 0.069 sec.

Reliability of a novel thermal imaging system for temperature assessment of healthy feet.

Science.gov (United States)

Petrova, N L; Whittam, A; MacDonald, A; Ainarkar, S; Donaldson, A N; Bevans, J; Allen, J; Plassmann, P; Kluwe, B; Ring, F; Rogers, L; Simpson, R; Machin, G; Edmonds, M E

2018-01-01

Thermal imaging is a useful modality for identifying preulcerative lesions ("hot spots") in diabetic foot patients. Despite its recognised potential, at present, there is no readily available instrument for routine podiatric assessment of patients at risk. To address this need, a novel thermal imaging system was recently developed. This paper reports the reliability of this device for temperature assessment of healthy feet. Plantar skin foot temperatures were measured with the novel thermal imaging device (Diabetic Foot Ulcer Prevention System (DFUPS), constructed by Photometrix Imaging Ltd) and also with a hand-held infrared spot thermometer (Thermofocus® 01500A3, Tecnimed, Italy) after 20 min of barefoot resting with legs supported and extended in 105 subjects (52 males and 53 females; age range 18 to 69 years) as part of a multicentre clinical trial. The temperature differences between the right and left foot at five regions of interest (ROIs), including 1st and 4th toes, 1st, 3rd and 5th metatarsal heads were calculated. The intra-instrument agreement (three repeated measures) and the inter-instrument agreement (hand-held thermometer and thermal imaging device) were quantified using intra-class correlation coefficients (ICCs) and the 95% confidence intervals (CI). Both devices showed almost perfect agreement in replication by instrument. The intra-instrument ICCs for the thermal imaging device at all five ROIs ranged from 0.95 to 0.97 and the intra-instrument ICCs for the hand-held-thermometer ranged from 0.94 to 0.97. There was substantial to perfect inter-instrument agreement between the hand-held thermometer and the thermal imaging device and the ICCs at all five ROIs ranged between 0.94 and 0.97. This study reports the performance of a novel thermal imaging device in the assessment of foot temperatures in healthy volunteers in comparison with a hand-held infrared thermometer. The newly developed thermal imaging device showed very good agreement in

Sweat function in the diabetic foot

Directory of Open Access Journals (Sweden)

Markendeya Nirmala

2004-01-01

Full Text Available Background: Autonomic dysfunction, an early manifestation of diabetic neuropathy, presents with altered sweating patterns, leading to dryness and fissuring. We conducted a study to assess the sweat function in the diabetic foot and to determine the interrelation between the duration of diabetes, sensation, fissuring, and sweating. Methods: The sweat function was assessed in 30 diabetic patients, 28 of whom had fissuring of the feet, using Ninhydrin impregnated discs. Results: There was a significant association between fissuring and sensation, but not between the duration of diabetes and fissuring and between loss of sweating and fissuring. In 18 patients (60% there was impairment or absence of sweating in the presence of normal sensation. Conclusion: Although fissuring increases with long-standing diabetes and sweating is reduced in diabetic patients with fissures on the foot, the correlation between these entities was not statistically significant. Since 60% patients had altered sweating in the presence of normal sensations, the sweat test can be used as an early indicator of diabetic neuropathy.

Computer aided diagnosis of diabetic peripheral neuropathy

Science.gov (United States)

Chekh, Viktor; Soliz, Peter; McGrew, Elizabeth; Barriga, Simon; Burge, Mark; Luan, Shuang

2014-03-01

Diabetic peripheral neuropathy (DPN) refers to the nerve damage that can occur in diabetes patients. It most often affects the extremities, such as the feet, and can lead to peripheral vascular disease, deformity, infection, ulceration, and even amputation. The key to managing diabetic foot is prevention and early detection. Unfortunately, current existing diagnostic techniques are mostly based on patient sensations and exhibit significant inter- and intra-observer differences. We have developed a computer aided diagnostic (CAD) system for diabetic peripheral neuropathy. The thermal response of the feet of diabetic patients following cold stimulus is captured using an infrared camera. The plantar foot in the images from a thermal video are segmented and registered for tracking points or specific regions. The temperature recovery of each point on the plantar foot is extracted using our bio-thermal model and analyzed. The regions that exhibit abnormal ability to recover are automatically identified to aid the physicians to recognize problematic areas. The key to our CAD system is the segmentation of infrared video. The main challenges for segmenting infrared video compared to normal digital video are (1) as the foot warms up, it also warms up the surrounding, creating an ever changing contrast; and (2) there may be significant motion during imaging. To overcome this, a hybrid segmentation algorithm was developed based on a number of techniques such as continuous max-flow, model based segmentation, shape preservation, convex hull, and temperature normalization. Verifications of the automatic segmentation and registration using manual segmentation and markers show good agreement.

Flexible flat feet in children: a real problem?

Science.gov (United States)

García-Rodríguez, A; Martín-Jiménez, F; Carnero-Varo, M; Gómez-Gracia, E; Gómez-Aracena, J; Fernández-Crehuet, J

1999-06-01

To estimate the prevalence of flexible flat feet in the provincial population of 4- to 13-year-old schoolchildren and the incidence of treatments considered unnecessary. Province of Málaga, Spain. We examined and graded by severity a sample of 1181 pupils taken from a total population of 198 858 primary schoolchildren (CI: 95%; margin of error: 5%). The sample group was separated into three 2-year age groups: 4 and 5 years, 8 and 9 years, and 12 and 13 years. The plantar footprint was classified according to Denis1 into three grades of flat feet: grade 1 in which support of the lateral edge of the foot is half that of the metatarsal support; grade 2 in which the support of the central zone and forefoot are equal; and grade 3 in which the support in the central zone of the foot is greater than the width of the metatarsal support. The statistical analysis for the evaluation of the differences between the groups was performed with Student's t and chi2 tests as appropriate. The prevalence of flat feet was 2.7%. Of the 1181 children sampled, 168 children (14.2%) were receiving orthopedic treatment, but only 2.7% had diagnostic criteria of flat feet. When we inspected the sample, we found that a number of children were being treated for flat feet with boots and arch supports. Most of them did not have a flat plantar footprint according to the criteria that we used for this work. Furthermore, in the group of children that we diagnosed as having flat feet, only 28.1% were being treated. We found no significant differences between the number of children receiving orthopedic treatments and the presence or absence of a flat plantar footprint. Children who were overweight in the 4- and 5-year-old group showed an increased prevalence for flat feet as diagnosed by us. The data suggest that an excessive number of orthopedic treatments had been prescribed in the province. When extrapolated to the 1997 population of schoolchildren within the age groups studied the figures

A 24-year-old Ethiopian Farmer with Burning Feet

NARCIS (Netherlands)

Visser, Benjamin Jelle; Korevaar, Daniel Arnoldus; van der Zee, Janneke

2012-01-01

Podoconiosis is a non-infectious tropical disease caused by exposure of bare feet to irritant alkalic clay soils. This causes an asymmetrical swelling of the feet and lower limbs due to lymphoedema. This swelling is called "elephantiasis" and may lead to severe disability of the patient. It is found

Clinical management of acute diabetic Charcot foot in Denmark

DEFF Research Database (Denmark)

Jansen, Rasmus Bo; Svendsen, Ole Lander; Kirketerp-Møller, Klaus

2016-01-01

INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS......: This study is based on a questionnaire survey sent out to healthcare professionals, primarily doctors, working with diabetic foot ulcers and Charcot feet in the public sector of the Danish healthcare system. RESULTS: The survey obtained a 52% response rate. A temperature difference of > 2 °C between the two...... and treatment practices of acute diabetic Charcot foot at diabetes foot clinics in Denmark. The responders seem to follow the international recommendations and guidelines on management of the acute diabetic Charcot foot, despite a lack of Danish guidelines. FUNDING: none. TRIAL REGISTRATION: not relevant....

Risk factors of foot ulceration in patients with Diabetes Mellitus type 2

Directory of Open Access Journals (Sweden)

Patricia Bañuelos-Barrera

2013-12-01

Full Text Available Objective. Identify the risk factors for foot ulceration in patients with diabetes type 2 (DM2 who attended a primary care center in the city of Colima (Mexico. Methodology. This was a descriptive cross-sectional study conducted during 2012 with the participation of 87 patients with DM2 from both sexes and older than 30 years of age. Socio-demographic, anthropometric, clinical, and biochemical variables were measured. The study inquired about prior evaluation of the feet and prior education on diabetes by the healthcare team. Results. The mean age was 59 years and 70% were women. The average number of years since diagnosis was nine years; only 35% had good glycemia control; 66% engage in exercise; 51% wear open shoes; none had temperature differences in the feet; 82% had some type of dermatological abnormality; 50% had deformities in their feet. A total of 24% had been diagnosed with peripheral neuropathy and another 11% had peripheral vascular disease. Sixty percent of all the patients had risk of foot ulceration. Only 23% of the participants had had previous foot exams. One of every three diabetic patients had received education about the disease. Conclusion. An important proportion of the patients had risk of foot ulceration, contrary to the insufficient percentage of individuals with previous inspection and education about foot care. For nursing, it is an area of opportunity in this level of care to improve the inspection and education on diabetes, specifically on foot care, mainly in those patients with a prolonged evolution of the disease, deficient glycemia control, and risk of ulceration.

Plantar fat-pad displacement in neuropathic diabetic patients with toe deformity: a magnetic resonance imaging study

NARCIS (Netherlands)

Bus, Sicco A.; Maas, Mario; Cavanagh, Peter R.; Michels, Robert P. J.; Levi, Marcel

2004-01-01

OBJECTIVE: The aim of this study was to quantify the association between claw/hammer toe deformity and changes in submetatarsal head (sub-MTH) fat-pad geometry in diabetic neuropathic feet. RESEARCH DESIGN AND METHODS: Thirteen neuropathic diabetic subjects (mean age 56.2 years) with toe deformity,

Is the foot elevation the optimal position for wound healing of a diabetic foot?

Science.gov (United States)

Park, D J; Han, S K; Kim, W K

2010-03-01

In managing diabetic foot ulcers, foot elevation has generally been recommended to reduce oedema and prevent other sequential problems. However, foot elevation may decrease tissue oxygenation of the foot more than the dependent position since the dependent position is known to increase blood flow within the arterial system. In addition, diabetic foot ulcers, which have peripheral vascular insufficiency, generally have less oedema than other wounds. Therefore, we argue that foot elevation may not be helpful for healing of vascularly compromised diabetic foot ulcers since adequate tissue oxygenation is an essential factor in diabetic wound healing. The purpose of this study was to evaluate the influence of foot height on tissue oxygenation and to determine the optimal foot position to accelerate wound healing of diabetic foot ulcers. This study included 122 cases (73 males and 47 females; two males had bilateral disease) of diabetic foot ulcer patients aged 40-93 years. Trans-cutaneous partial oxygen tension (TcpO(2)) values of diabetic feet were measured before and after foot elevation (n=21). Elevation was achieved by placing a foot over four cushions. We also measured foot TcpO(2) values before and after lowering the feet (n=122). Feet were lowered to the patient's tibial height, approximately 30-35 cm, beside a bed handrail. Due to the large number of lowering measurements, we divided them into five sub-groups according to initial TcpO(2.) Tissue oxygenation values were compared. Foot-elevation-lowered TcpO(2) values before and after elevation were 32.5+/-22.2 and 23.8+/-23.1 mmHg (pFoot-lowering-augmented TcpO(2) values before and after lowering were 44.6+/-23.8 and 58.0+/-25.9 mmHg (pfoot lowering, rather than elevation, significantly augments TcpO(2) and may stimulate healing of diabetic foot ulcers. (c) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Are we telling the diabetic patients adequately about foot care

International Nuclear Information System (INIS)

Ali, R.; Din, M.J.U.; Jadoon, R.J.; Farooq, U.; Alam, M.A.; Qureshi, A.; Shah, S.U.

2016-01-01

Background: Diabetes mellitus affects more than 285 million people worldwide. The prevalence is expected to rise to 439 million by the year 2030. Diabetic foot ulcers precede 84 percentage of non-traumatic amputations in diabetics. One lower limb is lost every 30 seconds around the world because of diabetic foot ulceration. Apart from being lengthy, the treatment of diabetic foot is also very expensive. There is very limited emphasis on foot care in diabetic patients. Even in developed countries patients feel that they do not have adequate knowledge about foot care. This study was conducted to find out how much information is imparted by doctors to diabetic patients about foot care. Methods: This cross-sectional study was conducted in admitted patients of the Department of Medicine, DHQ Hospital, Abbottabad from May 2014 to June 2015. 139 diabetic patients more than 25 years of age were included by non-probability consecutive sampling. Results: The mean age was 57.17 ( percentage 11.1) years. 35.3 percentage of patients were male and 64.7 percentage were female. The mean duration of diabetes in patients was 8.3 (±6) years. Only 36.7 percentage of patients said that their doctor told them about foot care. Less than 40 percentage of patients knew that they should daily inspect their feet, wash them with gentle warm water, and dry them afterwards. Only 25.2 percentage of the participants knew how to manage corns or calluses on feet. 66.5 percentage of patients knew that they should not walk bare foot. Overall, 63 percentage of our patients had less than 50 percentage knowledge of the 11 points regarding foot care that the investigators asked them. Conclusion: Diabetic foot problems are the one of the costliest, most disabling and disheartening complication of diabetes mellitus. Doctors are not properly telling diabetic patients about foot care. There is a deficiency of knowledge among the diabetic patients regarding foot care. (author)

[Therapeutic uses of ortho-podiatry in the diabetic foot].

Science.gov (United States)

López Herranz, Marta; Bas Caro, Pedro; Carabantes Alarcón, David; Padín Galea, José Manuel

2011-10-01

The neuropathic diabetic foot ulcers are a major public health problem given by different situations: the chronic nature of the injury, a low response to treatment, relapse rates, etc. Therefore pose a serious personal, family health and social, with a significant expenditure of human and material resources. Treatment requires a multidisciplinary team which integrates a podiatrist as part of it. He will address especially the pre-ulcers, and have a singular care in diabetic foot by treatment with orthosis. Since your question can be seen changes in the feet of diabetic patients could be treated on an outpatient basis.

Narrative review: Diabetic foot and infrared thermography

Science.gov (United States)

Hernandez-Contreras, D.; Peregrina-Barreto, H.; Rangel-Magdaleno, J.; Gonzalez-Bernal, J.

2016-09-01

Diabetic foot is one of the major complications experienced by diabetic patients. An early identification and appropriate treatment of diabetic foot problems can prevent devastating consequences such as limb amputation. Several studies have demonstrated that temperature variations in the plantar region can be related to diabetic foot problems. Infrared thermography has been successfully used to detect complication related to diabetic foot, mainly because it is presented as a rapid, non-contact and non-invasive technique to visualize the temperature distribution of the feet. In this review, an overview of studies that relate foot temperature with diabetic foot problems through infrared thermography is presented. Through this research, it can be appreciated the potential of infrared thermography and the benefits that this technique present in this application. This paper also presents the different methods for thermogram analysis and the advantages and disadvantages of each one, being the asymmetric analysis the method most used so far.

Terahertz imaging for early screening of diabetic foot syndrome: A proof of concept

Science.gov (United States)

Hernandez-Cardoso, G. G.; Rojas-Landeros, S. C.; Alfaro-Gomez, M.; Hernandez-Serrano, A. I.; Salas-Gutierrez, I.; Lemus-Bedolla, E.; Castillo-Guzman, A. R.; Lopez-Lemus, H. L.; Castro-Camus, E.

2017-02-01

Most people with diabetes suffer some deterioration of the feet. Diabetic foot syndrome causes ulceration in about 15% of cases and such deterioration leads to amputation in about 2.5% of diabetic patients, diminishing their quality of life and generating extraordinary costs for patients and public health systems. Currently, there is no objective method for the detection of diabetic foot syndrome in its early stages. We propose terahertz imaging as a method for the evaluation of such deterioration. This screening method could aid the prevention and medical treatment of this condition in the future.

A Pilot Study on Gait Kinematics of Old Women with Bound Feet

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Yan Zhang

2015-01-01

Full Text Available Foot binding has a long and influential history in China. Little is known about biomechanical changes in gait caused by bound foot. The purpose of this study was to investigate the differences in lower limb kinematics between old women with bound feet and normal feet during walking. Six old women subjects (three with bound feet and three controls with normal feet volunteered to participate in this study. Video data were recorded with a high speed video camera and analysed in the SIMI motion analysis software. Compared to normal controls, bound feet subjects had faster gait cadence with shorter stride length as well as smaller ankle and knee range of motion (ROM. During preswing phase, ankle remained to be dorsiflexion for bound foot subjects. The data from bound foot group also demonstrated that toe vertical displacement increased continuously during whole swing phase without a minimum toe clearance (MTC. The findings indicate that older women with bound feet exhibit significant differences in gait pattern compared to those with normal feet, which is characterised by disappeared propulsion/push-off and reduced mobility of lower limb segments.

Determining adult type 2 diabetes-related health care needs in an indigenous population from rural Guatemala: a mixed-methods preliminary study

Directory of Open Access Journals (Sweden)

Chary Anita

2012-12-01

Full Text Available Abstract Background In Guatemala, diabetes is an emerging public health concern. Guatemala has one of the largest indigenous populations in Latin America, and this population frequently does not access the formal health care system. Therefore, knowledge about the emergence of diabetes in this population is limited. Methods Interview participants (n=23 were recruited from a convenience sample of indigenous adults with type 2 diabetes at one rural diabetes clinic in Guatemala. A structured interview was used to assess knowledge about diabetes and its complications; access to diabetes-related health care and treatment; dietary and lifestyle changes; and family and social supports for individuals living with diabetes. Interviews were supplemented with two group interviews with community leaders and health care providers. Thematic analysis was used to produce insights into diabetes knowledge, attitudes, and practices. In addition, a chart review of the clinic’s electronic medical record identified all adult patients (n=80 presenting in one calendar year for a first-time diabetic consultation. Sociodemographic and clinical variables were extracted and summarized from these records. Results Salient demographic factors in both the structured interview and chart review samples included low educational levels and high indigenous language preference. In the interview sample, major gaps in biomedical knowledge about diabetes included understanding the causes, chronicity, and long-term end-organ complications of diabetes. Medication costs, medical pluralism, and limited social supports for dietary and lifestyles changes were major practical barriers to disease management. Quantitative data from medical records review revealed high rates of poor glycemic control, overweight and obesity, and medication prescription. Conclusions This study provides a preliminary sketch of type 2 diabetes in an indigenous Guatemalan population. Combined qualitative and

Earthquake at 40 feet

Science.gov (United States)

Miller, G. J.

1976-01-01

The earthquake that struck the island of Guam on November 1, 1975, at 11:17 a.m had many unique aspects-not the least of which was the experience of an earthquake of 6.25 Richter magnitude while at 40 feet. My wife Bonnie, a fellow diver, Greg Guzman, and I were diving at Gabgab Beach in teh outer harbor of Apra Harbor, engaged in underwater phoyography when the earthquake struck. 

Expression of Sterol Regulatory Element-Binding Proteins in epicardial adipose tissue in patients with coronary artery disease and diabetes mellitus: preliminary study

Science.gov (United States)

Pérez-Belmonte, Luis M.; Moreno-Santos, Inmaculada; Cabrera-Bueno, Fernando; Sánchez-Espín, Gemma; Castellano, Daniel; Such, Miguel; Crespo-Leiro, María G; Carrasco-Chinchilla, Fernando; Alonso-Pulpón, Luis; López-Garrido, Miguel; Ruiz-Salas, Amalio; Becerra-Muñoz, Víctor M.; Gómez-Doblas, Juan J.; de Teresa-Galván, Eduardo; Jiménez-Navarro, Manuel

2017-01-01

Objectives: Sterol regulatory element-binding proteins (SREBP) genes are crucial in lipid biosynthesis and cardiovascular homeostasis. Their expression in epicardial adipose tissue (EAT) and their influence in the development of coronary artery disease (CAD) and type-2 diabetes mellitus remain to be determined. The aim of our study was to evaluate the expression of SREBP genes in EAT in patients with CAD according to diabetes status and its association with clinical and biochemical data. Methods: SREBP-1 and SREBP-2 mRNA expression levels were measured in EAT from 49 patients with CAD (26 with diabetes) and 23 controls without CAD or diabetes. Results: Both SREBPs mRNA expression were significantly higher in patients with CAD and diabetes (pcardiovascular risk factor for coronary artery disease in patients with type-2 diabetes (SREBP-1: OR 1.7, 95%CI 1.1-2.5, p=0.02; SREBP-2: OR 1.6, 95%CI 1.2-3, p=0.02) and were independently associated with the presence of multivessel CAD, left main and anterior descending artery stenosis, and higher total and LDL cholesterol levels, and lower HDL cholesterol levels, in patients with CAD and diabetes. Conclusions: SREBP genes are expressed in EAT and were higher in CAD patients with diabetes than those patients without CAD or diabetes. SREBP expression was associated as cardiovascular risk factor for the severity of CAD and the poor lipid control. In this preliminary study we suggest the importance of EAT in the lipid metabolism and cardiovascular homeostasis for coronary atherosclerosis of patients with diabetes and highlight a future novel therapeutic target. PMID:28367087

Feet, Footwork, Footwear, and "Being Alive" in the Modern School

Science.gov (United States)

Burke, Catherine

2018-01-01

This article considers the theoretical argument of anthropologist Tim Ingold, that the denial and subsequent encasement of bare feet in footwear was a critical characteristic of the development of modern societies, in exploring three aspects of feet, footwork, and footwear in the history of the modern school. First, the material conditions of feet…

Appraisal Of Quality Of Life Of Diabetic Patients, Including Life ...

African Journals Online (AJOL)

The review showed that patients with diabetes mellitus had signi cantly low ... of life (physical health, psychological health, social relations, and environment). ... of quality of life regarding gender, age, or the level of education of the patients. ... neuropathy, impaired vision, elevated blood lipids and amputation of toes or feet.

Effect of irradiation on sensory quality of fermented spicy chicken feet

International Nuclear Information System (INIS)

Gao Meixu; Li Shurong; Pei Ying; Jiang Xiujie; Wang Zhidong; Deng Wenmin; Chen Xun; Huang Min; Chen Hao

2010-01-01

Irradiation could effectively control lactobacillus of fermented spicy chicken feet and extend its shelf life. Sensory evaluation standard of fermented spicy chicken feet was established to study the sensory change after irradiation according to related standards and research results. Color and shape (weight 30%), scent (weight 30%), texture and taste (weight 40%) were selected as sensory evaluation items. The sensory evaluation results after irradiation 3 days didn't show significance difference among control, 3, 5, 8 and 12 kGy irradiated samples, and the sensory evaluation score of 10 kGy irradiated sample was much higher then other sample groups. The results after irradiation 11d were almost as same as 3d results. It is indicated that the sensory quality of fermented spicy chicken feet would not destroyed by irradiation, and suitable dosage of irradiation may promote the sensory quality of fermented spicy chicken feet. (authors)

Gout on CT of the feet: A symmetric arthropathy

International Nuclear Information System (INIS)

Doyle, Anthony J.; Boyer, Lucinda; Dong, Jing; Dalbeth, Nicola; McQueen, Fiona; Rome, Keith; Frecklington, Mike

2016-01-01

The aim of this study was to assess the distribution of bone erosions in the feet of patients with gout using CT and thereby to test the hypothesis that gout is an asymmetric arthropathy. CT scans of both feet were obtained from 25 patients with chronic gout. CT scans were scored for bone erosion using a semi-quantitative method based on the rheumatoid arthritis MRI scoring system (RAMRIS). CT bone erosion was assessed at 22 bones in each foot (total 1,100 bones) by two independent radiologists. Symmetry was assessed by two methods: (i) comparing right and left foot scores for each patient; and (ii) calculating the proportion of paired joints with or without erosions. Observer agreement was excellent (intra-class correlation coefficient 0.92). In the group overall, the difference in scores between the feet was not significant (Student's t-test P = 0.8). In 17 of 25 patients, the difference in erosion scores between the two feet was less than the inter-observer difference. In 24 of 25 patients, the proportion of paired joints was greater than 0.5, indicating symmetric disease. Erosive disease from gout is, in fact, a symmetric process in our patient group. This finding is contrary to the established view of gout as an asymmetric arthritis and lends new insight into the behaviour of this common disease.

Advances in Propulsive Bionic Feet and Their Actuation Principles

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Pierre Cherelle

2014-07-01

Full Text Available In the past decades, researchers have deeply studied pathological and nonpathological gait to understand the human ankle function during walking. These efforts resulted in the development of new lower limb prosthetic devices aiming at raising the 3C-level (control, comfort, and cosmetics of amputees. Thanks to the technological advances in engineering and mechatronics, challenges in the field of prosthetics have become an important source of interest for roboticists. Currently, most of the bionic feet are still on a research level but show promising results and a preview of tomorrow's commercial prosthetic devices. In this paper, the authors present the current state-of-the-art and the latest advances in propulsive bionic feet with its actuation principles. The context of this review study is outlined followed by a brief description of the basics in human biomechanics and criteria for new prosthetic designs. A new categorization based on the actuation principle of propulsive ankle-foot prostheses is proposed. Based on simulations, the general principles and benefits of each actuation method are explained. The corresponding latest advances in propulsive bionic feet are presented together with their main characteristics and scientific outcomes. The authors also propose to the reader a comparison analysis of the presented devices with a discussion of the general tendencies in new prosthetic feet.

Backstroke start kinematic and kinetic changes due to different feet positioning.

Science.gov (United States)

de Jesus, Karla; de Jesus, Kelly; Figueiredo, Pedro; Gonçalves, Pedro; Pereira, Suzana Matheus; Vilas-Boas, João Paulo; Fernandes, Ricardo Jorge

2013-01-01

The backstroke swimming start international rules changed in 2005. This study compared two backstroke start variants, both with feet parallel to each other but in complete immersion and emersion. Six elite swimmers performed two sets of 4 maximal 15 m bouts, each set using one of the variants. The starts were videotaped in the sagittal plane with two cameras, providing bi-dimensional dual-media kinematic evaluation, and an underwater force plate and a handgrip instrumented with a load cell collected kinetic data. Backstroke start with feet immerged displayed greater centre-of-mass horizontal starting position, centre-of-mass horizontal velocity at hands-off and take-off angle. Backstroke start with feet emerged showed greater wall contact time, centre-of-mass horizontal and downward vertical velocity at take-off, lower limbs horizontal impulse, and centre-of-mass downward vertical velocity during flight phase. Backstroke start with feet immerged and emerged displayed similar centre-of-mass horizontal water reach, back arc angle and 5 m starting time. Irrespective of the swimmer's feet positioning, coaches should emphasise each variant's mechanical advantages during the wall contact phases. Furthermore, the maintenance of those advantages throughout the flight should be stressed for better backstroke start performance.

Psychological counselling in problematic diabetes

DEFF Research Database (Denmark)

Snoek, F. J.; Skinner, T. C.

2002-01-01

-destructive behaviour, but future research should substantiate these preliminary findings. Behaviour family therapy proved beneficial in terms of resolving family conflicts, but did not impact glycaemic control. Conclusions: Evidence to support the effect of psychological treatment in problematic diabetes is still......Background: In past decades clinicians have increasingly recognized the importance of psychological support for people with diabetes and their families, and many have recommended integrating psychological counselling into routine diabetes care. It is therefore important to consider whether...... psychological interventions in diabetes are effective in improving clinical outcomes. Methods: This review was limited to the literature reporting on the treatment of five common psychological problems known to complicate diabetes management: depression, eating disorders, anxiety/stress, self...

Decontamination of fermented chicken feet by 60Co irradiation

International Nuclear Information System (INIS)

Gao Peng; Wang Yan; Huang Min; Wu Ling; Du Xiaoying; Lei Qing; Xie Yan

2010-01-01

Fermented chicken feet was treated by 60Co irradiation, and the aerobic plate count, enumeration of coliforms, pathogens and TBARS value were measured during storage. The results showed that, aerobic plate count of all irradiated samples was lower than control, and enumeration of coliforms, and pathogens of Staphylococcus aureus, Shigella, Salmonella were not detected. TBARS value of all treatments was stable during 60 d storage. It could be concluded that 60Co irradiation of chicken feet was an effective method to prolong its shelf life. (authors)

Implementation of foot thermometry plus mHealth to prevent diabetic foot ulcers: study protocol for a randomized controlled trial.

Science.gov (United States)

Lazo-Porras, Maria; Bernabe-Ortiz, Antonio; Sacksteder, Katherine A; Gilman, Robert H; Malaga, German; Armstrong, David G; Miranda, J Jaime

2016-04-19

Diabetic foot neuropathy (DFN) is one of the most important complications of diabetes mellitus; its early diagnosis and intervention can prevent foot ulcers and the need for amputation. Thermometry, measuring the temperature of the feet, is a promising emerging modality for diabetic foot ulcer prevention. However, patient compliance with at-home monitoring is concerning. Delivering messages to remind patients to perform thermometry and foot care might be helpful to guarantee regular foot monitoring. This trial was designed to compare the incidence of diabetic foot ulcers (DFUs) between participants who receive thermometry alone and those who receive thermometry as well as mHealth (SMS and voice messaging) over a year-long study period. This is an evaluator-blinded, randomized, 12-month trial. Individuals with a diagnosis of type 2 diabetes mellitus, aged between 18-80 years, having a present dorsalis pedis pulse in both feet, are in risk group 2 or 3 using the diabetic foot risk classification system (as specified by the International Working Group on the Diabetic Foot), have an operating cell phone or a caregiver with an operating cell phone, and have the ability to provide informed consent will be eligible to participate in the study. Recruitment will be performed in diabetes outpatient clinics at two Ministry of Health tertiary hospitals in Lima, Peru. participants in both groups will receive education about foot care at the beginning of the study and they will be provided with a thermometry device (TempStat™). TempStat™ is a tool that captures a thermal image of the feet, which, depending on the temperature of the feet, shows different colors. In this study, if a participant notes a single yellow image or variance between one foot and the contralateral foot, they will be prompted to notify a nurse to evaluate their activity within the previous 2 weeks and make appropriate recommendations. In addition to thermometry, participants in the intervention arm

A Study on Stability of Limit Cycle Walking Model with Feet: Parameter Study

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Yonggwon Jeon

2013-01-01

Full Text Available In this paper, two kinds of feet, namely, curved and flat feet, are added to limit cycle walking model to investigate its stability properties. Although both models are already proposed and are investigated, most previous works are focused on efficiency and gait behaviors. Only the stability properties of the simplest walking model conceived Garcia et al. are well defined. Therefore, there is still a need for a precise research on the effect of feet, especially in the view of local stability, bifurcation route to chaos, global stability, falling boundary and energy balance line. Therefore, this article revisits the stability analysis of limit cycle walking model with various foot shape. To analyze the effects of feet, we re-derive the equation of motion of modified models by adding one more parameter of foot shape than the simplest walking model. Also, the falling boundary and energy balance line of modified models are derived to get proper initial conditions for stable walking and to explain global stability. Simulation results show us that the curved feet can enlarge both stable walking range and area of basin of attraction while the case of flat feet depends on foot shape parameter.

Chondroblastoma of the hands and feet

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Davila, Jesse A.; Amrami, Kimberly K.; Sundaram, Murali; Adkins, Mark C. [Mayo Clinic, Department of Radiology, Rochester (United States); Unni, Krishnan K. [Mayo Clinic, Department of Surgical Pathology, Rochester (United States)

2004-10-01

To review the imaging findings, age and gender distribution of chondroblastoma of the hands and feet. Twenty-five cases of pathologically proven chondroblastoma of the hands and feet were reviewed. Available imaging modalities included radiographs (n=24), CT (n=3), MRI (n=5), and radionuclide bone scintigraphy (n=1). The following imaging features for each case were tabulated: location, presence of sclerotic margin, calcification, expansion, presence of fluid/fluid levels on cross-sectional imaging and surrounding edema on MRI. The images were evaluated for skeletal maturity using closure of the physeal plate in the region as a standard. The average age at time of diagnosis was 23 years (range 7-57 years). Eighty-four percent (n=21) of the patients were skeletally mature. Males (20 of 25) outnumbered females by a ratio of 5:1. The bones of the foot accounted for 22 cases: calcaneus (n=8), talus (n=8), metatarsals (n=3), and the cuboid (n=3). The bones of the hand accounted for three cases: phalanx (n=1), triquetrum (n=1), and a metacarpal (n=1). Radiographically all lesions were osteolytic with identifiable calcification in 54% (13 of 24). Fluid/fluid levels were seen in four of five cases on MRI. Edema on MR images was seen in 40% (2 of 5). The size of the lesions ranged from 2 to 41 cm{sup 2}. Chondroblastomas of the hands and feet share many of the radiographic characteristics seen in the long bones, but manifest in skeletally mature patients with a higher male to female ratio than in long bone chondroblastoma. Talar and calcaneal lesions were encountered only in males. Chondroblastoma of the wrist and hand appears to be exceptionally rare. (orig.)

Chondroblastoma of the hands and feet

International Nuclear Information System (INIS)

Davila, Jesse A.; Amrami, Kimberly K.; Sundaram, Murali; Adkins, Mark C.; Unni, Krishnan K.

2004-01-01

To review the imaging findings, age and gender distribution of chondroblastoma of the hands and feet. Twenty-five cases of pathologically proven chondroblastoma of the hands and feet were reviewed. Available imaging modalities included radiographs (n=24), CT (n=3), MRI (n=5), and radionuclide bone scintigraphy (n=1). The following imaging features for each case were tabulated: location, presence of sclerotic margin, calcification, expansion, presence of fluid/fluid levels on cross-sectional imaging and surrounding edema on MRI. The images were evaluated for skeletal maturity using closure of the physeal plate in the region as a standard. The average age at time of diagnosis was 23 years (range 7-57 years). Eighty-four percent (n=21) of the patients were skeletally mature. Males (20 of 25) outnumbered females by a ratio of 5:1. The bones of the foot accounted for 22 cases: calcaneus (n=8), talus (n=8), metatarsals (n=3), and the cuboid (n=3). The bones of the hand accounted for three cases: phalanx (n=1), triquetrum (n=1), and a metacarpal (n=1). Radiographically all lesions were osteolytic with identifiable calcification in 54% (13 of 24). Fluid/fluid levels were seen in four of five cases on MRI. Edema on MR images was seen in 40% (2 of 5). The size of the lesions ranged from 2 to 41 cm 2 . Chondroblastomas of the hands and feet share many of the radiographic characteristics seen in the long bones, but manifest in skeletally mature patients with a higher male to female ratio than in long bone chondroblastoma. Talar and calcaneal lesions were encountered only in males. Chondroblastoma of the wrist and hand appears to be exceptionally rare. (orig.)

The management of diabetic foot ulcers in Danish hospitals is not optimal

DEFF Research Database (Denmark)

Kirketerp-Møller, Klaus; Svendsen, Ole Lander; Jansen, Rasmus Bo

2015-01-01

in the treatment. The objective of this study was to describe the treatment practices at the time the guidelines were launched. METHODS: A questionnaire-based survey was conducted among Danish hospital departments working with diabetic feet. All public departments were invited by e-mail to participate...

Gastroesophageal reflux disease in patients with diabetes: preliminary study.

Science.gov (United States)

Fujiwara, Mariko; Miwa, Takashi; Kawai, Takashi; Odawara, Masato

2015-03-01

Some studies report that complications of gastroesophageal reflux disease (GERD) occur more frequently in patients with diabetes mellitus (DM) than in non-diabetic patients. This study used transnasal endoscopy to elucidate the current status of concurrent GERD in patients with type 2 diabetes mellitus, and to examine the associations between intraesophageal pressure and GERD, as well as other neuropathic conditions. The study included 57 outpatients with type 2 diabetes mellitus. The mean age was 67 years and the duration of DM was 13 years. The mean hemoglobin A1c was 6.8%. Transnasal endoscopic evaluation items were (i) the presence or absence of esophagitis and its severity; (ii) intraesophageal pressure; and (iii) Helicobacter pylori status, which was evaluated by endoscopic findings, such as the presence or absence of gastritis and peptic ulcer, and by urea breath test. Of 57 patients, 24 (42.1%) were given a diagnosis of GERD based on endoscopy. Patients with concurrent GERD were younger, had shorter duration of DM, and were taller and heavier. Interestingly, no difference in body mass index was observed. There was no significant association between the presence of concurrent GERD and diabetic complications, including peripheral neuropathy, and infection or non-infection with H. pylori. Although there was no significant association between the presence of concurrent GERD and intraesophageal pressure values, we found aging, reduced estimated glomerular filtration rate, and the presence of autonomic nerve symptoms to correlate with reduced intraesophageal pressure. The results of this study could be used to answer the question of whether or not endoscopic GERD is a diabetic complication; however, further study is required. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Assessing Children's Legs and Feet

OpenAIRE

Wedge, John H.

1985-01-01

Shoes are necessary for protection and warmth. Normal children do not require shoes for support. There is no scientific evidence that shoes—‘orthopedic’ or otherwise—influence or alter the growth or shape of the normal child's foot except, perhaps, adversely if they fit poorly. Family physicians must understand common variations of normal foot and leg development if they are to effectively advise and reassure parents about appropriate footwear. Flat feet, knock knees, bow legs, in-toeing, and...

Establishing Differences in Thermographic Patterns between the Various Complications in Diabetic Foot Disease

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Alfred Gatt

2018-01-01

Full Text Available Aim. To evaluate the potential of thermography as an assessment tool for the detection of foot complications by understanding the variations in temperature that occur in type 2 diabetes mellitus (DM. Methods. Participants were categorized according to a medical examination, ankle brachial index, doppler waveform analysis, and 10-gram monofilament testing into five groups: healthy adult, DM with no complications, DM with peripheral neuropathy, DM with neuroischaemia, and DM with peripheral arterial disease (PAD groups. Thermographic imaging of the toes and forefeet was performed. Results. 43 neuroischaemic feet, 41 neuropathic feet, 58 PAD feet, 21 DM feet without complications, and 126 healthy feet were analyzed. The temperatures of the feet and toes were significantly higher in the complications group when compared to the healthy adult and DM healthy groups. The higher the temperatures of the foot in DM, the higher the probability that it is affected by neuropathy, neuroischaemia, or PAD. Conclusions. Significant differences in mean temperatures exist between participants who were healthy and those with DM with no known complications when compared to participants with neuroischaemia, neuropathy, or PAD. As foot temperature rises, so does the probability of the presence of complications of neuropathy, neuroischaemia, or peripheral arterial disease.

The management of diabetic foot ulcers in Danish hospitals is not optimal

DEFF Research Database (Denmark)

Kirketerp-Møller, Klaus; Svendsen, Ole Lander; Jansen, Rasmus Bo

2015-01-01

INTRODUCTION: The diabetic foot is a complicated health issue which ideally involves several different specialists to ensure the most effective treatment. The Danish Health and Medicines Authority recently published a national guideline to address the implementation of multidisciplinary teams......) were mostly orthopaedic surgeons. A classification system of the diabetic foot was rarely or never used, and eight respondents (42%) reported having a multidisciplinary team in accordance with the national guidelines. 73% of the respondents performed some form of surgical intervention on diabetic feet......, mainly minor procedures. CONCLUSION: The study demonstrated that several areas of treatment practices relating to the diabetic foot had potential for improvement as they did not adhere to national Danish guidelines. A follow-up survey, allowing time for local implementation, seems warranted....

Diffraction enhanced imaging of normal and arthritic mice feet

International Nuclear Information System (INIS)

Crittell, Suzanne; Cheung, K.C.; Hall, Chris; Ibison, Mark; Nolan, Paul; Page, Robert; Scraggs, David; Wilkinson, Steve

2007-01-01

The aim of this experiment was to produce X-ray images of mice feet using the diffraction-enhanced imaging (DEI) system at the UK Synchrotron Radiation Source (SRS) at Daresbury. There were two broad types of mice feet samples studied: normal and arthritic. The two types of samples were imaged using several views and compared in order to determine whether it would be possible to detect the early morphological changes linked with this form of arthritis. We found that the DEI images produced were indeed of sufficient quality to show the presence of some osteoarthritic changes

FTY720-loaded poly(DL-lactide-co-glycolide) electrospun scaffold significantly increases microvessel density over 7 days in streptozotocin-induced diabetic C57b16/J mice: preliminary results.

Science.gov (United States)

Bowers, D T; Chhabra, P; Langman, L; Botchwey, E A; Brayman, K L

2011-11-01

Nanofiber scaffolds could improve islet transplant success by physically mimicking the shape of extracellular matrix and by acting as a drug-delivery vehicle. Scaffolds implanted in alternate transplant sites must be prevascularized or very quickly vascularized following transplantation to prevent hypoxia-induced islet necrosis. The local release of the S1P prodrug FTY720 induces diameter enlargement and increases in length density. The objective of this preliminary study was to evaluate length and diameter differences between diabetic and nondiabetic animals implanted with FTY720-containing electrospun scaffolds using intravital imaging of dorsal skinfold window chambers. Electrospun mats of randomly oriented fibers we created from polymer solutions of PLAGA (50:50 LA:GA) with and without FTY720 loaded at a ratio of 1:200 (FTY720:PLAGA by wt). The implanted fiber mats were 4 mm in diameter and ∼0.2 mm thick. Increases in length density and vessel diameter were assessed by automated analysis of images over 7 days in RAVE, a Matlab program. Image analysis of repeated measures of microvessel metrics demonstrated a significant increase in the length density from day 0 to day 7 in the moderately diabetic animals of this preliminary study (P < .05). Furthermore, significant differences in length density at day 0 and day 3 were found between recently STZ-induced moderately diabetic and nondiabetic animals in response to FTY720 local release (P < .05, Student t test). Driving the islet revascularization process using local release of factors, such as FTY720, from biodegradable polymers makes an attractive system for the improvement of islet transplant success. Preliminary study results suggest that a recently induced moderately diabetic state may potentiate the mechanism by which local release of FTY720 from polymer fibers increases length density of microvessels. Therefore, local release of S1P receptor-targeted drugs is under further investigation for improvement of

Deep Underground Science and Engineering Laboratory - Preliminary Design Report

CERN Document Server

Lesko, Kevin T; Alonso, Jose; Bauer, Paul; Chan, Yuen-Dat; Chinowsky, William; Dangermond, Steve; Detwiler, Jason A; De Vries, Syd; DiGennaro, Richard; Exter, Elizabeth; Fernandez, Felix B; Freer, Elizabeth L; Gilchriese, Murdock G D; Goldschmidt, Azriel; Grammann, Ben; Griffing, William; Harlan, Bill; Haxton, Wick C; Headley, Michael; Heise, Jaret; Hladysz, Zbigniew; Jacobs, Dianna; Johnson, Michael; Kadel, Richard; Kaufman, Robert; King, Greg; Lanou, Robert; Lemut, Alberto; Ligeti, Zoltan; Marks, Steve; Martin, Ryan D; Matthesen, John; Matthew, Brendan; Matthews, Warren; McConnell, Randall; McElroy, William; Meyer, Deborah; Norris, Margaret; Plate, David; Robinson, Kem E; Roggenthen, William; Salve, Rohit; Sayler, Ben; Scheetz, John; Tarpinian, Jim; Taylor, David; Vardiman, David; Wheeler, Ron; Willhite, Joshua; Yeck, James

2011-01-01

The DUSEL Project has produced the Preliminary Design of the Deep Underground Science and Engineering Laboratory (DUSEL) at the rehabilitated former Homestake mine in South Dakota. The Facility design calls for, on the surface, two new buildings - one a visitor and education center, the other an experiment assembly hall - and multiple repurposed existing buildings. To support underground research activities, the design includes two laboratory modules and additional spaces at a level 4,850 feet underground for physics, biology, engineering, and Earth science experiments. On the same level, the design includes a Department of Energy-shepherded Large Cavity supporting the Long Baseline Neutrino Experiment. At the 7,400-feet level, the design incorporates one laboratory module and additional spaces for physics and Earth science efforts. With input from some 25 science and engineering collaborations, the Project has designed critical experimental space and infrastructure needs, including space for a suite of multi...

Differences in pediatric vertical ground reaction force between planovalgus and neutrally aligned feet.

Science.gov (United States)

Pauk, Jolanta; Szymul, Joanna

2014-01-01

Ground reaction forces (GRF) reflect the force history of human body contact with the ground. The purpose of this study was to explore human gait abnormalities due to planovalgus by comparing vertical GRF data between individuals with planovalgus and those with neutrally aligned feet. Second we estimated associations between various measurements and vertical GRF parameters in a pediatric population. Boys and girls between the ages of 4 and 18 years (72 planovalgus feet and 74 neutrally aligned feet) took part in this study. Ground reaction forces were recorded by two Kistler platforms and normalized to body weight. Comparison of vertical GRF between planovalgus and neutrally aligned feet suggests that the first and the second peaks of vertical force (Fz1, Fz2) are most affected by planovalgus. The results also indicate that neutrally aligned feet display a different ground reaction force pattern than planovalgus, and that differences between boys and girls may be observed. The shape of the vertical GRF curve can help in clinical interpretation of abnormal gait.

Ways to Correct Modified Risk Factors in the Management of Diabetic Foot Syndrome

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О.V. Marchenko

2015-08-01

Full Text Available The article presents modified risk factors that influence the development and clinical course of ulcers of the feet in patients with diabetes mellitus (DM and diabetic foot syndrome (DFS. Most DM patients on admission to hospital for DFS have: prolonged decompensation of DM, lipid metabolism disorders, concomitant cardiovascular disease (coronary heart disease, hypertension. It was found that the formation of sensorimotor neuropathy in patients with DM is a major risk factor for ulcers of the feet. At the time of ulcer detection, most patients have combination of sensorimotor neuropathy with other risk factors — foot deformity, presence of ulcers and/or amputations in past medical history, macroangiopathy. The presence of infection in the ulcerous defect is a significant risk factor for unfavorable course of DFS. Stable compensation of DM, the target values of blood lipids and blood pressure made it possible to achieve the healing of the ulcer in a shorter period.

Self-reported discrimination, diabetes distress, and continuous blood glucose in women with type 2 diabetes.

Science.gov (United States)

Wagner, Julie A; Tennen, Howard; Feinn, Richard; Osborn, Chandra Y

2015-04-01

We investigated whether self-reported racial discrimination was associated with continuous glucose levels and variability in individuals with diabetes, and whether diabetes distress mediated these associations. Seventy-four Black and White women with type 2 diabetes completed the Experience of Discrimination scale, a measure of lifetime racial discrimination, and the Problem Areas in Diabetes, a measure of diabetes distress. Participants wore a continuous glucose monitor for 24 h after 8 h of fasting, a standard meal, and a 4-h run in period. Higher discrimination predicted higher continuous mean glucose and higher standard deviation of glucose. For both mean and standard deviation of glucose, a race × discrimination interaction indicated a stronger relationship between discrimination and glucose for Whites than for Blacks. Diabetes distress mediated the discrimination-mean glucose relationship. Whites who report discrimination may be uniquely sensitive to distress. These preliminary findings suggest that racial discrimination adversely affects glucose control in women with diabetes, and does so indirectly through diabetes distress. Diabetes distress may be an important therapeutic target to reduce the ill effects of racial discrimination in persons with diabetes.

Foot Placement Modification for a Biped Humanoid Robot with Narrow Feet

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Kenji Hashimoto

2014-01-01

Full Text Available This paper describes a walking stabilization control for a biped humanoid robot with narrow feet. Most humanoid robots have larger feet than human beings to maintain their stability during walking. If robot’s feet are as narrow as humans, it is difficult to realize a stable walk by using conventional stabilization controls. The proposed control modifies a foot placement according to the robot's attitude angle. If a robot tends to fall down, a foot angle is modified about the roll axis so that a swing foot contacts the ground horizontally. And a foot-landing point is also changed laterally to inhibit the robot from falling to the outside. To reduce a foot-landing impact, a virtual compliance control is applied to the vertical axis and the roll and pitch axes of the foot. Verification of the proposed method is conducted through experiments with a biped humanoid robot WABIAN-2R. WABIAN-2R realized a knee-bended walking with 30 mm breadth feet. Moreover, WABIAN-2R mounted on a human-like foot mechanism mimicking a human's foot arch structure realized a stable walking with the knee-stretched, heel-contact, and toe-off motion.

Infection and Foot Care in Diabetics Seeking Treatment in a Tertiary Care Hospital, Bhubaneswar, Odisha State, India

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Sonali Kar

2015-01-01

Full Text Available Diabetes mellitus is a major public health problem that can cause a number of serious complications. Foot ulceration is one of its most common complications. Poor foot care knowledge and practices are important risk factors for foot problems among diabetics. The present study was undertaken in the diabetes outpatient department of a tertiary care hospital to assess the practices regarding foot care in diabetes, find out the determinants of foot ulcer in diabetics, and offer suggestions to improve care. After informed consent, a total of 124 diabetics were interviewed to collect all relevant information. The diabetic foot care practice responses were converted into scores and for the sake of analysis were inferred as poor (0–5, fair (6-7, and good (>7 practices. Of the study population, 68.5% (85/124 consisted of men. The disease was diagnosed within the last 5 years for 66% (81/124 of the study participants. Of the study subjects, 83% (103/124 were on oral hypoglycemic agents (OHAs, 15.3% (19 on insulin, and 2 on diet control only. Among them about 18.5% had a history of foot ulcer. 37.9% reported using special slippers, 12% diabetics used slippers indoors, and 66.9% used slippers while using toilet. Of the study subjects, 67.8% said that feet should be inspected daily. 27.4% said they regularly applied oil/moisturizer on their feet. There is a need on part of the primary or secondary physician and an active participation of the patient to receive education about foot care as well as awareness regarding risk factors, recognition, clinical evaluation, and thus prevention of the complications of diabetes.

A Study on Stability of Limit Cycle Walking Model with Feet: Parameter Study

OpenAIRE

Yonggwon Jeon; Youn-sik Park; Youngjin Park

2013-01-01

In this paper, two kinds of feet, namely, curved and flat feet, are added to limit cycle walking model to investigate its stability properties. Although both models are already proposed and are investigated, most previous works are focused on efficiency and gait behaviors. Only the stability properties of the simplest walking model conceived Garcia et al. are well defined. Therefore, there is still a need for a precise research on the effect of feet, especially in the view of local stability,...

Genetic correlations between claw health and feet and leg conformation in Norwegian Red cows.

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Ødegård, C; Svendsen, M; Heringstad, B

2014-07-01

The aim of this study was to estimate genetic correlations between claw disorders and feet and leg conformation traits in Norwegian Red cows. A total of 188,928 cows with claw health status recorded at claw trimming from 2004 to September 2013 and 210,789 first-lactation cows with feet and leg conformation scores from 2001 to September 2013 were included in the analyses. Traits describing claw health were corkscrew claw, infectious claw disorders (dermatitis, heel horn erosion, and interdigital phlegmon), and laminitis-related claw disorders (sole ulcer, white line disorder, and hemorrhage of sole and white line). The feet and leg conformation traits were rear leg rear view (new and old definition), rear leg side view, foot angle, and hoof quality. Feet and leg conformation traits were scored linearly from 1 to 9, with optimum scores depending on the trait. Claw disorders were defined as binary (0/1) traits for each lactation. Threshold sire models were used to model claw disorders, whereas the feet and leg conformation traits were described by linear sire models. Three multivariate analyses were performed, each including the 5 feet and leg conformation traits and 1 of the 3 claw disorders at a time. Posterior means of heritability of liability of claw disorders ranged from 0.10 to 0.20 and heritabilities of feet and leg conformation traits ranged from 0.04 to 0.11. Posterior standard deviation of heritability was ≤0.01 for all traits. Genetic correlations between claw disorders and feet and leg conformation traits were all low or moderate, except between corkscrew claw and hoof quality (-0.86), which are supposed to measure the same trait. The genetic correlations between rear leg rear view (new) and infectious claw disorders (-0.20) and laminitis-related claw disorders (0.26), and between hoof quality and laminitis-related claw disorders (-0.33) were moderate. Eight of the 15 genetic correlations between claw disorders and feet and leg conformation traits had 0

Patterns of radiographic changes in hands and feet of rheumatoid arthritis in Saudi Arabia

International Nuclear Information System (INIS)

Al-Arfaj, Abdurhman S.; Al-Boukai, Ahmad A.

2005-01-01

The aim of the study was to characterize the pattern of radiographic changes in the hands and feet of rheumatoid arthritis in Saudi patients. The radiographs of hands and feet of rheumatoid arthritis patients attending rheumatology outpatient clinics of King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia, over the period extending from March to June 2001, were examined and reported for the presence of osteopenia, joint space narrowing, and erosions. Fifty-six rheumatoid arthritis patients were studied. Their mean age was 50 + 1.9 years, and mean disease duration was 9.07 + 0.84 years. Generalized osteopenia was seen in 16/56 (29%) and periarticular osteopenia in 38/56 (68%). Joint space narrowing was present in 9/56 (16%) of feet and 35/56 (63%) of hand x-rays. Erosions were seen in 3/56 (6%) of feet and in 22/56 (39%) of hand x-rays. Significant correlation was seen between joints space narrowing, joint erosions, and disease duration. Radiographic changes in hands and feet of Saudi rheumatoid arthritis patients are less severe than those reported from the West, and the pattern is also different with less affection of the feet. (author)

Classification of Forefoot Plantar Pressure Distribution in Persons with Diabetes: A Novel Perspective for the Mechanical Management of Diabetic Foot?

Science.gov (United States)

Deschamps, Kevin; Matricali, Giovanni Arnoldo; Roosen, Philip; Desloovere, Kaat; Bruyninckx, Herman; Spaepen, Pieter; Nobels, Frank; Tits, Jos; Flour, Mieke; Staes, Filip

2013-01-01

Background The aim of this study was to identify groups of subjects with similar patterns of forefoot loading and verify if specific groups of patients with diabetes could be isolated from non-diabetics. Methodology/Principal Findings Ninety-seven patients with diabetes and 33 control participants between 45 and 70 years were prospectively recruited in two Belgian Diabetic Foot Clinics. Barefoot plantar pressure measurements were recorded and subsequently analysed using a semi-automatic total mapping technique. Kmeans cluster analysis was applied on relative regional impulses of six forefoot segments in order to pursue a classification for the control group separately, the diabetic group separately and both groups together. Cluster analysis led to identification of three distinct groups when considering only the control group. For the diabetic group, and the computation considering both groups together, four distinct groups were isolated. Compared to the cluster analysis of the control group an additional forefoot loading pattern was identified. This group comprised diabetic feet only. The relevance of the reported clusters was supported by ANOVA statistics indicating significant differences between different regions of interest and different clusters. Conclusion/s Significance There seems to emerge a new era in diabetic foot medicine which embraces the classification of diabetic patients according to their biomechanical profile. Classification of the plantar pressure distribution has the potential to provide a means to determine mechanical interventions for the prevention and/or treatment of the diabetic foot. PMID:24278219

Karotinaemi hos patient med excessivt betakarotinfødeindtag og dysreguleret diabetes mellitus

DEFF Research Database (Denmark)

Mikkelsen, Carsten Sauer; Mikkelsen, Dorthe Bisgaard; Lindegaard, Hanne Merete

2009-01-01

-carotene, but normal vitamine A value and liver enzymes. The patient reported an excessive intake of carrots (approximately 1 kg per day). The status of physiological amenorrhoea and dysregulated diabetes mellitus may have deteriorated the yellow discolouration of the skin. Udgivelsesdato: 2009-Jan-26......A case of carotinaemia in a patient with excessive beta-carotene food-intake, diabetes mellitus and physiological amenorrhea is reported. The patient developed yellow discolouration in the palms and the soles of her feet. Blood samples showed a significantly increased lever of serum beta...

Prenatal ultrasound diagnosis of isolated arthrogryposis of feet.

Science.gov (United States)

Degani, S; Shapiro, I; Lewinsky, R; Sharf, M

1989-01-01

Prenatal diagnosis of isolated arthrogryposis of the feet at the ankle joint was made by ultrasound and confirmed at birth. The criteria for ruling out joint contracture are absence of fixed limb deformity, and free fetal motion.

A preliminary study of levels of selected nutrients for neonates born to diabetic and non-diabetic mothers in Bangladesh

International Nuclear Information System (INIS)

Alam, A.M.S.; Chhowdhury, S.A.; Rahman, M.A.; Ali, S.M.K.; Huda, A.S.N.

2006-01-01

To investigate some selected nutrients status in the neonates born to diabetic and non-diabetic mothers a prospective study was carried out. From the Obstetric Unit of Bangladesh Institute of Rehabilitation in Diabetes, Endocrine and Metabolic disorder (BIRDEM) Hospital, Dhaka, Bangladesh, 236 newborns were recruited; 74 from diabetic, 59 from gestational diabetic and 103 from non-diabetic mothers group for this study. Cord-serum levels of Cu, Zn, Fe, Mg, Ca and ascorbic acid were investigated, and some anthropometric measurements were recorded to correlate with the nutrient levels. Fe was found significantly higher (p<0.05) whereas, ascorbic acid was found significantly lower (p<0.05) in diabetic group compared with other two groups. However, Mg and Ca levels were found significantly higher (p<0.05) in non-diabetic group. There was no significant difference observed in Cu, Zn levels for the 3 groups. Ca level was significantly correlated with birth weight and length of the neonates. These data suggests that diabetes has some effects on fetal growth and its nutritional status that also reflect the socio-economical status of the families of the neonates. (author)

A novel aromatic oil compound inhibits microbial overgrowth on feet: a case study

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Misner Bill D

2007-07-01

Full Text Available Abstract Background Athlete's Foot (Tinea pedis is a form of ringworm associated with highly contagious yeast-fungi colonies, although they look like bacteria. Foot bacteria overgrowth produces a harmless pungent odor, however, uncontrolled proliferation of yeast-fungi produces small vesicles, fissures, scaling, and maceration with eroded areas between the toes and the plantar surface of the foot, resulting in intense itching, blisters, and cracking. Painful microbial foot infection may prevent athletic participation. Keeping the feet clean and dry with the toenails trimmed reduces the incidence of skin disease of the feet. Wearing sandals in locker and shower rooms prevents intimate contact with the infecting organisms and alleviates most foot-sensitive infections. Enclosing feet in socks and shoes generates a moisture-rich environment that stimulates overgrowth of pungent both aerobic bacteria and infectious yeast-fungi. Suppression of microbial growth may be accomplished by exposing the feet to air to enhance evaporation to reduce moistures' growth-stimulating effect and is often neglected. There is an association between yeast-fungi overgrowths and disabling foot infections. Potent agents virtually exterminate some microbial growth, but the inevitable presence of infection under the nails predicts future infection. Topical antibiotics present a potent approach with the ideal agent being one that removes moisture producing antibacterial-antifungal activity. Severe infection may require costly prescription drugs, salves, and repeated treatment. Methods A 63-y female volunteered to enclose feet in shoes and socks for 48 hours. Aerobic bacteria and yeast-fungi counts were determined by swab sample incubation technique (1 after 48-hours feet enclosure, (2 after washing feet, and (3 after 8-hours socks-shoes exposure to a aromatic oil powder-compound consisting of arrowroot, baking soda, basil oil, tea tree oil, sage oil, and clove oil. Conclusion

MRI of the cuboid bone: Analysis of changes in diabetic versus non-diabetic patients and their clinical significance

International Nuclear Information System (INIS)

Pierre-Jerome, Claude; Reyes, Emmanuel J.; Moncayo, Valeria; Chen, Zhengjia Nelson; Terk, Michael R.

2012-01-01

Objectives: (1) To investigate the association between diabetes and marrow changes in the cuboid; and (2) to evaluate the influence of age, gender, body mass index (BMI) and use of insulin in the occurrence of marrow changes in the cuboid. Research design and methods: MR and X-ray foot examinations of 237 patients [94 males, 143 females; mean age, 47.1 years (range 16–93 years)], five of whom underwent bilateral examinations, were reviewed. MR and radiographic studies were analyzed for the presence of marrow edema and fractures in the cuboid. Findings were correlated with demographic data (age, gender) and clinical information (BMI and use of insulin). Results: Two hundred and forty two feet – 69 diabetic and 173 non-diabetic – were retrospectively evaluated. There was a higher prevalence of marrow edema and fractures in the diabetic cuboid (n = 31, 45%) compared to non-diabetic cuboid (n = 25, 14%, p = 0.02). A fracture line was seen in fourteen (20%) diabetic cuboid bones compared to 4 (2%) in non-diabetic cuboid bones (p < 0.0001). Eleven (79%) cases of cuboid fractures in the diabetic population were radiographically occult. Multivariate data analysis revealed an adjusted odds ratio of 4.416 (95% CI; 2.307, 8.454) for the relationship between marrow changes (edema and fractures) in the cuboid and diabetes. For each year of age, the odds of changes in the cuboid increased by 2.2% (95% CI; 1.001, 1.044). Conclusion: Despite not bearing weight, the cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients. Age seems to be an influential factor

MRI of the cuboid bone: Analysis of changes in diabetic versus non-diabetic patients and their clinical significance

Energy Technology Data Exchange (ETDEWEB)

Pierre-Jerome, Claude, E-mail: cpierr3@emory.edu [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States); Reyes, Emmanuel J.; Moncayo, Valeria; Chen, Zhengjia Nelson; Terk, Michael R. [Emory University School of Medicine, Department of Radiology and Imaging Sciences, Musculoskeletal Division, Orthopaedics and Spine Center, 59, Executive Park South, Atlanta, GA 30329 (United States)

2012-10-15

Objectives: (1) To investigate the association between diabetes and marrow changes in the cuboid; and (2) to evaluate the influence of age, gender, body mass index (BMI) and use of insulin in the occurrence of marrow changes in the cuboid. Research design and methods: MR and X-ray foot examinations of 237 patients [94 males, 143 females; mean age, 47.1 years (range 16–93 years)], five of whom underwent bilateral examinations, were reviewed. MR and radiographic studies were analyzed for the presence of marrow edema and fractures in the cuboid. Findings were correlated with demographic data (age, gender) and clinical information (BMI and use of insulin). Results: Two hundred and forty two feet – 69 diabetic and 173 non-diabetic – were retrospectively evaluated. There was a higher prevalence of marrow edema and fractures in the diabetic cuboid (n = 31, 45%) compared to non-diabetic cuboid (n = 25, 14%, p = 0.02). A fracture line was seen in fourteen (20%) diabetic cuboid bones compared to 4 (2%) in non-diabetic cuboid bones (p < 0.0001). Eleven (79%) cases of cuboid fractures in the diabetic population were radiographically occult. Multivariate data analysis revealed an adjusted odds ratio of 4.416 (95% CI; 2.307, 8.454) for the relationship between marrow changes (edema and fractures) in the cuboid and diabetes. For each year of age, the odds of changes in the cuboid increased by 2.2% (95% CI; 1.001, 1.044). Conclusion: Despite not bearing weight, the cuboid bone is more vulnerable to marrow edema and fractures in diabetic patients compared to non-diabetic patients. Age seems to be an influential factor.

A 24-year-old Ethiopian Farmer with Burning Feet

Science.gov (United States)

Visser, Benjamin Jelle; Korevaar, Daniel Arnoldus; van der Zee, Janneke

2012-01-01

Podoconiosis is a non-infectious tropical disease caused by exposure of bare feet to irritant alkalic clay soils. This causes an asymmetrical swelling of the feet and lower limbs due to lymphoedema. This swelling is called “elephantiasis” and may lead to severe disability of the patient. It is found in areas of tropical Africa, Central and South America and north-west India, where such soils coexist with high altitude, high seasonal rainfall and low income. Social stigmatization of people with the disease is widespread and economic losses are enormous. Podoconiosis is unique in being an entirely preventable non-communicable tropical disease. However, so far it has received little attention from health care policy makers. PMID:23042845

A U-shaped linear ultrasonic motor using longitudinal vibration transducers with double feet.

Science.gov (United States)

Liu, Yingxiang; Liu, Junkao; Chen, Weishan; Shi, Shengjun

2012-05-01

A U-shaped linear ultrasonic motor using longitudinal vibration transducers with double feet was proposed in this paper. The proposed motor contains a horizontal transducer and two vertical transducers. The horizontal transducer includes two exponential shape horns located at the leading ends, and each vertical transducer contains one exponential shape horn. The horns of the horizontal transducer and the vertical transducer intersect at the tip ends where the driving feet are located. Longitudinal vibrations are superimposed in the motor and generate elliptical motions at the driving feet. The two vibration modes of the motor are discussed, and the motion trajectories of driving feet are deduced. By adjusting the structural parameters, the resonance frequencies of two vibration modes were degenerated. A prototype motor was fabricated and measured. Typical output of the prototype is no-load speed of 854 mm/s and maximum thrust force of 40 N at a voltage of 200 V(rms).

Effect of irradiation on nutritional quality of chicken feet with pickled peppers in shelf life

International Nuclear Information System (INIS)

Li Shurong; Zhou Linyan; Yi Jianyong; Feng Min; Li Li; Yang Ping; Wang Dening; Gu Guiqiang; Zhu Jiating

2013-01-01

The effect of irradiation on nutritional quality of soft packaged chicken feet with pickled peppers within shelf life were investigated. Chicken feet were irradiated by E-beam which max dose was 10 kGy, and all the samples were stored at 0 ∼ 10℃ and analyzed one month after irradiation treatment. Significant sterilizing effect was got for soft packaged chicken feet with pickled peppers by irradiation; The contents of protein and fat were changed after irradiation treatment; the contents of V_A, V_E and V_B_3 in irradiated chicken feet were increased; The total contents of amino acids increased when irradiation dose were more than 4 kGy; The contents of total acids decreased after irradiation treatment, but the contents of cholesterol and nitrite increased. Above all, irradiation treatment can be used to improve nutritional quality of chicken feet with pickled peppers in shelf life. (authors)

Knowledge, attitudes and practices for the prevention of diabetic foot

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Natalia de Sá Policarpo

Full Text Available The purpose of this study was to identify the knowledge, attitudes and practices for the prevention of diabetic foot in patients with diabetes mellitus type 2. This study was based on a cross-sectional survey conducted in two Family Health Units, in the city of Picos - PI, Brazil, with 85 diabetics of both sexes, by means of a semi-structured Knowledge, Attitude and Practice questionnaire. There was a predominance of females in the study (62.4%. On the topic of foot care, 49.4% had no knowledge on hygiene or what to observe in their feet. In relation to nail care, 56.5% were unaware of the correct way to cut nails. Regarding attitudes, 80% were willing to engage in self-care. In terms of practice, results showed that activities such as washing, drying, moisturizing and massaging were not executed together. It is therefore necessary to develop educational strategies to create awareness, both for diabetics and health professionals, on the effective prevention of diabetic foot.

Terrain Adaptability Mechanism of Large Ruminants' Feet on the Kinematics View.

Science.gov (United States)

Zhang, Qun; Ding, Xilun; Xu, Kun

2015-01-01

Ruminants live in various parts of land. Similar cloven hooves assist ruminants in adapting to different ground environment during locomotion. This paper analyzes the general terrain adaptability of the feet of ruminants using kinematics of the equivalent mechanism model based on screw theory. Cloven hooves could adjust attitude by changing relative positions between two digits in swing phase. This function helps to choose better landing orientation. "Grasping" or "holding" a rock or other object on the ground passively provides extra adhesion force in stance phase. Ruminants could adjust the position of the metacarpophalangeal joint or metatarsophalangeal joint (MTP or MCP) with no relative motion between the tip of feet and the ground, which ensures the adhesion and dexterity in stance phase. These functions are derived from an example from chamois' feet and several assumptions, which are believed to demonstrate the foundation of adaptation of ruminants and ensure a stable and continuous movement.

Cinderella's Lessons on Footbinding: How Tiny Feet Found their Way into the Chinese Cinderella Story

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Tyler Scott Smith

2013-05-01

Full Text Available The story of Cinderella has had many variants, some dating back to ancient Tibetan trade routes and dynastic China. When the tale is analysed in comparison to other variants it is found that in the Chinese version Yeh-Shen (Cinderella is prized for the small size of her feet. The result of Yeh-Shen having small feet in the story is that she is led her into wealth, power and marriage, the same pursuable goals that led to the custom of footbinding. In southern China the custom of footbinding became a historically defining feature of the society. A women's beauty and her delicacy were judged by the size of her feet, and small feet were the aim of the binding. Small feet played such an important role in the society that it can be found as early as the ninth century C.E., in the traditional oral story, Yeh-Shen.

Evaluating Parents' Self-Efficacy for Diabetes Management in Pediatric Type 1 Diabetes.

Science.gov (United States)

Noser, Amy E; Patton, Susana R; Van Allen, Jason; Nelson, Michael B; Clements, Mark A

2017-04-01

To examine the factor structure and construct validity of the Maternal Self-Efficacy for Diabetes Management Scale (MSED) in 135 youth ( Mage  = 13.50  ±  1.83 years), with type 1 diabetes mellitus. The study used exploratory factor analysis (EFA) to examine the factor structure and correlations to examine relationships among MSED factors and select parent and child diabetes-related health behaviors and outcomes. EFA identified an 11-item three-factor solution (χ 2 (25, n  = 133)  = 40.22, p  manage their child's diabetes (MSED-M), problem-solve issues surrounding glycemic control (MSED-P), and teach their child about diabetes care (MSED-T). Correlational analyses revealed significant associations between the MSED-M and MSED-T and parent-reported optimism and youth's diabetes-specific self-efficacy. The MSED-T was also associated with glycated hemoglobin and self-monitoring blood glucose. Results provide preliminary evidence for the reliability and validity of a three-factor solution of the MSED. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Correlation of secreted protein acidic and rich in cysteine with diabetic nephropathy

OpenAIRE

Li, Lei; Song, Hai-Yan; Liu, Kai; An, Meng-Meng

2015-01-01

To detect the serum concentrations of secreted protein acidic and rich in cysteine (SPARC) in patients with diabetic nephropathy and SPARC mRNA and protein expressions in renal tissue of db/db mice (C57BL/KsJ, diabetic nephropathy mice), thus preliminary exploration on the role of secreted protein acidic riches in cysteine in the development of diabetic nephropathy were carried out. Serum SPARC levels in normal subjects, patients with type 2 diabetes mellitus (without diabetic nephropathy), c...

Effect of flat insoles with different shore A values on posture stability in diabetic neuropathy

NARCIS (Netherlands)

Van Geffen, J.A.; Dijkstra, P.U.; Hof, A.L.; Halbertsma, J.P.K.; Postema, K.

The objective of the study was to determine whether insoles with a low Shore A value (15 degrees) as prescribed for patients with a diabetic neuropathy have a negative effect on posture stability because these insoles may reduce somatosensory input under the feet. It was conducted in the Center for

Analysis of cognitive disorders in older people with diabetes – preliminary study

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Aneta Kozieł

2016-04-01

Full Text Available Introduction : Diabetes is a growing public health problem. Epidemiological studies indicate that the disease shortens life and significantly deteriorates its quality. The impact of diabetes on physical health of patients is well documented, but its impact on cognitive abilities has not been studied in detail so far. The deficit of reports regarding this problem among Polish researchers was an inspiration to start new studies. Aim of the research: To evaluate mild cognitive disorders in elderly patients with diabetes. Material and methods: The study was conducted in 2015. The study group included 7 elderly people with type 2 diabetes for more than 10 years. The control group consisted of 7 individuals of the same age without diabetes. The research tool was a self-made questionnaire to examine the cognitive abilities. An analysis of cognitive functions such as short-term memory, performing analysis and synthesis processes, understanding and creating metaphorical examples, narration and performing metalinguistic operations was performed. Results : Differences in cognitive functioning in the field of the studied variables were observed between examined groups. Elderly people with diabetes achieved significantly lower scores in all examined cognitive functions than healthy respondents. Conclusions : Elderly patients with type 2 diabetes are particularly susceptible to mild cognitive impairment. It is necessary to take this group of patients under diagnosis and early secondary prevention in order to prevent the negative impact of the disease.

Plantar pressures are higher in cases with diabetic foot ulcers compared to controls despite a longer stance phase duration.

Science.gov (United States)

Fernando, Malindu E; Crowther, Robert G; Lazzarini, Peter A; Sangla, Kunwarjit S; Wearing, Scott; Buttner, Petra; Golledge, Jonathan

2016-09-15

Current international guidelines advocate achieving at least a 30 % reduction in maximum plantar pressure to reduce the risk of foot ulcers in people with diabetes. However, whether plantar pressures differ in cases with foot ulcers to controls without ulcers is not clear. The aim of this study was to assess if plantar pressures were higher in patients with active plantar diabetic foot ulcers (cases) compared to patients with diabetes without a foot ulcer history (diabetes controls) and people without diabetes or a foot ulcer history (healthy controls). Twenty-one cases with diabetic foot ulcers, 69 diabetes controls and 56 healthy controls were recruited for this case-control study. Plantar pressures at ten sites on both feet and stance phase duration were measured using a pre-established protocol. Primary outcomes were mean peak plantar pressure, pressure-time integral and stance phase duration. Non-parametric analyses were used with Holm's correction to correct for multiple testing. Binary logistic regression models were used to adjust outcomes for age, sex and body mass index. Median differences with 95 % confidence intervals and Cohen's d values (standardised mean difference) were reported for all significant outcomes. The majority of ulcers were located on the plantar surface of the hallux and toes. When adjusted for age, sex and body mass index, the mean peak plantar pressure and pressure-time integral of toes and the mid-foot were significantly higher in cases compared to diabetes and healthy controls (p diabetic foot ulcers despite having a longer stance phase duration which would be expected to lower plantar pressure. Whether plantar pressure changes can predict ulcer healing should be the focus of future research. These results highlight the importance of offloading feet during active ulceration in addition to before ulceration.

Sea urchin tube feet are photosensory organs that express a rhabdomeric-like opsin and PAX6

Science.gov (United States)

Lesser, Michael P.; Carleton, Karen L.; Böttger, Stefanie A.; Barry, Thomas M.; Walker, Charles W.

2011-01-01

All echinoderms have unique hydraulic structures called tube feet, known for their roles in light sensitivity, respiration, chemoreception and locomotion. In the green sea urchin, the most distal portion of these tube feet contain five ossicles arranged as a light collector with its concave surface facing towards the ambient light. These ossicles are perforated and lined with pigment cells that express a PAX6 protein that is universally involved in the development of eyes and sensory organs in other bilaterians. Polymerase chain reaction (PCR)-based sequencing and real time quantitative PCR (qPCR) also demonstrate the presence and differential expression of a rhabdomeric-like opsin within these tube feet. Morphologically, nerves that could serve to transmit information to the test innervate the tube feet, and the differential expression of opsin transcripts in the tube feet is inversely, and significantly, related to the amount of light that tube feet are exposed to depending on their location on the test. The expression of these genes, the differential expression of opsin based on light exposure and the unique morphological features at the distal portion of the tube foot strongly support the hypothesis that in addition to previously identified functional roles of tube feet they are also photosensory organs that detect and respond to changes in the underwater light field. PMID:21450733

Comparison of electrochemical skin conductance and vibration perception threshold measurement in the detection of early diabetic neuropathy.

Directory of Open Access Journals (Sweden)

Amit Goel

Full Text Available The early diagnosis of diabetic peripheral neuropathy (DPN is challenging. Sudomotor dysfunction is one of the earliest detectable abnormalities in DPN. The present study aimed to determine the diagnostic performance of the electrochemical skin conductance (ESC test in detecting early DPN, compared with the vibration perception threshold (VPT test and diabetic neuropathy symptom (DNS score, using the modified neuropathy disability score (NDS as the reference standard. Five hundred and twenty-three patients with type 2 diabetes underwent an NDS-based clinical assessment for neuropathy. Participants were classified into the DPN and non-DPN groups based on the NDS (≥ 6. Both groups were evaluated further using the DNS, and VPT and ESC testing. A receiver-operator characteristic (ROC curve analysis was performed to compare the efficacy of ESC measurements with those of DNS and VPT testing in detecting DPN. The DPN group (n = 110, 21% had significantly higher HbA1c levels and longer diabetes durations compared with the non-DPN group (n = 413. The sensitivity of feet ESC 15 V, and DNS ≥ 1, were 16.4, 10.9 and 1.8, respectively. ESC measurement is an objective and sensitive technique for the early detection of DPN. Feet ESC measurement was superior to VPT testing for identifying patients with early DPN.

Differences in foot self-care and lifestyle between men and women with diabetes mellitus

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Mariana Angela Rossaneis

Full Text Available ABSTRACT Objective: to investigate differences with regard to foot self-care and lifestyle between men and women with diabetes mellitus. Method: cross-sectional study conducted in a sample of 1,515 individuals with diabetes mellitus aged 40 years old or older. Poisson regression models were used to identity differences in foot self-care deficit and lifestyle between sexes, adjusting for socioeconomic and clinical characteristics, smoking and alcohol consumption. Results: foot self-care deficit, characterized by not regularly drying between toes; not regularly checking feet; walking barefoot; poor hygiene and inappropriately trimmed nails, was significantly higher among men, though men presented a lower prevalence of feet scaling and use of inappropriate shoes when compared to women. With regard to lifestyle, men presented less healthy habits, such as not adhering to a proper diet and taking laboratory exams to check for lipid profile at the frequency recommended. Conclusion: the nursing team should take into account gender differences concerning foot self-care and lifestyle when implementing educational activities and interventions intended to decrease risk factors for foot ulceration.

Effect of a polyherbal formulation cream on diabetic neuropathic pain among patients with type 2 diabetes – A pilot study

Science.gov (United States)

Viswanathan, Vijay; Rajsekar, Seena; Selvaraj, Bamila; Kumpatla, Satyavani

2016-01-01

Background & objectives: Painful diabetic neuropathy is a common complication of diabetes and can severely limit patients’ daily functions. The aim of this pilot study was to evaluate the safety and effect of using a polyherbal formulation in reducing the symptoms of diabetic neuropathic pain in comparison with placebo among patients with type 2 diabetes. Methods: A total of 50 (M:F = 33:17) consecutive type 2 diabetes patients with painful diabetic neuropathy were enrolled in this study. All these patients had either two or more symptoms of diabetic neuropathy such as pain, burning and pricking sensations and numbness in their feet. They were randomly assigned to two groups: group 1 (n = 26) patients were treated with polyherbal formulation cream and group 2 (n = 24) patients were administered placebo. The patients were followed up for six months. Changes in the symptoms of painful diabetic neuropathy of each patient were recorded at baseline, third and sixth month using the Diabetic Neuropathic Score. Results: The mean age of the patients, duration of diabetes and glycated haemoglobin (HbA1c) were similar in both groups at baseline. During follow up visits, there was a decrease in the HbA1c levels in the study and control groups. The symptoms of painful diabetic neuropathy were also similar in both groups at baseline. A significant decrease in symptoms of neuropathic pain was observed among the group of patients treated with polyherbal formulation cream (76.9 per cent) compared to the placebo-treated group (12.5 per cent) (P<0.001), at the end of the final follow up. Interpretation & conclusions: In this pilot study polyherbal formulation cream was found to be effective as well as safe to treat painful diabetic neuropathy. However, its long term use needs to be evaluated for any further effectiveness and side effects. PMID:27934800

Preconception counseling and contraception after gestational diabetes

DEFF Research Database (Denmark)

Mølsted-Pedersen, L; Skouby, S O; Damm, P

1991-01-01

-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective......Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during...... a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels...

Development of public health program for type 1 diabetes in a university community: preliminary evaluation of behavioural change wheel.

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Nwose, Ezekiel Uba; Digban, K A; Anyasodor, A E; Bwititi, P T; Richards, R S; Igumbor, E O

2017-10-23

Diabetes mellitus, including type 1 is a global public health problem among the young persons. While public health campaign and screening program is a potential strategy, but communication skills, knowledge and opinion of the healthcare personnel are indicated as variables that can impact patient's education, which will lead to better outcome of care. Thus, in designing or planning a program for public health, workforce development considers opinion and behavioural change wheel of prospective personnel. The purpose of this preliminary study was to evaluate if a university academic department has the behavioural change wheel to function as workforce infrastructure for an envisioned program. Survey of knowledge, attitude and practice (KAP) of a university community regarding diabetes type 1 was performed. The KAP were translated into behavioural change wheel comprising capacity, motivation and opportunity (CMO). There are baseline indications of the behavioural change wheel potential of the public health department to run a T1D screening program. The number of participants who knew someone with T1D was significantly higher than the subgroup with no such knowledge (pwheel or CMO to develop a workforce infrastructure for T1D screening program, the experience that comes with age of lecturers will be an important factor to enable such program to succeed.

Development of inexpensive prosthetic feet for high-heeled shoes using simple shoe insole model.

Science.gov (United States)

Meier, Margrit R; Tucker, Kerice A; Hansen, Andrew H

2014-01-01

The large majority of prosthetic feet are aimed at low-heeled shoes, with a few models allowing a heel height of up to 5 cm. However, a survey by the American Podiatric Medical Association indicates that most women wear heels over 5 cm; thus, current prosthetic feet limit most female prosthesis users in their choice. Some prosthetic foot components are heel-height adjustable; however, their plantar surface shapes do not change to match the insole shapes of the shoes with different heel heights. The aims of the study were therefore (1) to develop a model that allows prediction of insole shape for various heel height shoes in combination with different shoe sizes and (2) to develop and field-test low-cost prototypes of prosthetic feet whose insole shapes were based on the new model. An equation was developed to calculate insole shapes independent of shoe size. Field testing of prototype prosthetic feet fabricated based on the equation was successful and demonstrated the utility of the equation.

Feasibility and preliminary effects of a virtual environment for adults with type 2 diabetes: pilot study.

Science.gov (United States)

Johnson, Constance; Feinglos, Mark; Pereira, Katherine; Hassell, Nancy; Blascovich, Jim; Nicollerat, Janet; Beresford, Henry F; Levy, Janet; Vorderstrasse, Allison

2014-04-08

of 2.5 hours/week over the course of 6 months. High DSM class attendance was reflected by the largest percentage of time spent in the classroom (48.6%). Self-efficacy, social support, and foot care showed significant improvement (P<.05). There were improvement trends in clinical outcomes that were clinically meaningful but did not reach statistical significance given the small sample size. Because relatively little is known about usability, acceptability, and efficacy of health interventions in VEs, this study constitutes an important, innovative first step in exploring the potential of VEs for facilitating DSM. The preliminary data suggest that VEs provide a feasible and useful platform for patients and educators that affects self-management and related mediators. Flexible access to both synchronous and asynchronous diabetes education, skill building activities, and support from a home computer remove barriers to attending clinic-based meetings. This program has potential for improving DSM in an easily disseminated alternative model.

FLAT FEET OF DHE CHILDREN IN PRE-SCHOOL AGE

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Admira Koničanin

2011-03-01

Full Text Available Subjekt : Of this research are flat feet of the children of both sexes in pre-school age children Aim : Of the research is confirm wheter is exists or flat feel of the children of both sexes in pre-school age.

Diabetes mellitus: preliminary health-promotion activity based on ...

African Journals Online (AJOL)

Objectives: To investigate the effects of a service-learning-based health promotion elective in influencing knowledge of diabetes mellitus (DM) and ways to prevent it. Method: A computer-based quiz, an information poster, interactive models and a take-home information leaflet on DM were developed as part of an exhibit ...

Assessing diabetic foot ulcer development risk with hyperspectral tissue oximetry

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Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

2011-02-01

Foot ulceration remains a serious health concern for diabetic patients and has a major impact on the cost of diabetes treatment. Early detection and preventive care, such as offloading or improved hygiene, can greatly reduce the risk of further complications. We aim to assess the use of hyperspectral tissue oximetry in predicting the risk of diabetic foot ulcer formation. Tissue oximetry measurements are performed during several visits with hyperspectral imaging of the feet in type 1 and 2 diabetes mellitus subjects that are at risk for foot ulceration. The data are retrospectively analyzed at 21 sites that ulcerated during the course of our study and an ulceration prediction index is developed. Then, an image processing algorithm based on this index is implemented. This algorithm is able to predict tissue at risk of ulceration with a sensitivity and specificity of 95 and 80%, respectively, for images taken, on average, 58 days before tissue damage is apparent to the naked eye. Receiver operating characteristic analysis is also performed to give a range of sensitivity/specificity values resulting in a Q-value of 89%.

Lifestyle interventions to reduce risk of diabetes among women with prior gestational diabetes mellitus.

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Chasan-Taber, Lisa

2015-01-01

While lifestyle interventions involving exercise and a healthy diet in high-risk adults have been found to reduce progression to type 2 diabetes by >50%, little attention has been given to the potential benefits of such strategies in women with a history of gestational diabetes mellitus (GDM). We conducted a literature search of PubMed for English language studies of randomized controlled trials of lifestyle interventions among women with a history of GDM. In total, nine studies were identified which fulfilled the eligibility criteria. The majority of randomized trials of lifestyle interventions in women with GDM have been limited to pilot or feasibility studies. However, preliminary findings suggest that such interventions can improve diabetes risk factors in women with a history of GDM. Larger, well-designed controlled randomized trials are needed to assess the effects of lifestyle interventions on preventing subsequent progression to type 2 diabetes among women with GDM. Copyright © 2014 Elsevier Ltd. All rights reserved.

A clinician's guide to the treatment of foot burns occurring in diabetic patients.

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Jones, Larry M; Coffey, Rebecca; Khandelwal, Sorabh; Atway, Said; Gordillo, Gayle; Murphy, Claire; Fries, Jody A; Dungan, Kathleen

2014-12-01

Diabetes mellitus affects 25.8 million Americans and is predicted to almost double by 2050. The presence of diabetes complicates hospital courses because of the microvascular complications associated with disease progression. Patients with diabetes represent 18.3% of annual burn admissions to our unit and 27% have burns to the feet. The purpose of this project was to develop an evidence-based guideline for care of the patient with diabetes and foot burns A multidisciplinary group was charged with developing an evidence-based guideline for the treatment of foot burns in patients with diabetes. Evidence was evaluated in the areas of diabetes, burn care, hyperbaric medicine, care of diabetic foot wounds and physical therapy. After guideline development and approval, key aspects were incorporated into order sets. Key aspects of this guideline are the ability to identify patients with undiagnosed diabetes, assess diabetic control, optimize glycemic and metabolic control, optimize burn wound management, treat microvascular disease, and provide education and a discharge plan. Evaluated outcomes are glycemic control, length of stay, complication rates, amputation rates, infection rates and the use of hyperbaric oxygen. Best outcomes for this high risk population will be attainable with an evidence based guideline. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Normative data for cutaneous threshold and spatial discrimination in the feet.

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Rinkel, Willem D; Aziz, M Hosein; Van Deelen, Meike J M; Willemsen, Sten P; Castro Cabezas, Manuel; Van Neck, Johan W; Coert, J Henk

2017-09-01

No data are available for normative values of cutaneous threshold and spatial discrimination in the feet. We developed clinically applicable reference values in relation to the nerve distributions of the feet. We determined foot sensation in 196 healthy individuals. Cutaneous threshold (1-point static discrimination, S1PD) was tested with monofilaments (0.008 to 300 gram) and spatial discrimination (2-point static [S2PD] and moving [M2PD] discrimination) on five locations per foot. There was a significant age-dependent increase in S1PD, S2PD, and M2PD values (P < 0.05). No significant differences were found between both feet. S1PD values differed up to 0.8 g between genders. There were no significant differences between genders for S2PD and M2PD measurements. M2PD values were generally lower than S2PD values. This study provides age-related normative values for foot sensation to help clinicians assess sensory deficits in relation to aging and identify patients with underlying nerve problems. Muscle Nerve 56: 399-407, 2017. © 2016 Wiley Periodicals, Inc.

Assessment of Knowledge of Diabetes Mellitus in the Urban Areas of Klang District, Malaysia.

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Chinnappan, Sasikala; Sivanandy, Palanisamy; Sagaran, Rajenthina; Molugulu, Nagashekhara

2017-02-23

Diabetes is the most common cause of non-traumatic lower limb amputations and cardiovascular diseases. However, only a negligible percentage of the patients and subjects knew that the feet are affected in diabetes and diabetes affects the heart. Hence, a cross-sectional study was carried out to evaluate the knowledge of diabetes mellitus among the public of different age group, gender, ethnicity, and education level. A sample of 400 participants was randomly selected and data was collected using a structured questionnaire under non-contrived setting. The results showed that there is a statistically significant difference in knowledge on diabetes mellitus among different age groups and different ethnic origin but there is no significant difference in the knowledge among different gender and education level. Out of 400 respondents, 284 respondents (71%) knew that diabetes mellitus is actually a condition characterized by raised blood sugar. Age and education level of respondents were found to be the predominant predictive factors on diabetes knowledge, whereas the gender of respondents did not affect the findings of this study. An improved and well-structured educational programme that tackles the areas of weaknesses should be recommended to increase the level of knowledge on diabetes among Malaysians.

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients

International Nuclear Information System (INIS)

Anan, Futoshi; Takayuki, Masaki; Takahashi, Naohiko; Nakagawa, Mikiko; Eshima, Nobuoki; Saikawa, Tetsunori; Yoshimatsu, Hironobu

2009-01-01

Diabetic retinopathy (DR) and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This preliminary study was therefore designed to test the hypothesis that DR is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients without insulin treatment. Seventy persons were diagnosed to have type 2 diabetes in the examination from June 2004 to May 2006. The study group consisted of 29 type 2 diabetic patients with DR (age: 58±6 years, mean±standard deviation (s.d.)) and 41 type 2 diabetic patients with no DR (NDR) (n=41, 58±5 years). Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart rate variability, plasma norepinephrine concentration and cardiac 123 I-metaiodobenzylguanidine (MIBG) scintigraphic findings. DR patients had lower BRS, early and delayed 123 I-MIBG myocardial uptake values and higher percent washout rate (WR) of 123 I-MIBG than the NDR patients. With respect to metabolic findings, DR patients had higher fasting plasma insulin concentration (P 123 I-MIBG (P 123 I-MIBG are independently associated with DR in Japanese patients with type 2 diabetes mellitus. (author)

EVIDENCE FOR ROTATIONAL MOTIONS IN THE FEET OF A QUIESCENT SOLAR PROMINENCE

International Nuclear Information System (INIS)

Orozco Suárez, D.; Asensio Ramos, A.; Trujillo Bueno, J.

2012-01-01

We present observational evidence of apparent plasma rotational motions in the feet of a solar prominence. Our study is based on spectroscopic observations taken in the He I 1083.0 nm multiplet with the Tenerife Infrared Polarimeter attached to the German Vacuum Tower Telescope. We recorded a time sequence of spectra with 34 s cadence placing the slit of the spectrograph almost parallel to the solar limb and crossing two feet of an intermediate size, quiescent hedgerow prominence. The data show opposite Doppler shifts, ±6 km s –1 , at the edges of the prominence feet. We argue that these shifts may be interpreted as prominence plasma rotating counterclockwise around the vertical axis to the solar surface as viewed from above. The evolution of the prominence seen in EUV images taken with the Solar Dynamics Observatory provided us with clues to interpret the results as swirling motions. Moreover, time-distance images taken far from the central wavelength show plasma structures moving parallel to the solar limb with velocities of about 10-15 km s –1 . Finally, the shapes of the observed intensity profiles suggest the presence of, at least, two components at some locations at the edges of the prominence feet. One of them is typically Doppler shifted (up to ∼20 km s –1 ) with respect to the other, thus suggesting the existence of supersonic counter-streaming flows along the line of sight.

An increased fluid intake leads to feet swelling in 100-km ultra-marathoners - an observational field study

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Cejka Caroline

2012-04-01

Full Text Available Abstract Background An association between fluid intake and changes in volumes of the upper and lower limb has been described in 100-km ultra-marathoners. The purpose of the present study was (i to investigate the association between fluid intake and a potential development of peripheral oedemas leading to an increase of the feet volume in 100-km ultra-marathoners and (ii to evaluate a possible association between the changes in plasma sodium concentration ([Na+] and changes in feet volume. Methods In seventy-six 100-km ultra-marathoners, body mass, plasma [Na+], haematocrit and urine specific gravity were determined pre- and post-race. Fluid intake and the changes of volume of the feet were measured where the changes of volume of the feet were estimated using plethysmography. Results Body mass decreased by 1.8 kg (2.4% (p +] increased by 1.2% (p p = 0.0005. The volume of the feet remained unchanged (p > 0.05. Plasma volume and urine specific gravity increased (p r = 0.54, p +] (r = -0.28, p = 0.0142. Running speed was negatively related to both fluid intake (r = -0.33, p = 0.0036 and the change in feet volume (r = -0.23, p = 0.0236. The change in the volume of the feet was negatively related to the change in plasma [Na+] (r = -0.26, p = 0.0227. The change in body mass was negatively related to both post-race plasma [Na+] (r = -0.28, p = 0.0129 and running speed (r = -0.34, p = 0.0028. Conclusions An increase in feet volume after a 100-km ultra-marathon was due to an increased fluid intake.

Risk Factors For Diabetic Foot In Tetouan, Morocco - A Case-Control Study

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Hicham AOUFI

2015-12-01

Full Text Available Introduction  Diabetes is a globally major public health problem. Its evolution is insidious and silent before the appearance of serious complications as a consequence in terms of morbidity than of mortality.  Complications in the feet are among the most frequent and feared. This study helps identify factors associated with diabetic foot in diabetic patients in the province of Tetouan in public and private sector.Methods This is a case-control study in which 136 diabetic patients monitored in the public and private sector in the province of Tetouan were chosen. 68 patients had diabetic foot and 68 were diabetic patients without this complication. Data were collected from patients’ records and supplemented by interviews. The factors compared between the two groups were socio-demographic, biological and related to diabetes and lifestyle. These risk factors were determined by bivariate and multivariate analyses.Results Statistically significant associations were found between diabetic foot and several factors including: the irregular monitoring of patients: ORadjusted = 7.7 [1.9-23], the rate of glycated hemoglobin: ORadjusted = 1.7 [1.2-2.3], diabetes duration: ORadjusted = 1.2 [1.03-1.26], and physical activity ORadjusted = 1.1 [0.02-0.9]. However, no association was found between diabetic foot and the level of education or occupation.Conclusion To prevent the development of diabetic foot, more attention should be given to diabetic patients whose diabetes duration is long, patient monitoring should be regular and diabetes control should be optimal. In addition, physical activity is recommended for diabetic patients as part of promoting healthy lifestyles

Total parenteral nutrition in diabetic rats

International Nuclear Information System (INIS)

Norcross, E.D.; Stein, T.P.

1986-01-01

Parenteral Nutrition with hypertonic glucose is frequently given to diabetic patients. Large amounts of insulin can be required. The purpose of this investigation was to develop a totally parenterally nourished diabetic rat model. 200 g Female Sprague Dawley rats were made diabetic by i.v. injection of streptozotocin (50 mg/kg). Rats were then allowed to recover for at least 1 week before undergoing surgical insertion of a central venous catheter for parenteral feeding. TPN was begun 3 days after surgery. Prior to this they were allowed unlimited access to food and water. Control (non-streptozotocin treated) rats were run at the same time. Protein turnover was investigated by using 15 N glycine. Preliminary results: diabetic rats given mostly fat as a calorie source survived well in the absence of exogenous insulin whereas those that were given glucose only as their non-protein calorie source showed poor survival even with exogenous insulin. N balance and protein turnover in the lipid treated diabetic rats were comparable to the non-diabetic control rats

Risk factors for developing diabetic foot

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Julia Estela Willrich Boell

2014-06-01

Full Text Available The goal of the present study is to identify the risk factors for developing diabetic foot. A cross-sectional study, with a convenience sample, developed with 70 individuals with diabetes mellitus (DM, registered in three basic health units in the municipality of Florianópolis/SC, Brazil, in the period from November 2010 to May 2011. Biometric data was collected regarding their sociodemographic, health and illness conditions. An assessment of the feet was also carried out. The average participant age was 66.17 years and time with diagnosed disease was under ten years (61.42%. The following risk factors were identified: advanced age; time of DM diagnosis; few years of schooling; overweight/obesity; inadequate diet; physical inactivity; inadequate metabolic control; lack of proper and specific foot care; and arterial hypertension. We conclude that the majority of the population presented one or more risk factors that favor the appearance of foot-related complications. doi: 10.5216/ree.v16i2.20460.

Energy storage and release of prosthetic feet. Part 1: biomechanical analysis related to user benefits

NARCIS (Netherlands)

Postema, K.; Hermens, Hermanus J.; de Vries, J.; de Vries, J.; Koopman, Hubertus F.J.M.; Eisma, W.H.

1997-01-01

The energy storing and releasing behaviour of 2 energy storing feet (ESF) and 2 conventional prosthetic feet (CF) were compared (ESF: Otto Bock Dynamic Pro and Hanger Quantum; CF: Otto Bock Multi Axial and Otto Bock Lager). Ten trans-tibial amputees were selected. The study was designed as a

Radiographic features of Ewing's sarcoma of the bones of the hands and feet

International Nuclear Information System (INIS)

Baraga, J.J.; Amrami, K.K.; Swee, R.G.; Wold, L.; Unni, K.K.

2001-01-01

The radiographic features of Ewing's sarcoma of the bones of the hands and feet are reviewed utilizing cases obtained from the Mayo Clinic patient files and the consultation files of Drs. D.C. Dahlin and K.K. Unni. This series consists of a total of 43 cases of pathologically proven Ewing's sarcoma involving the small bones of the hands and feet. The classic radiographic features of Ewing's sarcoma in the long bones, including lytic, permeative destruction, aggressive periosteal reaction, cortical violation, and a soft tissue mass, are also seen in the bones of the hands and feet, with similar frequency. These classic features are most commonly present in lesions affecting the short tubular bones. Lesions affecting the tarsal bones more often demonstrate atypical radiographic features. These atypical radiographic appearances may play a role in the reported delay in diagnosis of Ewing's sarcoma within the tarsal bones. (orig.)

Extraction of Collagen from Chicken Feet with Various Acidic Solutions and Soaking Time

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Prayitno Prayitno

2007-05-01

Full Text Available The objective of this research was to know the ability of various acidic solutions on dissolving collagen  chicken feet, with different soaked time.  Each acid 5 percent (v/v, collagen extraction was done by washing chicken feet and then cutted into small pieces and finally grinded.  Every 100 gram treatment was soaked in acetic acid (a1, citric acid (a2, lactic acid (a3 and hydrochloric acid (a4, for 12, 24 and 36 hours.  Precipitated collagen in the filtrate was 5 percent NaOH to reach the neutral pH (pH 7.  Collagen precipitate was separated by filtration usingfilter paper and then  rendement was calculated, HPLC was used to determin amino acid composition, and SDS-PAGE was use determin the type of collagen.  This experiment use factorial completely randomized design (CRD 4 x 3 and three time replication.   Result showed that lactic acid has highest capability to dissolve collagen, while citric acid the lowest.  Combination of acid solution and soaking time had significant (P<0.01 effect on dissolving collagen of chicken feet.  Extracted collagen in all acid solution, hassame amino acid, composition but different in percentage of amino acid molecules.  Collagen type in treatment combination was the same, but for soaking time of 36 hours revealed some peptide band.  Lactic acid had highest capability of collagen extraction in chicken feet than citric acid, acetic acid and hydrochloric acid with soaking time of 12, 24 and 36 hours.  It was estimated that extracted collagen can be grouped to type I consisted of two chain of a1. (Animal Production 9(2: 99-104 (2007   Key Words : Chicken feet, acids, soaking time, collagen

Thermal comfort zone of the hands, feet and head in males and females.

Science.gov (United States)

Ciuha, Urša; Mekjavic, Igor B

2017-10-01

The present study compared the thermal comfort zones (TCZ) of the hands, feet and head in eight male and eight female participants, assessed with water-perfused segments (WPS). On separate occasions, and separated by a minimum of one day, participants were requested to regulate the temperature of three distal skin regions (hands, feet and head) within their TCZ. On each occasion they donned a specific water-perfused segment (WPS), either gloves, socks or hood for assessing the TCZ of the hands, feet and head, respectively. In the absence of regulation, the temperature of the water perfusing the WPS changed in a saw-tooth manner from 10 to 50°C; by depressing a switch and reversing the direction of the temperature at the limits of the TCZ, each participant defined the TCZ for each skin region investigated. The range of regulated temperatures (upper and lower limits of the TCZ) did not differ between studied skin regions or between genders. Participants however maintained higher head (35.7±0.4°C; p˂0.001) skin temperature (Tsk) compared to hands (34.5±0.8°C) and feet (33.8±1.1°C). When exposed to normothermic conditions, distal skin regions do not differ in ranges of temperatures, perceived as thermally comfortable. Copyright © 2017. Published by Elsevier Inc.

Sex differences in relative foot length and perceived attractiveness of female feet: relationships among anthropometry, physique, and preference ratings.

Science.gov (United States)

Voracek, Martin; Fisher, Maryanne L; Rupp, Barbara; Lucas, Deanna; Fessler, Daniel M T

2007-06-01

Foot size proportionate to stature is smaller in women than in men, and small feet apparently contribute to perceived physical attractiveness of females. This exploratory study investigated the sex difference in relative foot length and interrelations among foot length, physique, and foot preference ratings in samples from Austria and Canada, each comprised of 75 men and 75 women. The findings included the following lines of evidence: the sex difference in relative foot length replicated in both data sets; the magnitude of this sex effect was large. Relative foot length was smaller in young, nulliparous, and slim women. Pointed-toe and high-heel shoes were more likely worn by smaller, lighter, and slimmer women. Men reported liking women's feet in general more than vice versa. A vast majority of both men and women favored small feet in women, but large feet in men. One's own foot size appeared to correspond to evaluations of attractiveness; particularly, women with small feet preferred small feet in women in general. The preference for small feet in women was convergent across different methods of evaluating attractiveness. Directions for investigations in this emerging field of research on physical attractiveness are discussed.

Prevention of type 2 diabetes in childhood.

Science.gov (United States)

Cook, V V; Hurley, J S

1998-02-01

The incidence of type 2 diabetes has increased dramatically in the past decade in Pima (Akimel O'odham) children, aged 5-17 years, living in the Gila River Indian Community (GRIC). As a result, a diabetes primary prevention program called Quest was implemented in 1996 at an elementary school in the GRIC for students in kindergarten and grades 1-2. The Quest program has four components: (1) biochemical and anthropometric assessments, (2) classroom instruction about diabetes, (3) increased daily physical activity at school, and (4) a structured school breakfast and lunch program. Preliminary results of the program indicate that the school provides a stable environment for behavior change and interventions that slow weight gain in early childhood.

The relationship between flat feet and cavus foot with body mass index in girl students

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Behnaz Hajirezaei

2017-10-01

Full Text Available Background and Aims: The aim of this study was to investigate the relationship between flat feet and cavus foot with body mass index in girl students. Methods: The study population consisted of the Mazandaran University students that their number was 260 (130 girl college students and 130 girl students of non-physical education formed. Sampling of participants over the two days. Height and weight of the subjects were measured, then they were placed on a mirror box and were taken the photographs of the Plantar foot. for picture Plantar foot was used of the mirror box (pedescope. data analyzed by Pearson and Spearman correlation coefficient. Results: The results of Pearson correlation coefficient test in physical education subjects showed there was no relationship the between BMI and flat feet (0.306. Also, the relationship between BMI and cavus foot was significant and direct (0.330. The results of Spearman correlation coefficient test in physical education subjects showed that the relationship between BMI and flat feet was significant (0.457. Also, there was no relationship between BMI and cavus foot (-0.026. The results in non-physical education subjects showed the relationship between BMI and flat feet was significant, but was in the opposite direction (-0.493. Also, the relationship between BMI and cavus foot was significant and direct (0.424. The results of Spearman correlation test showed that the relationship and flat feet was significant but was in the opposite direction (-0.648. Also, the relationship between BMI and cavus foot was significant (0.413. Conclusion: According to the results of this study, it seems to there was no relationship between flat feet and cavus foot with body mass index in girl students.

Effects of carrying a backpack in a symmetrical manner on the shape of the feet.

Science.gov (United States)

Drzał-Grabiec, Justyna; Snela, Sławomir; Rachwał, Maciej; Rykała, Justyna; Podgórska, Justyna

2013-01-01

The aim of this study was to assess changes in the shape of the feet while carrying a backpack constituting 10% of a child's weight. It was an observational, cross-sectional study involving 118 primary school children aged 11-13 years. Selected parameters of foot shape were assessed in both a normal position and with a backpack using podoscopy and a CQ-ST examination device. The study revealed significant differences in the length and width of the right and left feet between assessments. Moreover, the longitudinal arch of the foot was significantly lowered and deformity of the great toe was reported. Carrying a backpack constituting 10% of a child's weight results in lowering of the longitudinal and traverse arches of the feet and advanced toe deformities. We performed an observational, cross-sectional study examining the effect of carrying a backpack constituting 10% of a child's weight on parameters of foot shape and observed significant lowering of the longitudinal and traverse arches of the feet and advanced toe deformities.

Methods for the cultural adaptation of a diabetes lifestyle intervention for Latinas: an illustrative project.

Science.gov (United States)

Osuna, Diego; Barrera, Manuel; Strycker, Lisa A; Toobert, Deborah J; Glasgow, Russell E; Geno, Cristy R; Almeida, Fabio; Perdomo, Malena; King, Diane; Doty, Alyssa Tinley

2011-05-01

Because Latinas experience a high prevalence of type 2 diabetes and its complications, there is an urgent need to reach them with interventions that promote healthful lifestyles. This article illustrates a sequential approach that took an effective multiple-risk-factor behavior-change program and adapted it for Latinas with type 2 diabetes. Adaptation stages include (a) information gathering from literature and focus groups, (b) preliminary adaptation design, and (c) preliminary adaptation test. In this third stage, a pilot study finds that participants were highly satisfied with the intervention and showed improvement across diverse outcomes. Key implications for applications include the importance of a model for guiding cultural adaptations, and the value of procedures for obtaining continuous feedback from staff and participants during the preliminary adaptation test.

A case study of Chinese bound feet: application of footprint analysis.

Science.gov (United States)

Reischl, Uwe; Nandikolla, Vidja; Colby, Conrad; Mijović, Budimir; Wei, Hsian-Chuen

2008-06-01

Foot print patterns of the bound feet of a 90-year-old Chinese female were made to obtain insight into the ergonomic consequences of a Chinese custom that caused significant disabilities for many women throughout history. Pressure patterns were evaluated using the techniques applied to standard thumb print analsyis. A digital summary of the pressure patterns were compared to the patterns obtained from a normal subject. The outcomes indicated that the bound foot produced greater plantar tissue pressures than the non-bound foot. These observations help explain the discomfort, gait abnormalities, and disabilities exhibited by many older women with bound feet living in China today. Although foot-binding is no longer practiced, this study offers an ergonomic perspective on a custom practiced in China for centuries.

Assessment of Knowledge of Diabetes Mellitus in the Urban Areas of Klang District, Malaysia

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Sasikala Chinnappan

2017-02-01

Full Text Available Diabetes is the most common cause of non-traumatic lower limb amputations and cardiovascular diseases. However, only a negligible percentage of the patients and subjects knew that the feet are affected in diabetes and diabetes affects the heart. Hence, a cross-sectional study was carried out to evaluate the knowledge of diabetes mellitus among the public of different age group, gender, ethnicity, and education level. A sample of 400 participants was randomly selected and data was collected using a structured questionnaire under non-contrived setting. The results showed that there is a statistically significant difference in knowledge on diabetes mellitus among different age groups and different ethnic origin but there is no significant difference in the knowledge among different gender and education level. Out of 400 respondents, 284 respondents (71% knew that diabetes mellitus is actually a condition characterized by raised blood sugar. Age and education level of respondents were found to be the predominant predictive factors on diabetes knowledge, whereas the gender of respondents did not affect the findings of this study. An improved and well-structured educational programme that tackles the areas of weaknesses should be recommended to increase the level of knowledge on diabetes among Malaysians.

Feet swelling in a multistage ultraendurance triathlete: a case study

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Knechtle B

2015-10-01

Full Text Available Beat Knechtle,1 Matthias Alexander Zingg,2 Patrizia Knechtle,1 Thomas Rosemann,2 Christoph Alexander Rüst2 1Gesundheitszentrum St Gallen, St Gallen, 2Institute of Primary Care, University of Zurich, Zurich, Switzerland Abstract: Recent studies investigating ultraendurance athletes showed an association between excessive fluid intake and swelling of the lower limbs such as the feet. To date, this association has been investigated in single-stage ultraendurance races, but not in multistage ultraendurance races. In this case study, we investigated a potential association between fluid intake and feet swelling in a multistage ultraendurance race such as a Deca Iron ultratriathlon with ten Ironman triathlons within 10 consecutive days. A 49-year-old well-experienced ultratriathlete competed in autumn 2013 in the Deca Iron ultratriathlon held in Lonata del Garda, Italy, and finished the race as winner within 129:33 hours:minutes. Changes in body mass (including body fat and lean body mass, foot volume, total body water, and laboratory measurements were assessed. Food and fluid intake during rest and competing were recorded, and energy and fluid turnovers were estimated. During the ten stages, the volume of the feet increased, percentage body fat decreased, creatinine and urea levels increased, hematocrit and hemoglobin values decreased, and plasma [Na+] remained unchanged. The increase in foot volume was significantly and positively related to fluid intake during the stages. The poststage volume of the foot was related to poststage total body water, poststage creatinine, and poststage urea. This case report shows that the volume of the foot increased during the ten stages, and the increase in volume was significantly and positively related to fluid intake during the stages. Furthermore, the poststage volume of the foot was related to poststage total body water, poststage creatinine, and poststage urea. The continuous feet swelling during the race was

Educational strategies for diabetic people at risk for foot neuropathy: synthesis of good evidence

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Luciana Catunda Gomes de Menezes

2016-12-01

Full Text Available The aim of the present study was to identify the best evidence concerning health education strategies used in teaching-learning for people with diabetes mellitus who are at risk for foot neuropathy. An integrative review was conducted in the databases PubMed, LILACS, CINAHL and SCOPUS in January 2015; a total of 14 papers was analyzed in detail. The results are shown in a summary table and categories are discussed, covering various health education strategies for prevention and management with patients at risk of foot neuropathy (group; individual in face-to-face visits or via telephone; and using interactive technologies, and a synthesis of the best evidence for the effectiveness of these interventions in reducing diabetic foot complications. It was concluded that all the educational strategies are effective in promoting diabetic foot self-care. However, the group strategies showed greater effectiveness, enabling significant improvements in the knowledge, attitude, and practices of care for feet and general health of diabetic patients.

Pharmacological treatment of diabetic neuropathic pain.

Science.gov (United States)

Smith, Howard S; Argoff, Charles E

2011-03-26

Neuropathic pain continues to be a difficult and challenging clinical issue to deal with effectively. Painful diabetic polyneuropathy is a complex pain condition that occurs with reasonable frequency in the population and it may be extremely difficult for clinicians to provide patients with effective analgesia. Chronic neuropathic pain may occur in approximately one of every four diabetic patients. The pain may be described as burning or a deep-seated ache with sporadic paroxysms of lancinating painful exacerbations. The pain is often constant, moderate to severe in intensity, usually primarily involves the feet and generally tends to worsen at night. Treatment may be multimodal but largely involves pharmacological approaches. Pharmacological therapeutic options include antidepressants (tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors), α2δ ligands and topical (5%) lidocaine patch. Other agents may be different antiepileptic drugs (carbamazepine, lamotrigine, topiramate), topical capsaicin, tramadol and other opioids. Progress continues with respect to understanding various mechanisms that may contribute to painful diabetic neuropathy. Agents that may hold some promise include neurotrophic factors, growth factors, immunomodulators, gene therapy and poly (adenosine diphosphate-ribose) polymerase inhibitors. It is hoped that in the future clinicians will be able to assess patient pathophysiology, which may help them to match optimal therapeutic agents to target individual patient aberrant mechanisms.

The three-dimensional shapes of underground coal miners' feet do not match the internal dimensions of their work boots.

Science.gov (United States)

Dobson, Jessica A; Riddiford-Harland, Diane L; Bell, Alison F; Steele, Julie R

2018-04-01

Mining work boots provide an interface between the foot and the ground, protecting and supporting miners' feet during lengthy coal mining shifts. Although underground coal miners report the fit of their work boots as reasonable to good, they frequently rate their boots as uncomfortable, suggesting that there is a mismatch between the shape of their feet and their boots. This study aimed to identify whether dimensions derived from the three-dimensional scans of 208 underground coal miners' feet (age 38.3 ± 9.8 years) differed from the internal dimensions of their work boots. The results revealed underground coal miners wore boots that were substantially longer than their feet, possibly because boots available in their correct length were too narrow. It is recommended boot manufacturers reassess the algorithms used to create boot lasts, focusing on adjusting boot circumference at the instep and heel relative to increases in foot length. Practitioner Summary: Fit and comfort ratings suggest a mismatch between the shape of underground coal miners' feet and their boots exists. This study examined whether three-dimensional scans of 208 miners' feet differed from their boot internal dimensions. Miners wore boots substantially longer than their feet, possibly due to inadequate width.

Skin disorders affecting the feet | Motswaledi | South African Family ...

African Journals Online (AJOL)

Skin disorders of the feet can affect the glabrous skin on the dorsal aspects, or the thick skin on the plantar aspects, thereof, or both. Some can affect one foot, and others both of them. These diseases can be inflammatory, genetically inherited, infectious and neoplastic in origin. It is important to identify them and to start ...

Foot deformation during walking: differences between static and dynamic 3D foot morphology in developing feet.

Science.gov (United States)

Barisch-Fritz, Bettina; Schmeltzpfenning, Timo; Plank, Clemens; Grau, Stefan

2014-01-01

The complex functions of feet require a specific composition, which is progressively achieved by developmental processes. This development should take place without being affected by footwear. The aim of this study is to evaluate differences between static and dynamic foot morphology in developing feet. Feet of 2554 participants (6-16 years) were recorded using a new scanner system (DynaScan4D). Each foot was recorded in static half and full weight-bearing and during walking. Several foot measures corresponding to those used in last construction were calculated. The differences were identified by one-way ANOVA and paired Student's t-test. Static and dynamic values of each foot measure must be considered to improve the fit of footwear. In particular, footwear must account for the increase of forefoot width and the decrease of midfoot girth. Furthermore, the toe box should have a more rounded shape. The findings are important for the construction of footwear for developing feet.

Knowledge and self-care practices regarding diabetes among newly diagnosed type 2 diabetics in Bangladesh: a cross-sectional study

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Saleh Farzana

2012-12-01

Full Text Available Abstract Background Levels of knowledge about diabetes mellitus (DM among newly diagnosed diabetics in Bangladesh are unknown. This study assessed the relationship between knowledge and practices among newly diagnosed type 2 DM patients. Methods Newly diagnosed adults with type 2 diabetes (N = 508 were selected from 19 healthcare centers. Patients’ knowledge and self-care practices were assessed via interviewer-administered questionnaires using a cross-sectional design. Knowledge questions were divided into basic and technical sections. Knowledge scores were categorized as poor (mean + 1 SD. Chi square testing and multivariate logistic regression were conducted to examine the relationship between diabetes-related knowledge and self-care practices. Results Approximately 16%, 66%, and 18% of respondents had good, average, and poor (GAP basic knowledge respectively and 10%, 78%, and 12% of respondents had GAP technical knowledge, about DM. About 90% of respondents from both basic and technical GAP did not test their blood glucose regularly; a significant relationship existed between basic knowledge and glucose monitoring. Technical knowledge and foot care were significantly related, though 81% with good technical knowledge and about 70% from average and poor groups did not take care of their feet. Approximately 85%, 71%, and 52% of the GAP technical knowledge groups, consumed betel nuts; a significant relationship existed between technical knowledge and consumption of betel nuts. Around 88%, 92%, and 98% of GAP technical knowledge groups failed to follow dietary advice from a diabetes educator. About 26%, 42%, and 51% of GAP basic and technical sometimes ate meals at a fixed time (p Conclusions Newly diagnosed type 2 diabetics had similar levels of basic and technical knowledge of DM. Health education and motivation should create positive changes in diabetes-control-related self-care practices.

Effects of umbilical cord blood stem cells on healing factors for diabetic foot injuries.

Science.gov (United States)

Çil, N; Oğuz, E O; Mete, E; Çetinkaya, A; Mete, G A

2017-01-01

The use of stem or progenitor cells from bone marrow, or peripheral or umbilical cord blood is becoming more common for treatment of diabetic foot problems. These cells promote neovascularization by angiogenic factors and they promote epithelium formation by stimulating cell replication and migration under certain pathological conditions. We investigated the role of CD34 + stem cells from human umbilical cord blood in wound healing using a rat model. Rats were randomly divided into a control group and two groups with diabetes induced by a single dose of 55 mg/kg intraperitoneal streptozocin. Scarred areas 5 mm in diameter were created on the feet of all rats. The diabetic rats constituted the diabetes control group and a diabetes + stem cell group with local injection into the wound site of 0.5 × 106 CD34 + stem cells from human umbilical cord blood. The newly formed skin in the foot wounds following CD34 + stem cell treatment showed significantly improvement by immunohistochemistry and TUNEL staining, and were closer to the wound healing of the control group than the untreated diabetic animals. The increase in FGF expression that accompanied the local injection of CD34 + stem cells indicates that FGF stimulation helped prevent apoptosis. Our findings suggest a promising new treatment approach to diabetic wound healing.

Argon laser in the treatment of diabetic retinopathy (Preliminary communication)

International Nuclear Information System (INIS)

Saprykin, P.I.; Simonova, K.K.; Belyaeva, M.I.

1974-01-01

The complications observed in the photocoagulation treatment of diabetic angiopathy and retinopathy include the following conditions: tractional retinal detachment, accelerated development of proliferating retinitis and massive hemmorrhaging into the vitreous body. (V.A.P.)

Gut microbiota diversity and T1DM onset: Preliminary data of a case-control study

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Deborah Traversi

2017-12-01

Full Text Available Type-1 diabetes incidence is increasing during the last decades. Recently, a role of microbiota alteration is proposed as pre-diabetic and diabetic risk factor. A bicentric case-control study is in progress in Northern Italy. Here preliminary results are shown. The microbiome clusterization showed a division between cases and controls even if fingerprint profiles are heterogenic. Methanobrevibacter smithii is highly present only in few patients. The diversity index and the microorganism sequenced in cases and controls, seems to be quite dissimilar. The conclusive results could show a significant predictive value for the bio-indicators evaluated. Keywords: Type 1 diabetes mellitus, Microbiota, Children, Methanobrevibacter smithii, qRT-PCR

Development of inexpensive prosthetic feet for high-heeled shoes using simple shoe insole model

OpenAIRE

Margrit R. Meier, PhD; Kerice A. Tucker, BSc; Andrew H. Hansen, PhD

2014-01-01

The large majority of prosthetic feet are aimed at low-heeled shoes, with a few models allowing a heel height of up to 5 cm. However, a survey by the American Podiatric Medical Association indicates that most women wear heels over 5 cm; thus, current prosthetic feet limit most female prosthesis users in their choice. Some prosthetic foot components are heel-height adjustable; however, their plantar surface shapes do not change to match the insole shapes of the shoes with different heel height...

Investigation of the Performance of Foot and Eye Care in Patients with Type II Diabetes in Fasa: An Application of the Theory of Planned Behavior

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Ali Khani Jeihooni

2016-12-01

Full Text Available Background and Objectives: Diabetic foot ulcers and eye problems are the most frequent complications of patients with diabetes and can be controlled with care. This study aimed at investigating the situation of foot and eye care in patients with type II diabetes based on the Theory of Planned Behavior of Fasa. Materials and Methods: In this cross-sectional study, simple randomized sampling was used to select 151 patients with type II diabetes, who had referred to Shariati Teaching Hospital diabetic clinic, during year 2016. Data were gathered using a questionnaire including demographic data and measure theory of planned behavior (attitude, subjective norm, perceived behavioral control, and intention and the care of feet and eyes. Next, the data were entered in the SPSS statistical software, version 20 and analyzed using independent t test and descriptive statistical methods. P values of < 0.05 were considered statistically significant. Results: The mean age of participants was 52.17±12.41 and the mean duration of diabetes was 76.62±4.9. Knowledge on the care of feet and eyes was low. Foot and eye care, subjective norm and people are going to be at a moderate level. Among knowledge, attitude, subjective norm, perceived behavioral control, and intention, there was a significant correlation with performance (P<0.05. Knowledge, attitudes, perceived behavioral control, subjective norms, and intention were predictors of foot care and eye performance in patients with type 2 diabetes. Overall, variables predicted 31.6% of the performance of foot care and 28.4% of eye care. Conclusions: According to this study, design and implementation of training programs theory centered on promoting foot care and eye performance is recommended for patients with diabetes.

Radiographic Measurements of the Affected and Unaffected Feet in Patients with Unilateral Hallux Limitus A Case-Control Pilot Study.

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Knox, Andrew F; Bryant, Alan R

2016-05-01

Controversy exists regarding the structural and functional causes of hallux limitus, including metatarsus primus elevatus, a long first metatarsal, first-ray hypermobility, the shape of the first metatarsal head, and the presence of hallux interphalangeus. Some articles have reported on the radiographic evaluation of these measurements in feet affected by hallux limitus, but no study has directly compared the affected and unaffected feet in patients with unilateral hallux limitus. This case-control pilot study aimed to establish whether any such differences exist. Dorsoplantar and lateral weightbearing radiographs of both feet in 30 patients with unilateral hallux limitus were assessed for grade of disease, lateral intermetatarsal angle, metatarsal protrusion distance, plantar gapping at the first metatarsocuneiform joint, metatarsal head shape, and hallux abductus interphalangeus angle. Data analysis was performed using a statistical software program. Mean radiographic measurements for affected and unaffected feet demonstrated that metatarsus primus elevatus, a short first metatarsal, first-ray hypermobility, a flat metatarsal head shape, and hallux interphalangeus were prevalent in both feet. There was no statistically significant difference between feet for any of the radiographic parameters measured (Mann-Whitney U tests, independent-samples t tests, and Pearson χ(2) tests: P > .05). No significant differences exist in the presence of the structural risk factors examined between affected and unaffected feet in patients with unilateral hallux limitus. The influence of other intrinsic factors, including footedness and family history, should be investigated further.

Development of the long bones in the hands and feet of children: radiographic and MR imaging correlation

Energy Technology Data Exchange (ETDEWEB)

Laor, Tal [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Clarke, Jeffrey P. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Yin, Hong [Children' s Healthcare of Atlanta, Department of Pathology, Atlanta, GA (United States)

2016-04-15

The long bones of the hands and feet in children have an epiphyseal end with a secondary center of ossification and an adjacent transverse physis. In contrast to other long bones in the body, the opposite end in the hands and feet, termed the non-epiphyseal end, is characterized by direct metaphyseal extension of bone to complete terminal ossification. The purpose of this pictorial essay is to illustrate the developmental stages of each end of the long bones of the hands and feet with radiographic and MR imaging to provide a foundation from which to differentiate normal from abnormal growth. (orig.)

Use of a novel smart heating sleeping bag to improve wearers' local thermal comfort in the feet.

Science.gov (United States)

Song, W F; Zhang, C J; Lai, D D; Wang, F M; Kuklane, K

2016-01-13

Previous studies have revealed that wearers had low skin temperatures and cold and pain sensations in the feet, when using sleeping bags under defined comfort and limit temperatures. To improve wearers' local thermal comfort in the feet, a novel heating sleeping bag (i.e., MARHT) was developed by embedding two heating pads into the traditional sleeping bag (i.e., MARCON) in this region. Seven female and seven male volunteers underwent two tests on different days. Each test lasted for three hours and was performed in a climate chamber with a setting temperature deduced from EN 13537 (2012) (for females: comfort temperature of -0.4 °C, and for males: the limit temperature of -6.4 °C). MARHT was found to be effective in maintaining the toe and feet temperatures within the thermoneutral range for both sex groups compared to the linearly decreased temperatures in MARCON during the 3-hour exposure. In addition, wearing MARHT elevated the toe blood flow significantly for most females and all males. Thermal and comfort sensations showed a large improvement in feet and a small to moderate improvement in the whole body for both sex groups in MARHT. It was concluded that MARHT is effective in improving local thermal comfort in the feet.

Use of a novel smart heating sleeping bag to improve wearers’ local thermal comfort in the feet

Science.gov (United States)

Song, W. F.; Zhang, C. J.; Lai, D. D.; Wang, F. M.; Kuklane, K.

2016-01-01

Previous studies have revealed that wearers had low skin temperatures and cold and pain sensations in the feet, when using sleeping bags under defined comfort and limit temperatures. To improve wearers’ local thermal comfort in the feet, a novel heating sleeping bag (i.e., MARHT) was developed by embedding two heating pads into the traditional sleeping bag (i.e., MARCON) in this region. Seven female and seven male volunteers underwent two tests on different days. Each test lasted for three hours and was performed in a climate chamber with a setting temperature deduced from EN 13537 (2012) (for females: comfort temperature of -0.4 °C, and for males: the limit temperature of -6.4 °C). MARHT was found to be effective in maintaining the toe and feet temperatures within the thermoneutral range for both sex groups compared to the linearly decreased temperatures in MARCON during the 3-hour exposure. In addition, wearing MARHT elevated the toe blood flow significantly for most females and all males. Thermal and comfort sensations showed a large improvement in feet and a small to moderate improvement in the whole body for both sex groups in MARHT. It was concluded that MARHT is effective in improving local thermal comfort in the feet.

Characteristics of diabetic foot lesions and its complications

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Carla Luiza da Silva

2012-06-01

Full Text Available Diabetes mellitus is a group of metabolic diseases, and the third leading cause of morbidity and mortality, involving some complications, leaving the patient vulnerable. The aim of this work was to determine the prevalence of lower limb amputations due to diabetic ulcers of patients with infection at a Family Health Unit and analyze the physiological changes detected during the assessment of the patients. This is a retrospective approach to quantitative research, conducted from May to October 2010 with a sample of 40 people involved in the activities. As a result it was found out that the patients have some deformity or bony prominence (30.8% and relative insensitivity and the dryness of the feet, 46.2% had such complications. It is concluded that health professionals, especially nurses should perform care for these patients, thus delivering knowledge-focused in the care and prevention, through educational activities aimed at the social well-being.

Symptomatic reversal of peripheral neuropathy in patients with diabetes.

Science.gov (United States)

Kochman, Alan B; Carnegie, Dale H; Burke, Thomas J

2002-03-01

Forty-nine consecutive subjects with established diabetic peripheral neuropathy were treated with monochromatic near-infrared photo energy (MIRE) to determine if there was an improvement of sensation. Loss of protective sensation characterized by Semmes-Weinstein monofilament values of 4.56 and above was present in 100% of subjects (range, 4.56 to 6.45), and 42 subjects (86%) had Semmes-Weinstein values of 5.07 or higher. The ability to discriminate between hot and cold sensation was absent (54%) or impaired (46%) in both groups prior to the initiation of MIRE treatment. On the basis of Semmes-Weinstein monofilament values, 48 subjects (98%) exhibited improved sensation after 6 treatments, and all subjects had improved sensation after 12 treatments. Therefore, MIRE may be a safe, drug-free, noninvasive treatment for the consistent and predictable improvement of sensation in diabetic patients with peripheral neuropathy of the feet.

Diabetic foot--what can we learn from leprosy? Legacy of Dr Paul W. Brand.

Science.gov (United States)

Boulton, Andrew J M

2012-02-01

Leprosy and diabetes, though two very different conditions, may both result in severe loss of sensation in the feet, which are then a great risk of painless injury and ulceration. Seminal observations made by the late Dr Paul W. Brand, a surgeon working with leprosy patients in South India in the mid-20th century, resulted in the subsequent development of treatments to manage insensitive foot ulcers that are today entirely applicable to patients with diabetes. As a consequence of his research, the recognition of the relationship between insensitivity, repetitive pressures and skin breakdown has helped our understanding of the aetiopathogenesis of neuropathic foot lesions in diabetes: the development of the total contact cast and other casting devices to treat such lesions forms the basis of management of diabetic foot lesions with off-loading devices that are widely used in the 21st century in diabetic foot clinics around the world. Moreover, observations by Brand that the foot 'heats up before it breaks down' resulted in more recent research showing that self-skin temperature monitoring might help reduce the incidence of recurrent neuropathic foot ulcers in diabetes. In summary, Brand's understanding of 'the gift of pain' that, when lost, results in the late complications of diabetic neuropathy has guided the prevention, diagnosis and management of diabetic foot problems in the 21st century. Copyright © 2012 John Wiley & Sons, Ltd.

Basal insulin analogues in diabetic pregnancy: a literature review and baseline results of a randomised, controlled trial in type 1 diabetes

DEFF Research Database (Denmark)

Mathiesen, Elisabeth R; Damm, Peter; Jovanovic, Lois

2011-01-01

hagedorn insulin, both with insulin aspart, in women with type 1 diabetes planning a pregnancy (n = 306) or are already pregnant (n = 164). Inclusion criteria include type 1 diabetes > 12 months' duration; screening HbA1c ≤ 9.0% (women recruited prepregnancy), or pregnant with gestational age 8-12 weeks...... with prandial insulin aspart. The results are expected mid-2011 with full publications expected later this year. Baseline characteristics show that basal insulin analogues are already frequently used in pregnant women with type 1 diabetes. This study will hopefully elucidate the safety and efficacy of the basal...... of the current literature concerning basal insulin analogue use in diabetic pregnancy, and to present the design and preliminary, non-validated baseline characteristics of a currently ongoing randomized, controlled, open-label, multicentre, multinational trial comparing insulin detemir with neutral protamine...

Basal insulin analogues in diabetic pregnancy: a literature review and baseline results of a randomised, controlled trial in type 1 diabetes

DEFF Research Database (Denmark)

Mathiesen, Elisabeth R; Damm, Peter; Jovanovic, Lois

2011-01-01

hagedorn insulin, both with insulin aspart, in women with type 1 diabetes planning a pregnancy (n = 306) or are already pregnant (n = 164). Inclusion criteria include type 1 diabetes > 12 months' duration; screening HbA1c = 9.0% (women recruited prepregnancy), or pregnant with gestational age 8-12 weeks...... with prandial insulin aspart. The results are expected mid-2011 with full publications expected later this year. Baseline characteristics show that basal insulin analogues are already frequently used in pregnant women with type 1 diabetes. This study will hopefully elucidate the safety and efficacy of the basal...... of the current literature concerning basal insulin analogue use in diabetic pregnancy, and to present the design and preliminary, non-validated baseline characteristics of a currently ongoing randomized, controlled, open-label, multicentre, multinational trial comparing insulin detemir with neutral protamine...

Sex-related differences in foot shape of adult Caucasians--a follow-up study focusing on long and short feet.

Science.gov (United States)

Krauss, I; Langbein, C; Horstmann, T; Grau, S

2011-03-01

The study's purpose was to substantiate findings on sex-related differences in foot morphology focusing on fringe sizes. Altogether, 287 Caucasian adults with long or short feet were scanned. Data were analysed together with data from 847 subjects from a previous study with comparable inclusion criteria and anthropometric data by: (1)comparing absolute measures within 237-277 mm foot length (FL); (2) comparing averaged measures across sizes in % of foot length for 203-323 mm FL; (3) reclassifying the additional subjects into a previously defined foot type classification. Male feet were wider and higher for the same FL. Averaged across sizes, no relevant differences between sexes were found for widths and heights. Slender or flat-pointed foot types were more common in longer feet, shorter feet tended to be bigger. Definitions for 'long' and 'short' are sex-related with an offset of three shoe sizes (EU). Results of this follow-up study on long and short feet can substantiate previous findings mainly described for the most common sizes. STATEMENT OF RELEVANCE: Improper footwear can cause pain and injury and proper fit is a major criterion for shoe buyers. Knowledge about sex-related differences in foot shape is important for shoe design. This study supplements the field of knowledge for very small and large feet.

Hallux abductus interphalangeus in normal feet, early-stage hallux limitus, and hallux valgus.

Science.gov (United States)

Castillo-Lopez, Jose M; Ramos-Ortega, Javier; Reina-Bueno, Maria; Domínguez-Maldonado, Gabriel; Palomo-Toucedo, Inmaculada C; Munuera, Pedro V

2014-03-01

Excessive deviation of the distal phalanx in abduction frequently occurs in advanced stages of hallux rigidus but not in hallux valgus. Therefore, theoretically there should be no significant differences in the hallux interphalangeal angle (HIPA) between individuals with normal feet, those with hallux valgus, and those with mild hallux limitus. The objective of the present study was thus to determine if significant differences in HIPA exist in the early stages of hallux valgus or hallux limitus deformities. The hallux interphalangeal angle was measured in three groups of participants: a control group with normal feet (45 participants), a hallux valgus group (49 participants), and a hallux limitus group (48 participants). Both of the pathologies were at an early stage. A dorsoplantar radiograph under weightbearing conditions was taken for each individual, and measurements (HIPA and hallux abductus angle [HAA]) were taken using AutoCAD (Autodesk Inc, San Rafael, California) software. Intergroup comparisons of HIPA, and correlations between HIPA, HAA, and hallux dorsiflexion were calculated. The comparisons revealed no significant differences in the values of HIPA between any of the groups (15.2 ± 5.9 degrees in the control group, 15.5 ± 3.9 degrees in the hallux valgus group, and 16.15 ± 4.3 in the hallux limitus group; P  =  0.634). The Pearson correlation coefficients in particular showed no correlation between hallux dorsiflexion, HAA, and HIPA. For the study participants, there were similar deviations of the distal phalanx of the hallux with respect to the proximal phalanx in normal feet and in feet with the early stages of the hallux limitus and hallux valgus deformities.

Child seat belt guidelines: Examining the 4 feet 9 inches rule as the standard.

Science.gov (United States)

Morse, Amber M; Aitken, Mary E; Mullins, Samantha H; Miller, Beverly K; Pomtree, Mindy M; Ulloa, Erin M; Montgomery, Jeffrey S; Saylors, Marie E

2017-08-01

Current American Academy of Pediatrics recommendations regarding transition from child safety/booster seat to adult safety belt use indicate that children should be at least 4 feet 9 inches, 8 years old, or 80 pounds. Proper fit in the vehicle seat, assessed with a five-point fit test, should also be met. Although most children reach 4 feet 9 inches around age 8 years, each child and vehicle presents a unique combination; thus a child may not fit appropriately in all vehicle types using only the 4 feet 9 inches requirement. We enrolled children, aged 7 years to 12 years, into our study. Height, weight, and demographic data were obtained. A Child Passenger Safety Technician then performed the five-point fit test in each of a uniform lineup of five vehicles. Data were collected on fit in the standard vehicle seat and also in a booster seat. We set 90% as the threshold proportion of children who meet all criteria for proper fit to validate current recommendations of a height of 4 feet 9 inches. Data were collected on 388 children. The percentage of 90% proper fit was met in the compact car and small sport-utility vehicle (SUV). However, only 80 (77%) of 104 students (p vehicles (large SUVs and trucks). This emphasizes the need for evaluation of fit by a trained personnel and/or development of standard back seat dimensions in all vehicles for maximum safety. Epidemiologic study, level III; Therapeutic study, level V.

Lifestyle Change Plus Dental Care (LCDC) program improves knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus among the elderly with type 2 diabetes.

Science.gov (United States)

Saengtipbovorn, Saruta; Taneepanichskul, Surasak

2015-03-01

Currently, there is an increased prevalence of diabetes mellitus among the elderly. Chronic inflammation from diabetes mellitus effects glycemic control and increases risk of diabetes complications. To assess the effectiveness of a Lifestyle Change plus Dental Care (LCDC) program by improved knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus among the elderly with type 2 diabetes. A quasi-experimental study was conducted in two Health Centers (HC 54 intervention and HC 59 control) between October 2013 and April 2014. Sixty-six diabetic patients per health center were recruited. At baseline, the intervention group attended a 20-minute lifestyle and oral health education program, individual lifestyle counseling using motivational interviewing, application of self-regulation manual, and individual oral hygiene instruction. At 3-month follow-up, the intervention group received individual lifestyle counseling and oral hygiene instruction. The intervention group received booster education every visit by viewing a 15-minute educational video. The control group received the routine program. Participants were assessed at baseline, 3-month, and 6-month follow-up for knowledge, attitude, and practice (KAP) toward oral health and diabetes mellitus. Data was analyzed by using descriptive statistic, Chi-square test, Fisher's exact test, and repeated measure ANOVA. After the 6-month follow-up, repeated measure ANOVA analysis showed that participants in the intervention group had significantly higher knowledge and attitude toward oral health and diabetes mellitus. The participants in the intervention group were more likely to exercise, modify diet, have foot examinations, always wear covered shoes, participate in self-feet screening, use dental floss, and use inter-proximal brush than the control group with statistically significant differences. The combination of lifestyle change and dental care in one program improved knowledge, attitude

Quantitative estimation of the state of vault feet gymnasts on the different stages of the long-term training

Directory of Open Access Journals (Sweden)

O.V. Makarova

2013-10-01

Full Text Available The analysis of the vaults given about the state is conducted feet gymnasts on the different stages of the long-term training. 93 sportswomen of different qualification took part in research. The system of Big foot was used. It is set that on the early stages of the long-term training for gymnasts observed flattening heights of unevenness of navicular bone above the floor. With growth of qualification of sportswomen to avoid development of pathological changes of vaults feet actually not possibly. It is conditioned the rules of competitions to complication of competition compositions and technique of execution of elements of calisthenics. It is marked that appearance of flattening feet requires: corrections in the system of training; introduction of the specially developed methods on the removal of existent deformations; prophylaxis of flat-footedness; strengthening of musculoskeletal system feet.

Preliminary design of the beam loss monitor system for the Advanced Photon Source

International Nuclear Information System (INIS)

Patterson, D.R.

1992-01-01

The preliminary design of the beam loss monitor for the ANL Advanced Photon Source is based on the use of an air dielectric coaxial cable as a long ionization chamber. Each coaxial cable section uses a high sensitivity DC current-to-voltage converter with both linear and integrating ranges. Pulse timing circuits determine the positions of individual losses by measuring the time at which the resulting voltage pulses arrive at the beginning of the coaxial ionization chamber. A possible timing ambiguity can be removed by correlating the particle bunch timing with the resulting voltage pulse timing. Measurements have shown that pulse rise times less than 15 nanoseconds can be obtained, so that determining loss locations to better than 7 feet may be possible. Best performance may be obtained when 500 VDC is applied to a 50-ohm, 7/8-inch air dielectric coaxial cable filled with approximately 8 psig of a 95% argon, 5% carbon dioxide gas mixture. Cable lengths will be between 100 and 300 feet long, depending on the part of the accelerator being monitored

Biomechanical characteristics, patient preference and activity level with different prosthetic feet: a randomized double blind trial with laboratory and community testing.

Science.gov (United States)

Raschke, Silvia U; Orendurff, Michael S; Mattie, Johanne L; Kenyon, David E A; Jones, O Yvette; Moe, David; Winder, Lorne; Wong, Angie S; Moreno-Hernández, Ana; Highsmith, M Jason; J Sanderson, David; Kobayashi, Toshiki

2015-01-02

Providing appropriate prosthetic feet to those with limb loss is a complex and subjective process influenced by professional judgment and payer guidelines. This study used a small load cell (Europa™) at the base of the socket to measure the sagittal moments during walking with three objective categories of prosthetic feet in eleven individuals with transtibial limb loss with MFCL K2, K3 and K4 functional levels. Forefoot stiffness and hysteresis characteristics defined the three foot categories: Stiff, Intermediate, and Compliant. Prosthetic feet were randomly assigned and blinded from participants and investigators. After laboratory testing, participants completed one week community wear tests followed by a modified prosthetics evaluation questionnaire to determine if a specific category of prosthetic feet was preferred. The Compliant category of prosthetic feet was preferred by the participants (P=0.025) over the Stiff and Intermediate prosthetic feet, and the Compliant and Intermediate feet had 15% lower maximum sagittal moments during walking in the laboratory (P=0.0011) compared to the Stiff feet. The activity level of the participants did not change significantly with any of the wear tests in the community, suggesting that each foot was evaluated over a similar number of steps, but did not inherently increase activity. This is the first randomized double blind study in which prosthetic users have expressed a preference for a specific biomechanical characteristic of prosthetic feet: those with lower peak sagittal moments were preferred, and specifically preferred on slopes, stairs, uneven terrain, and during turns and maneuvering during real world use. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Preliminary study of urine metabolism in type two diabetic patients based on GC-MS

OpenAIRE

Zhang, Ning; Geng, Fang; Hu, Zhong-Hua; Liu, Bin; Wang, Ye-Qiu; Liu, Jun-Cen; Qi, Yong-Hua; Li, Li-Jing

2016-01-01

Objective: Comparative study of type 2 diabetes and healthy controls by metabolomics methods to explore the pathogenesis of Type II diabetes. Methods: Gas chromatography - mass spectrometry (GC-MS) with a variety of multivariate statistical analysis methods to the healthy control group 58 cases, 68 cases of Type II diabetes group were analyzed. Chromatographic conditions: DB-5MS column; the carrier gas He; flow rate of 1 mL·min-1, the injection volume 1 uL; split ratio is 100: 1. MS condition...

Biofeedback can reduce foot pressure to a safe level and without causing new at-risk zones in patients with diabetes and peripheral neuropathy.

Science.gov (United States)

De León Rodriguez, D; Allet, L; Golay, A; Philippe, J; Assal, J-Ph; Hauert, C-A; Pataky, Z

2013-02-01

Plantar pressure reduction is mandatory for diabetic foot ulcer healing. Our aim was to evaluate the impact of a new walking strategy learned by biofeedback on plantar pressure distribution under both feet in patients with diabetic peripheral neuropathy. Terminally augmented biofeedback has been used for foot off-loading training in 21 patients with diabetic peripheral sensory neuropathy. The biofeedback technique was based on a subjective estimation of performance and objective visual feedback following walking sequences. The patient was considered to have learned a new walking strategy as soon as the peak plantar pressure (PPP) under the previously defined at-risk zone was within a range of 40-80% of baseline PPP in 70% of the totality of steps and during three consecutive walking sequences. The PPP was measured by a portable in-shoe foot pressure measurement system (PEDAR(®)) at baseline (T0), directly after learning (T1) and at 10-day retention test (T2). The PPP under at-risk zones decreased significantly at T1 (165 ± 9 kPa, p biofeedback leads to a safe and regular plantar pressure distribution without inducing any new 'at-risk' area under both feet. Copyright © 2012 John Wiley & Sons, Ltd.

Job insecurity and risk of diabetes

DEFF Research Database (Denmark)

Ferrie, Jane E.; Virtanen, Marianna; Jokela, Markus

2016-01-01

participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary...... risk estimate. Results: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk...... of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09–1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking...

Energy expenditure in people with transtibial amputation walking with crossover and energy storing prosthetic feet: A randomized within-subject study.

Science.gov (United States)

McDonald, Cody L; Kramer, Patricia A; Morgan, Sara J; Halsne, Elizabeth G; Cheever, Sarah M; Hafner, Brian J

2018-05-01

Energy storing feet are unable to reduce the energy required for normal locomotion among people with transtibial amputation. Crossover feet, which incorporate aspects of energy storing and running specific feet, are designed to maximize energy return while providing stability for everyday activities. Do crossover prosthetic feet reduce the energy expenditure of walking across a range of speeds, when compared with energy storing feet among people with transtibial amputation due to non-dysvascular causes? A randomized within-subject study was conducted with a volunteer sample of twenty-seven adults with unilateral transtibial amputation due to non-dysvascular causes. Participants were fit with two prostheses. One had an energy storing foot (Össur Variflex) and the other a crossover foot (Össur Cheetah Xplore). Other components, including sockets, suspension, and interface were standardized. Energy expenditure was measured with a portable respirometer (Cosmed K4b2) while participants walked on a treadmill at self-selected slow, comfortable, and fast speeds with each prosthesis. Gross oxygen consumption rates (VO 2  ml/min) were compared between foot conditions. Energy storing feet were used as the baseline condition because they are used by most people with a lower limb prosthesis. Analyses were performed to identify people who may benefit from transition to crossover feet. On average, participants had lower oxygen consumption in the crossover foot condition compared to the energy storing foot condition at each self-selected walking speed, but this difference was not statistically significant. Participants with farther six-minute walk test distances, higher daily step counts, and higher Medicare Functional Classification Levels at baseline were more likely to use less energy in the crossover foot. Crossover feet may be most beneficial for people with higher activity levels and physical fitness. Further research is needed to examine the effect of crossover feet on

Conocimientos y conductas de los pacientes con diabetes mellitus sobre el pie diabético Knowledge and behaviors of the patients with diabetes mellitus in relation to the diabetic foot

Directory of Open Access Journals (Sweden)

Ulises de Jesús Gallardo Pérez

2008-03-01

Full Text Available Se identificaron los conocimientos y conductas de los pacientes con diabetes mellitus sobre el pie diabético. Se realizó un estudio cualitativo en 2 consultorios del Policlínico "Hermanos Ruíz Aboy", del municipio San Miguel del Padrón. Se ejecutaron 4 grupos focales, con un total de 28 participantes de ambos sexos, entre 50 y 80 años de edad. La mayoría de los pacientes mostró falta de conocimientos sobre la definición de pie diabético y sus factores de riesgo. Los pacientes realizan un autocuidado insuficiente de sus pies y asumen conductas de riesgo por la falta de educación. Consideramos importante reforzar el componente educativo en la atención integral de los pacientes con diabetes mellitus para elevar su nivel de conocimientos, crear hábitos saludables y evitar la aparición del pie diabético. La técnica del grupo focal constituyó un instrumento rápido y efectivo para la obtención de información.The knowledge and behavior of the patients with diabetes mellitus in connection with the diabetic foot were identified. A qualitative study was conducted in 2 family physician's offices of "Hermanos Ruíz Aboy" Polyclinic of San Miguel del Padrón municipality. 4 focal groups were selected with a total of 28 participants aged 50-80 of both sexes. Most of the patients lacked knowledge to define the diabetic foot and its risk factors. The patients' self-care of their feet is insufficient and they assume risk conducts due to their deficient education. It is important to reinforce the educative component in the comprehensive attention of the patients with diabetes mellitus to raise their knowledge level, to create healthy habits and to prevent the appearance of diabetic foot. The focal group technique is a rapid and effective tool to obtain information.

Reliability of digital photography for assessing lower extremity alignment in individuals with flatfeet and normal feet types.

Science.gov (United States)

Ashnagar, Zinat; Hadian, Mohammad Reza; Olyaei, Gholamreza; Talebian Moghadam, Saeed; Rezasoltani, Asghar; Saeedi, Hassan; Yekaninejad, Mir Saeed; Mahmoodi, Rahimeh

2017-07-01

The aim of this study was to investigate the intratester reliability of digital photographic method for quantifying static lower extremity alignment in individuals with flatfeet and normal feet types. Thirteen females with flexible flatfeet and nine females with normal feet types were recruited from university communities. Reflective markers were attached over the participant's body landmarks. Frontal and sagittal plane photographs were taken while the participants were in a standardized standing position. The markers were removed and after 30 min the same procedure was repeated. Pelvic angle, quadriceps angle, tibiofemoral angle, genu recurvatum, femur length and tibia length were measured from photographs using the Image j software. All measured variables demonstrated good to excellent intratester reliability using digital photography in both flatfeet (ICC: 0.79-0.93) and normal feet type (ICC: 0.84-0.97) groups. The findings of the current study indicate that digital photography is a highly reliable method of measurement for assessing lower extremity alignment in both flatfeet and normal feet type groups. Copyright © 2016. Published by Elsevier Ltd.

Child seat belt guidelines: Examining the 4 feet 9 inches rule as the standard.

Science.gov (United States)

Morse, Amber M; Aitken, Mary E; Mullins, Samantha H; Miller, Beverly K; Pomtree, Mindy M; Ulloa, Erin M; Montgomery, Jeffrey S; Saylors, Marie E

2017-11-01

Current American Academy of Pediatrics recommendations regarding transition from child safety/booster seat to adult safety belt use indicate that children should be at least 4 feet 9 inches, 8 years old, or 80 pounds. Proper fit in the vehicle seat, assessed with a five-point fit test, should also be met. Although most children reach 4 feet 9 inches around age 8 years, each child and vehicle presents a unique combination; thus a child may not fit appropriately in all vehicle types using only the 4 feet 9 inches requirement. We enrolled children, aged 7 years to 12 years, into our study. Height, weight, and demographic data were obtained. A Child Passenger Safety Technician then performed the five-point fit test in each of a uniform lineup of five vehicles. Data were collected on fit in the standard vehicle seat and also in a booster seat. We set 90% as the threshold proportion of children who meet all criteria for proper fit to validate current recommendations of a height of 4 feet 9 inches. Data were collected on 388 children. The percentage of 90% proper fit was met in the compact car and small sport-utility vehicle (SUV). However, only 80 (77%) of 104 students (p guidelines for an adult seat belt do not meet safety requirements for fit, especially in larger, commonly used vehicles (large SUVs and trucks). This emphasizes the need for evaluation of fit by a trained personnel and/or development of standard back seat dimensions in all vehicles for maximum safety. Epidemiologic level 1.

Foot Placement Indicator for Balance of Planar Bipeds with Point Feet

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Pieter van Zutven

2013-05-01

Full Text Available Abstract If humanoid robots are to be used in society, they should be able to maintain their balance. Knowing where to step is crucially important. In this paper we contribute an algorithm that can compute the foot step location such that bipedal balance is maintained for planar bipeds with point feet and an arbitrary number of non-massless links on a horizontal and flat ground. The algorithm is called the foot placement indicator (FPI and it extends the foot placement estimator (FPE. The FPE uses an inverted pendulum model to capture the dynamics of a humanoid robot, whereas the FPI deals with multi-body models with distributed masses. This paper analyses equilibrium sets and the stability of planar bipeds with point feet. The algorithm uses conservation of energy throughout the step, taking into account the instantaneous impact dynamics at foot strike. A simulation case study on a five-link planar biped shows the effectiveness of the FPI.

What's work got to do with it? A qualitative study of work life among people with type 2 diabetes

DEFF Research Database (Denmark)

Cleal, Bryan; Nexø, Mette Andersen; Willaing, Ingrid

Background Epidemiological and health economic analyses highlight that lost productivity at work among people with diabetes represents a significant social and individual burden. The reasons for this have been investigated in relation to type 1 diabetes (T1D), but less is known about...... most extreme, one participant bemoaned walking a lot at work while having no feeling in his feet, simultaneously rejecting that diabetes had impacted on his work life. The challenging and negative experiences which did emerge were similar to those highlighted in relation to work and T1D e.g. medication......, food consumption, exercise. Discrimination and stigma were mentioned by a very small number of participants. In short, there was no indication of work-related challenges specific to T2D. Discussion In contrast to studies conducted among people with type 1 diabetes, people with T2D seemed generally less...

Radiographic features of Ewing's sarcoma of the bones of the hands and feet

Energy Technology Data Exchange (ETDEWEB)

Baraga, J.J.; Amrami, K.K.; Swee, R.G. [Mayo Clinic, Rochester, MN (United States). Dept. of Radiology; Wold, L. [Mayo Clinic, Rochester, MN (United States).. Dept. of Laboratory Medicine and Pathology; Unni, K.K. [Mayo Clinic, Rochester, MN (United States). Dept. of Surgical Pathology

2001-03-01

The radiographic features of Ewing's sarcoma of the bones of the hands and feet are reviewed utilizing cases obtained from the Mayo Clinic patient files and the consultation files of Drs. D.C. Dahlin and K.K. Unni. This series consists of a total of 43 cases of pathologically proven Ewing's sarcoma involving the small bones of the hands and feet. The classic radiographic features of Ewing's sarcoma in the long bones, including lytic, permeative destruction, aggressive periosteal reaction, cortical violation, and a soft tissue mass, are also seen in the bones of the hands and feet, with similar frequency. These classic features are most commonly present in lesions affecting the short tubular bones. Lesions affecting the tarsal bones more often demonstrate atypical radiographic features. These atypical radiographic appearances may play a role in the reported delay in diagnosis of Ewing's sarcoma within the tarsal bones. (orig.)

Effects of lower limb amputation on the mental rotation of feet

NARCIS (Netherlands)

Curtze, Carolin; Otten, Bert; Postema, Klaas

What happens to the mental representation of our body when the actual anatomy of our body changes? We asked 18 able-bodied controls, 18 patients with a lower limb amputation and a patient with rotationplasty to perform a laterality judgment task. They were shown illustrations of feet in different

The effect that energy storage and return feet have on the propulsion of the body: a pilot study.

Science.gov (United States)

Crimin, Anthony; McGarry, Anthony; Harris, Elena Jane; Solomonidis, Stephan Emanuel

2014-09-01

A variety of energy storage and return prosthetic feet are currently available for use within lower limb prostheses. Designs claim to provide a beneficial energy return during push-off, but the extent to which this occurs remains disputed. Techniques currently used to measure energy storage, dissipation and return within the structure of the prosthetic foot are debatable, with limited evidence to support substantial elastic energy storage and return from existing designs. The aim of this study was to evaluate the performance of energy storage and return foot designs through considering the ankle power during push-off and the effect on body centre of mass propulsion. To achieve this aim, the gait patterns of six trans-tibial prosthetic users wearing different designs of energy storage and return feet were analysed while ascending a ramp. Three examples of energy storage and return feet (suitable for moderate activity) were selected and randomly evaluated: the Blatchford's Epirus, Össur Assure and College Park Tribute feet. The power at the anatomical and mechanical ankle joints was integrated to evaluate the work done over the gait cycle. The direction of the inertial force, and therefore propulsion of the body centre of mass, was used to indicate the effect of the energy return by the energy storage and return feet. Results indicate that although energy storage and return feet may provide energy return, the work done around the prosthetic ankle indicates net power absorption. Therefore, the prosthetic limb is unable to contribute to the body centre of mass propulsion to the same extent as the biological limb. © IMechE 2014.

Foot placement indicator for balance of planar bipeds with point feet

NARCIS (Netherlands)

Zutven, van P.W.M.; Nijmeijer, H.

2013-01-01

When humanoid robots are going to be used in society, they should be capable to maintain the balance. Knowing where to step appears to be crucially important to remain balanced. In this paper we contribute an algorithm for planar bipeds with point feet and an arbitrary number of non-massless links

Radiographic appearance of the feet of mammoth donkeys and the finding of subclinical laminitis

International Nuclear Information System (INIS)

Walker, M.; Taylor, T.; Slater, M.; Hood, D.; Weir, V.; Elslander, J.

1995-01-01

All feet of 10 clinically sound mammoth donkeys (Group I) were radiographed to determine the appearance of the distal phalanx. The distal phalanges had blunted to concave-shaped dorsal solar margins which varied in appearance from slight to pronounced. The distal phalanges of the forefeet were wider than those of the hindfeet, and also were positioned a greater distance from the dorsal aspect of the hoof wall. The greater distance between the dorsal aspect of the hoof wall and the distal phalanges seemed related to the presence of a periosteal-like bony proliferation on the dorsum of the distal phalanx. This bony proliferation occurred in those distal phalanges which also had radiographic findings consistent with pedal osteitis. Next, all feet of 5 additional mammoth donkeys (Group II) that were to be necropsied for various reasons, were examined similarly to Group I, necropsied and found to have laminitis. Only 2 of these 5 donkeys had been lame; only one had rotation of the distal phalanges (in the forefeet). Radiographic data from the 4 donkeys without rotation seemed most similar to that found in those Group I donkeys which had periosteal reactions on their distal phalanges. Conclusions from this study were that: 1) feet of mammoth donkeys have some anatomic differences from those of domestic horses, 2) subclinical laminitis and pedal osteitis can occur in mammoth donkeys, 3) rotation of the distal phalanx occurs in some, but not all laminitic donkeys, 4) laminitic changes may be more pronounced in their fore than in their hindfeet, and 5) additional studies of donkeys need to be done, examining both proven normal and confirmed laminitic feet

Preliminary study: Evaluation of melatonin secretion in children and adolescents with type 1 diabetes mellitus.

Science.gov (United States)

Kor, Yilmaz; Geyikli, Iclal; Keskin, Mehmet; Akan, Muslum

2014-07-01

Melatonin is an indolamine hormone, synthesized from tryptophan in the pineal gland primarily. Melatonin exerts both antioxidative and immunoregulatory roles but little is known about melatonin secretion in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to measure serum melatonin levels in patients with T1DM and investigates their relationship with type 1 diabetes mellitus. Forty children and adolescents with T1DM (18 boys and 22 girls) and 30 healthy control subjects (17 boys and 13 girls) participated in the study. All patients followed in Pediatric Endocrinology and Metabolism Unit of Gaziantep University Faculty of Medicine and also control subjects had no hypertension, obesity, hyperlipidemia, anemia, and infection. Blood samples were collected during routine analysis, after overnight fasting. Serum melatonin levels were analyzed with ELISA. There were no statistically significant differences related with age, sex, BMI distribution between diabetic group and control group. Mean diabetic duration was 2.89 ± 2.69 years. The variables were in the equation. Mean melatonin level in diabetic group was 6.75 ± 3.52 pg/ml and mean melatonin level in control group was 11.51 ± 4.74 pg/ml. Melatonin levels were significantly lower in diabetic group compared to controls (P 1). Melatonin was associated with type 1 diabetes mellitus significantly. Because of the varied roles of melatonin in human metabolic rhythms, these results suggest a role of melatonin in maintaining normal rhythmicity. Melatonin may play role in preventing process of inflammation and oxidative stress.

Preliminary study: Evaluation of melatonin secretion in children and adolescents with type 1 diabetes mellitus

Directory of Open Access Journals (Sweden)

Yilmaz Kor

2014-01-01

Full Text Available Objective: Melatonin is an indolamine hormone, synthesized from tryptophan in the pineal gland primarily. Melatonin exerts both antioxidative and immunoregulatory roles but little is known about melatonin secretion in patients with type 1 diabetes mellitus (T1DM. The aim of this study was to measure serum melatonin levels in patients with T1DM and investigates their relationship with type 1 diabetes mellitus. Materials and Methods: Forty children and adolescents with T1DM (18 boys and 22 girls and 30 healthy control subjects (17 boys and 13 girls participated in the study. All patients followed in Pediatric Endocrinology and Metabolism Unit of Gaziantep University Faculty of Medicine and also control subjects had no hypertension, obesity, hyperlipidemia, anemia, and infection. Blood samples were collected during routine analysis, after overnight fasting. Serum melatonin levels were analyzed with ELISA. Results: There were no statistically significant differences related with age, sex, BMI distribution between diabetic group and control group. Mean diabetic duration was 2.89 ± 2.69 years. The variables were in the equation. Mean melatonin level in diabetic group was 6.75 ± 3.52 pg/ml and mean melatonin level in control group was 11.51 ± 4.74 pg/ml. Melatonin levels were significantly lower in diabetic group compared to controls (P < 0.01. Conclusions: Melatonin was associated with type 1 diabetes mellitus significantly. Because of the varied roles of melatonin in human metabolic rhythms, these results suggest a role of melatonin in maintaining normal rhythmicity. Melatonin may play role in preventing process of inflammation and oxidative stress.

One-stop microvascular screening service: an effective model for the early detection of diabetic peripheral neuropathy and the high-risk foot.

Science.gov (United States)

Binns-Hall, O; Selvarajah, D; Sanger, D; Walker, J; Scott, A; Tesfaye, S

2018-04-02

To evaluate the feasibility of a one-stop microvascular screening service for the early diagnosis of diabetic distal symmetrical polyneuropathy, painful distal symmetrical polyneuropathy and the at-risk diabetic foot. People with diabetes attending retinal screening in hospital and community settings had their feet examined by a podiatrist. Assessment included: Toronto Clinical Neuropathy Score evaluation; a 10-g monofilament test; and two validated, objective and quick measures of neuropathy obtained using the point-of-care devices 'DPN-Check', a hand-held device that measures sural nerve conduction velocity and amplitude, and 'Sudoscan', a device that measures sudomotor function. The diagnostic utility of these devices was assessed against the Toronto Clinical Neuropathy Score as the 'gold standard'. A total of 236 consecutive people attending the retinal screening service, 18.9% of whom had never previously had their feet examined, were evaluated. The prevalence of distal symmetrical polyneuropathy, assessed using the Toronto Clinical Neuropathy Score, was 30.9%, and was underestimated by 10-g monofilament test (14.4%). The prevalence of distal symmetrical polyneuropathy using DPN-check was 51.5% (84.3% sensitivity, 68.3% specificity), 38.2% using Sudoscan foot electrochemical skin conductance (77.4% sensitivity, 68.3% specificity), and 61.9% using abnormality in either of the results (93.2% sensitivity, 52.8% specificity). The results of both devices correlated with Toronto Clinical Neuropathy Score (Peye, foot and renal screening is feasible, has a high uptake, reduces clinic visits, and identifies painful distal symmetrical polyneuropathy and the at-risk foot. Combined large- and small-nerve-fibre assessment using non-invasive, quantitative and quick point-of-care devices may be an effective model for the early diagnosis of distal symmetrical polyneuropathy. © 2018 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Cinderella's Lessons on Footbinding: How Tiny Feet Found their Way into the Chinese Cinderella Story

OpenAIRE

Tyler Scott Smith

2013-01-01

The story of Cinderella has had many variants, some dating back to ancient Tibetan trade routes and dynastic China. When the tale is analysed in comparison to other variants it is found that in the Chinese version Yeh-Shen (Cinderella) is prized for the small size of her feet. The result of Yeh-Shen having small feet in the story is that she is led her into wealth, power and marriage, the same pursuable goals that led to the custom of footbinding. In southern China the custom of footbinding b...

HFS-II hands and feet contamination monitor for α, β

International Nuclear Information System (INIS)

Du Xiangyang; Han Shuping; Wang Xiaodong; Fan Liya; Zhang Yong; Rao Xianming; Fang Jintu

1999-11-01

HFS-II Hands and Feet Contamination Monitor for α, β is a necessary device which monitors the entrance of controlling area of nuclear power plant and nuclear facility, and it consists of nuclear detector, nuclear electronic circuit, computer data processing and controlling divisions, input/output controlling etc. Physical indicators conform to the requirements of relative national standard GB8703-87 and department standard EJ/T586

Effects of aluminum hinged shoes on the structure of contracted feet in Thoroughbred yearlings.

Science.gov (United States)

Tanaka, Kousuke; Hiraga, Atsushi; Takahashi, Toshiyuki; Kuwano, Atsutoshi; Morrison, Scott Edward

2015-01-01

We applied aluminum hinged shoes (AHSs) to the club foot-associated contracted feet of 11 Thoroughbred yearlings to examine the effects of the shoes on the shape of the hoof and third phalanx (P III). After 3 months of AHS use, the size of the affected hooves increased significantly, reaching the approximate size of the healthy contralateral hooves with respect to the maximum lateral width of the foot, the mean ratio of the bearing border width to the coronary band width, and the mean ratio of the solar surface width to the articular surface width. These results suggest that the AHSs corrected the contracted feet in these yearling horses.

Rare Case of Aspergillus ochraceus Osteomyelitis of Calcaneus Bone in a Patient with Diabetic Foot Ulcers

Directory of Open Access Journals (Sweden)

Farhang Babamahmoodi

2015-01-01

Full Text Available Diabetes is the most common metabolic disease in humans. One of the major complications of the disease is foot ulcer that is prone to infection. The most common causes of infection which have been reported in these patients are bacteria and fungi such as Candida, Aspergillus, and Rhizopus species. We report one such rare case with calcaneal osteomyelitis caused by Aspergillus ochraceus in a patient with diabetic foot osteomyelitis. The case was a 68-year-old male with a history of type II diabetes for 2 years. The patient had two ulcers on the right heel bones for the past 6 months with no significant improvement. One of the most important predisposing factors to infectious diseases, especially opportunistic fungal infection, is diabetes mellitus. Aspergillus species can involve bony tissue through vascular system, direct infection, and trauma. Proper and early diagnosis and treatment of diabetic foot infection can reduce or prevent complications, such as osteomyelitis and amputation. The annual examination of feet for skin and nail lesion, sensation, anatomical changes, and vascular circulation can be useful for prevention and control of infection.

Do free-falling quantum cats land on their feet?

International Nuclear Information System (INIS)

Chryssomalakos, C; Serrano-Ensástiga, E; Hernández-Coronado, H

2015-01-01

We present a quantum description of the mechanism by which a free-falling cat manages to reorient itself and land on its feet, having all along zero angular momentum. Our approach is geometrical, making use of the fiber bundle structure of the cat configuration space. We show how the classical picture can be recovered, but also point out a purely quantum scenario, that ends up with a Schroedinger cat. Finally, we sketch possible applications to molecular, nuclear, and nano-systems. (paper)

Diabetes and Foot Problems

Science.gov (United States)

... too much pressure on your toes. If your feet have changed shape, such as from Charcot’s foot, you may need ... care visit if you have changes in the shape of your feet loss of feeling in your feet peripheral artery ...

Medical care of type 2 diabetes in German disease management programmes: a population-based evaluation.

Science.gov (United States)

Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf

2011-05-01

Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.

Dynamics and Optimal Feet Force Distributions of a Realistic Four-legged Robot

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Saurav Agarwal

2012-08-01

Full Text Available This paper presents a detailed dynamic modeling of realistic four-legged robot. The direct and inverse kinematic analysis for each leg has been considered in order to develop an overall kinematic model of the robot, when it follows a straight path. This study also aims to estimate optimal feet force distributions of the said robot, which is necessary for its real-time control. Three different approaches namely, minimization of norm of feet forces (approach 1, minimization of norm of joint torques (approach 2 and minimization of norm of joint power (approach 3 have been developed. Simulation result shows that approach 3 is more energy efficient foot force formulation than other two approaches. Lagrange-Euler formulation has been utilized to determine the joint torques. The developed dynamic models have been examined through computer simulation of continuous gait of the four-legged robot.

A Four-Feet Walking-Type Rotary Piezoelectric Actuator with Minute Step Motion.

Science.gov (United States)

Liu, Yingxiang; Wang, Yun; Liu, Junkao; Xu, Dongmei; Li, Kai; Shan, Xiaobiao; Deng, Jie

2018-05-08

A four-feet walking-type rotary piezoelectric actuator with minute step motion was proposed. The proposed actuator used the rectangular motions of four driving feet to push the rotor step-by-step; this operating principle was different with the previous non-resonant actuators using direct-driving, inertial-driving, and inchworm-type mechanisms. The mechanism of the proposed actuator was discussed in detail. Transient analyses were accomplished by ANSYS software to simulate the motion trajectory of the driving foot and to find the response characteristics. A prototype was manufactured to verify the mechanism and to test the mechanical characteristics. A minimum resolution of 0.095 μrad and a maximum torque of 49 N·mm were achieved by the prototype, and the output speed was varied by changing the driving voltage and working frequency. This work provides a new mechanism for the design of a rotary piezoelectric actuator with minute step motion.

Relationship between blood pressure, cognitive function and education level in elderly patients with diabetes: a preliminary study.

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Talfournier, J; Bitu, J; Paquet, C; Gobron, C; Guillausseau, P J; Hugon, J; Dumurgier, J

2013-10-01

This study aimed to assess the relationship between blood pressure and cognitive function in elderly patients with diabetes mellitus (DM). A total of 32 patients with DM aged ≥ 65 years (seven women and 25 men; mean ± SD age: 74.3 ± 6.4 years) were included in this cross-sectional study. Relationships between blood pressure and neuropsychological tests were determined using Spearman's rank correlations (ρ) and multivariable linear regression models. Lower diastolic blood pressure was associated with lower scores on the Frontal Assessment Battery (ρ=0.32, P=0.02), longer times to complete the Trail Making Test Part B (ρ=0.51, P=0.003), lower scores for the Finger Tapping Test (ρ=0.36, P=0.046) and less verbal fluency (ρ=0.36, P=0.047). In multivariable models, these relationships were attenuated after adjusting for levels of education. There was an association between lower diastolic blood pressure and poorer executive function in this cohort of elderly DM patients. These results underline the importance of systematic cognitive evaluation in elderly patients with DM, and suggest that a too-low diastolic blood pressure may have deleterious effects on mental function. Larger studies in the future are required to confirm these preliminary results. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Skeletal pathology and variable anatomy in elephant feet assessed using computed tomography

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Sophie Regnault

2017-01-01

Full Text Available Foot problems are a major cause of morbidity and mortality in elephants, but are underreported due to difficulties in diagnosis, particularly of conditions affecting the bones and internal structures. Here we evaluate post-mortem computer tomographic (CT scans of 52 feet from 21 elephants (seven African Loxodonta africana and 14 Asian Elephas maximus, describing both pathology and variant anatomy (including the appearance of phalangeal and sesamoid bones that could be mistaken for disease. We found all the elephants in our study to have pathology of some type in at least one foot. The most common pathological changes observed were bone remodelling, enthesopathy, osseous cyst-like lesions, and osteoarthritis, with soft tissue mineralisation, osteitis, infectious osteoarthriti, subluxation, fracture and enostoses observed less frequently. Most feet had multiple categories of pathological change (81% with two or more diagnoses, versus 10% with a single diagnosis, and 9% without significant pathology. Much of the pathological change was focused over the middle/lateral digits, which bear most weight and experience high peak pressures during walking. We found remodelling and osteoarthritis to be correlated with increasing age, more enthesopathy in Asian elephants, and more cyst-like lesions in females. We also observed multipartite, missing and misshapen phalanges as common and apparently incidental findings. The proximal (paired sesamoids can appear fused or absent, and the predigits (radial/tibial sesamoids can be variably ossified, though are significantly more ossified in Asian elephants. Our study reinforces the need for regular examination and radiography of elephant feet to monitor for pathology and as a tool for improving welfare.

Increased length of inpatient stay and poor clinical coding: audit of patients with diabetes.

Science.gov (United States)

Daultrey, Harriet; Gooday, Catherine; Dhatariya, Ketan

2011-11-01

People with diabetes stay in hospital for longer than those without diabetes for similar conditions. Clinical coding is poor across all specialties. Inpatients with diabetes often have unrecognized foot problems. We wanted to look at the relationships between these factors. A single day audit, looking at the prevalence of diabetes in all adult inpatients. Also looking at their feet to find out how many were high-risk or had existing problems. A 998-bed university teaching hospital. All adult inpatients. (a) To see if patients with diabetes and foot problems were in hospital for longer than the national average length of stay compared with national data; (b) to see if there were people in hospital with acute foot problems who were not known to the specialist diabetic foot team; and (c) to assess the accuracy of clinical coding. We identified 110 people with diabetes. However, discharge coding data for inpatients on that day showed 119 people with diabetes. Length of stay (LOS) was substantially higher for those with diabetes compared to those without (± SD) at 22.39 (22.26) days, vs. 11.68 (6.46) (P coding was poor with some people who had been identified as having diabetes on the audit, who were not coded as such on discharge. Clinical coding - which is dependent on discharge summaries - poorly reflects diagnoses. Additionally, length of stay is significantly longer than previous estimates. The discrepancy between coding and diagnosis needs addressing by increasing the levels of awareness and education of coders and physicians. We suggest that our data be used by healthcare planners when deciding on future tariffs.

[Efficacy of the strategy to improve the quality indicators of Diabetes Mellitus 2 Care Process in Advanced Diabetes Centre Macarena].

Science.gov (United States)

Vélez, Juan Manuel; García, Rosa; Pina, Enrique; Morales, Cristóbal; Escalera, Carmen; Ortega, Antonio; Poyatos, Blas; Carrasco, Dolores; Prieto, Jesús; Ángeles Eslava, M; Antonio Corrales, J; Barón, María O; Llano, Mercedes; Ruiz, Francisco; Sánchez, Romualdo; Victorino Pino, Manuel; Luisa Redondo, M; Castellanos, Antonio; Mayoral, Eduardo

2018-02-21

The assessment of the Diabetes Mellitus 2 Care Process (PAI-DM2) through the assessment tool for the chronic illness' care models (IEMAC-Diabetes) allows the design of health interventions for the improvement of medical care. Analysing the quality of healthcare provided to DM2 patients. Quasiexperimental study before and after intervention with a not randomised control group. Health care district of primary care Sevilla. 12 groups of ascribed patients, 5 Primary Care Healthcenter, chosen in a discretionary way. Physicians and nurses from the 12 intervention groups took part in a training program, including an external rotation in the Diabetes Daycare Hospital. Number of included patients, glycated hemoglobin, feet exploration (FE), and ocular fundus (OF). 1,475 DM-2 patients were analysed. The proportion of included patients per group was 8.5%, 45.5% were women. At the beginning of the study, the rate of patients with HbA1c<7% were 38.9% in 2013 against 47.7% in 2014 and 40.2% in 2016; 33% of the patients had an OF in 2013 against 41.77% in 2014; 51.6% of patients had an EF against 54.7% in 2014. After the intervention, statistically significant differences were reached in HbA1c (p=0.01) and retinography requested (p=0.01). IEMAC-Diabetes allows spotting improvement areas in the PAI-DM2. The absence of statistically significant differences may be the result of contamination in the sample and/or Hawthorne effect. Copyright © 2017 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Project Rulison: A preliminary report

Energy Technology Data Exchange (ETDEWEB)

Reynolds, Miles Jr [Austral Oil Company Incorporated, Houston, TX (United States); Bray, Bruce G; Mann, Robert L [CER Geonuclear Corporation, Las Vegas, NV (United States)

1970-05-01

Project Rulison was designed to use underground nuclear technology to determine the potential of this technique for commercial development of the deep, thick, lenticular, low permeability, Mesaverde Formation of the Rulison Field in Garfield County, Colorado. Since discovery in 1952, this reservoir has been tested by nine widely-spaced conventionally completed wells. A method of stimulation, far greater in magnitude and efficiency than conventional hydraulic fracturing, is needed to recover this gas at economic rates. A feasibility study completed in July 1966 indicated that nuclear explosives were a potentially economic method of stimulating recovery of natural gas from the reservoir. The gas-in-place, estimated to be between 90-125 billion cubic feet per 640 acres from earlier wells, was confirmed from information obtained on two conventional wells completed in 1966. The Project Rulison exploratory well, R-EX, was completed in May 1968. Detailed testing of this well provided data on geology, hydrology and reservoir characteristics. The data obtained from the testing have been used to determine the flow capacity of the Mesaverde reservoir. The reservoir characteristics were then used as input data to make predictions of post-shot reservoir performance in the nuclear stimulated well, using a radial, unsteady state gas flow computer model. A nuclear explosive with a design yield of 40 kilotons was emplaced in a 10-3/4 inch hole at a depth of 8426 feet below ground surface and detonated on September 10, 1969. A preliminary appraisal of the data taken at shot time indicate that the explosive behaved as predicted. The explosion was completely contained underground as predicted and no major seismic damage occurred. The post-shot drilling program, to reenter the chimney, will congruence in March 1970, approximately six months after detonation. A test program will be initiated at that time to determine the degree of reservoir stimulation achieved. (author)

An estimation of the prevalence of diabetes mellitus and diabetic retinopathy in adults in Timor-Leste.

Science.gov (United States)

Dawkins, Rosie Claire Hewitt; Oliver, Genevieve Frances; Sharma, Manoj; Pinto, Basilio Martins; Jeronimo, Belmerio; Pereira, Bernadete; Magno, Julia; Motta, Lara Alexandra; Verma, Nitin; Shephard, Mark

2015-06-18

Once considered an affliction of people in high-income countries, diabetes mellitus is increasingly seen as a global epidemic. However, for many countries very little is known about the prevalence of diabetes and its complications. This study aims to estimate the prevalence of diabetes, and diabetic retinopathy, in adults in Timor-Leste. From March 2013 to May 2014, adult patients being assessed for cataract surgery at the Sentru Matan Nasional (National Eye Centre) in Dili, Timor-Leste had a point-of-care HbA1c measurement performed on the DCA Vantage device (Siemens Ltd) under a quality framework. A diagnostic cut-off of 6.5% (48 mmol/mol) HbA1c was used for diagnosis of diabetes. Ocular examination, blood pressure, demographic and general health data were also collected. Diabetic retinopathy assessment was carried out by ophthalmologists. A total of 283 people [mean age 63.6 years (range 20-90 years)] were tested and examined during the study period. Forty-three people (15.2%) were found to have diabetes, with a mean HbA1c of 9.5% (77 mmol/mol). Of these, 27 (62.9%) were newly diagnosed, with a mean HbA1c of 9.7% (83 mmol/mol) and a range of 6.6-14% (49-130 mmol/mol). Nearly half (48.1%) of people newly diagnosed with diabetes had an HbA1c over 10.0% (86 mmol/mol). Of those with known diabetes, only 68.8% were receiving any treatment. Mean HbA1c for treated patients was 9.9% (85 mmol/mol). Diabetic retinopathy was identified in 18.6% of people with diabetes, of whom half had no previous diagnosis of diabetes. This study estimates the prevalence of diabetes at 15% in adults in Timor-Leste, a substantial proportion of whom have evidence of diabetic retinopathy. This is consistent with regional estimates. With the majority of patients undiagnosed, and management of people known to have diabetes largely inadequate, point-of-care testing is a valuable tool to assist with diabetes case detection and management. Whilst only a preliminary estimate, our data provides

Variations in daily quality assurance dosimetry from device levelling, feet position and backscatter material

International Nuclear Information System (INIS)

Ceylan, Abdurrahman; Cullen, Ashley; Butson, Martin; Yu, Peter K.N.; Alnawaf, Hani

2012-01-01

Daily quality assurance procedures are an essential part of radiotherapy medical physics. Devices such as the Sun Nuclear, DQA3 are effective tools for analysis of daily dosimetry including flatness, symmetry, energy, field size and central axis radiation dose measurement. The DQA3 can be used on the treatment couch of the linear accelerator or on a dedicated table/bed for superficial and orthovoltage x-ray machines. This device is levelled using its dedicated feet. This work has shown that depending on the quantity of backscatter material behind the DQA3 device, the position of the levelling feet can affect the measured central axis dose by up to 1.8 % (250 kVp and 6 MV) and that the introduction of more backscatter material behind the DQA3 can lead to up to 7.2 % (6 MV) variations in measured central axis dose. In conditions where no backscatter material is present, dose measurements can vary up to 1 %. As such this work has highlighted the need to keep the material behind the DQA3 device constant as well as maintaining the accuracy of the feet position on the device to effectively measure the most accurate daily constancy achievable. Results have also shown that variations in symmetry and energy calculations of up to 1 % can occur if the device is not levelled appropriately. As such, we recommend the position of the levelling feet on the device be as close as possible to the device so that a constant distance is kept between the DQA3 and the treatment couch and thus minimal levelling variations also occur. We would also recommend having no extra backscattering material behind the DQA3 device during use to minimise any variations which might occur from these backscattering effects.

Persistent and late occurring lesions in irradiated feet of rats: their clinical relevance

International Nuclear Information System (INIS)

Hopewell, J.W.

1982-01-01

Radiation-induced deformity, as characterized by tissue loss, has been investigated in rat feet. The acute epithelial response and the loss of deeper tissues occur concomitantly after irradiation. The greatest loss of tissue (severe deformity) was produced in feet where the healing of the epithelial reaction was greatly delayed. While deformity will clearly continue to ''persist'' after the acute reaction has healed it is misleading to refer to this lesion as ''late'' damage. A late-occurring lesion, not previously described in the literature, can be produced in the rat foot by high doses of radiation delivered in such a way that moist desquamation is avoided, i.e. by extending the total treatment time. Parallels are drawn between reactions in rodents and those in the skin of pig and man. (author)

Determination of Efficacy of Reflexology in Managing Patients with Diabetic Neuropathy: A Randomized Controlled Clinical Trial

OpenAIRE

Dalal, Krishna; Maran, V. Bharathi; Pandey, Ravindra M.; Tripathi, Manjari

2014-01-01

Background. The restricted usage of existing pharmacological methods which do not seem to provide the treatment of diabetic neuropathy may lead to exploring the efficacy of a complementary therapy. In this context, this paper was devoted to evaluate the efficacy of foot reflexology. This health science works on the hypothesis that the dysfunctional states of body parts could be identified by observing certain skin features and be rectified by stimulating certain specific areas mapped on feet....

Brief Report: The Relationship of Parental Support and Conflict to Physical Activity in Preadolescents with Type 1 Diabetes

OpenAIRE

Mackey, Eleanor Race; Streisand, Randi

2008-01-01

Objective To use structural equation modeling to provide a preliminary examination of the relationship between parental support and conflict regarding physical activity behaviors in preadolescents with type 1 diabetes. Method Parent–child dyads (n = 85, M child age = 10.8) completed physical activity items from the Diabetes Family Behavior Scale, Diabetes Related Conflict Scale, and Self-Care Inventory. Children completed physical activity items from the Center for Disease Control's Youth Ris...

Hypoglycemic activity of Cassia javanica Linn. in normal and streptozotocin-induced diabetic rats

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Urmila C Kumavat

2012-01-01

Full Text Available In present work, one of the ornamentals and medicinally less known plant Cassia javanica has been explored for hypoglycemic potential. It aimed to check the hypoglycemic effect of C. javanica leaves on normal and streptozotocin (STZ-induced diabetic rats by acute and sub-acute studies. Prior to the hypoglycemic study, acute oral toxicity testing of drug was performed. Later, the effects of single and multiple doses of test drug were studied using various parameters. Dried powdered leaf material was used as an oral drug. The preliminary phytochemistry of drug was done by standard qualitative tests. Diabetes was induced in rats by single intraperitoneal injection of STZ. Single and multiple doses of test drug (0.5 g/kg body weight/day were given to normal and diabetic rats. The parameters studied were blood glucose, serum cholesterol, serum triglycerides, and serum proteins. The results of test drug were compared with standard hypoglycemic drug-glibenclamide (0.01 g/kg/day. Statistical analysis was done by ′Student′s ′t′ test′ and one way ANOVA test. In preliminary phytochemistry, antidiabetic compounds were detected. Unlike acute, subacute treatment of test drug showed highly significant reduction (37.62% in blood glucose level of diabetic rats in ten days. This effect was considerably good in comparison with standard drug (63.51%. The test drug and standard drug exhibited insignificant change in the abnormal levels of serum metabolites of diabetic rats. Preclinically, C. javanica was proved to be effective hypoglycemic agent.

Social Media as a Platform for Information About Diabetes Foot Care: A Study of Facebook Groups.

Science.gov (United States)

Abedin, Tasnima; Al Mamun, Mohammad; Lasker, Mohammad A A; Ahmed, Syed Walid; Shommu, Nusrat; Rumana, Nahid; Turin, Tanvir C

2017-02-01

Diabetes is one of the most challenging chronic health conditions in the current era. Diabetes-related foot problems need proper patient education, and social media could a play role to disseminate proper information. A systematic search was performed on Facebook groups using the key words "diabetes foot care", "diabetes foot", "diabetes foot management" and "podiatric care". The search resulted in 57 groups and detailed activity information was collected from those groups. Usefulness of each relevant post was determined. Regression analysis was performed to explore the factors associated with the level of usefulness of diabetes foot care-related Facebook groups. Our search resulted in a total of 16 eligible diabetes foot care-related Facebook groups with a total of 103 eligible posts. The average number of group members for the selected groups were 265.75 with an interquartile range of 3.5-107.75. Of the total 103 timeline posts, 45.6% posts were categorized as useful, while the remaining posts were not useful. Top mentioned diabetes foot care practice was "Checking feet daily". Multivariable logistic regression analysis showed that the level of usefulness of diabetes foot care-related Facebook groups were significantly associated with the type of posts and no association was found with presence of "likes" and presence of comment. Facebook being a widely used social networking system, patient welfare organizations, doctors, nurses and podiatrists could use this platform to provide support to educating diabetes patients and their caregivers by disseminating useful and authentic knowledge and information related to diabetes foot care. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Variability of morphometric parameters of feet in various forms of lower extremities

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Konnova O.V.

2014-12-01

Full Text Available Purpose: to identify the various forms of lower extremities variability of linear and angular parameters of feet in girls aged 17-19 years. Material and Methods. The object of the study included 242 students from Saratov State Medical University, 17—19 years. Foot digital plantography photometric device-software complex «Plantvizor» and measuring distances between sibling points of lower extremities to highlight their forms have been used as a method of research. Results. 8 forms of lower extremities, among which half per cent occurs in isolated form, valgus-direct from the mil-lennim clearance opening and a trapezoidal shape of lower extremities varus. In all forms of lower extremities morphometric parameters of feet and ratio of statistically significant differences in various forms of lower extremities have been studied. Conclusion. Anatomical basis for operational adjustment of axial disorders of tibiae and its influence on morphofunctional state of foot can be resulted from the study.

Detecting intrinsic muscle weakness of the hallux as an addition to early-stage screening of the feet in patients with diabetes

NARCIS (Netherlands)

Mahieu, R.; Coenen, M. N. O.; van Bemmel, T.; van der Zaag-Loonen, H. J.; Theuvenet, W. J.

Aims: Present-day screening of the diabetic foot involves the Semmes Weinstein Monofilament Test for evaluating loss of sensibility, while testing for intrinsic muscle weakness is not implied. Just as with the early detection of sensibility loss, early detection of intrinsic muscle weakness might

Easier operation and similar power of 10 g monofilament test for screening diabetic peripheral neuropathy.

Science.gov (United States)

Zhang, Qi; Yi, Na; Liu, Siying; Zheng, Hangping; Qiao, Xiaona; Xiong, Qian; Liu, Xiaoxia; Zhang, Shuo; Wen, Jie; Ye, Hongying; Zhou, Linuo; Li, Yiming; Hu, Renming; Lu, Bin

2018-01-01

Objective The 10 g Semmes-Weinstein monofilament evaluation (SWME) of 4 sites on each foot is recommended for distal symmetric polyneuropathy screening and diagnosis. A similar method has been proposed to diagnose 'high-risk' (for ulceration) feet, using 3 sites per foot. This study compared the effectiveness of SWME for testing 3, 4 and 10 sites per foot to identify patients with diabetic neuropathy. Methods We included 3497 subjects in a SWME of 10 sites; records from the 10-site SWME were used for a SWME of 3 and 4 sites. Neuropathy symptom scores and neuropathy deficit scores were evaluated to identify patients with diabetic peripheral neuropathy. Results The sensitivities of the 10 g SWME for 3, 4 and 10 sites were 17.8%, 19.0% and 22.4%, respectively. The Kappa coefficients for the SWME tests of 3, 4 and 10 sites were high (range: 0.78-0.93). Conclusions There were no significant differences in the effectiveness of 3-, 4- and 10-site SWME testing for diabetic peripheral neuropathy screening. SWME testing of 3 sites on each foot may be sufficient to screen for diabetic neuropathy.

Modeling and analysis of passive dynamic bipedal walking with segmented feet and compliant joints

Science.gov (United States)

Huang, Yan; Wang, Qi-Ning; Gao, Yue; Xie, Guang-Ming

2012-10-01

Passive dynamic walking has been developed as a possible explanation for the efficiency of the human gait. This paper presents a passive dynamic walking model with segmented feet, which makes the bipedal walking gait more close to natural human-like gait. The proposed model extends the simplest walking model with the addition of flat feet and torsional spring based compliance on ankle joints and toe joints, to achieve stable walking on a slope driven by gravity. The push-off phase includes foot rotations around the toe joint and around the toe tip, which shows a great resemblance to human normal walking. This paper investigates the effects of the segmented foot structure on bipedal walking in simulations. The model achieves satisfactory walking results on even or uneven slopes.

Optimal conditions for obtaining collagen from chicken feet and its characterization

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Íris Braz da Silva ARAÚJO

2018-04-01

Full Text Available Abstract The objective of this study was to extract collagen from chicken feet, determining optimal extraction conditions according to acetic acid concentration, pepsin content and time of enzymatic hydrolysis. A factorial design 23 was used, with three replications at the central point, totaling 11 experiments. The response variable studied was the collagen content of the isolate obtained. In addition to the optimization, the characterization of the isolates with higher and lower collagen content, in relation to the amino acid profile, electrophoretic profile, peptide hydrophobicity and functional properties, such as water solubility, water retention capacity and emulsifying activity, were carried out. The proposed model was statistically significant, with conditions of higher collagen content of 0.3 mol/L of acetic acid, 0.2% of pepsin and 12 hours of hydrolysis. The collagen isolate under these conditions showed higher iminoacids content, higher sum of peptide areas, higher solubility in water and water retention at 60 °C. The treatment with lower collagen content showed high emulsifying activity. The collagen isolate of the chicken feet presented characteristics makes it suitable for application in the food industry.

Preliminary bathymetry of Blackstone Bay and Neoglacial changes of Blackstone Glaciers, Alaska

Science.gov (United States)

Post, Austin

1980-01-01

Preliminary bathymetry (at 1:20,000 scale) and scientific studies of Blackstone Bay Alaska, by the Research Vessel Growler in 1978 disclose that the head of the bay consists of two basins separated by Willard Island and a submarine ridge. Both basins are closed on the north by terminal-moraine bars where Blackstone Glacier and its tributaries terminated as recently as about A.D. 1350; a carbon-14 date of 580 years before present on Badger Point, and old trees farther up the bay, disclose that the glaciers retreated to two narrow inlets at the head of the bay before 1400. The inlets were still glacier-covered until at least 1909. Glaciers in both inlets have continued to retreat; at present they terminate at the head of tidewater, where they discharge small icebergs. Only relatively thin sediments have accumulated in the eastern basin south of the terminal-moraine bar, and most of the bottom is hard and irregular as disclosed by soundings and profiles. The northern part of Blackstone Bay is very deep; at more than 1,100 feet below sea level a large, level accumulation of sediment is present which is presumably as much as 1,000 feet deep and has been accumulating since late Pleistocene glaciers retreated. (USGS)

Allogeneic epidermal substitutes in the treatment of chronic diabetic leg and foot ulcers

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Andrea Marchesi

2014-09-01

Full Text Available Aim: Diabetic foot ulcers are the most common cause of nontraumatic lower extremity amputations in the industrialized world. Tissue-engineering products offer a lower extremity salvage strategy when healing does not proceed according to the standard of care. New allogeneic sheets are available for the management of diabetic leg and foot ulcers. Methods: The endpoints of this case series study regard preliminary outcomes of the application of allogeneic keratinocytes composed of benzyl ester of hyaluronic acid to 16 diabetic foot and leg ulcers in 11 patients with type 2 diabetes mellitus. Results: Between 21 and 70 days after cellular therapy, 6 out of 16 lesions were completely healed, reducing the wound dimension by 70% and improving the wound bed score by 52%. Conclusion: The clinical results of the new allogeneic sheets indicate that allogeneic keratinocytes may represent an effective and safe therapy for diabetic foot and leg ulcers in the multidisciplinary approach to this diabetes-related complication.

Obesity, diabetes, hypertension, and vegetarian status among Seventh-Day Adventists in Barbados: preliminary results.

Science.gov (United States)

Brathwaite, Noel; Fraser, Henry S; Modeste, Naomi; Broome, Hedy; King, Rosaline

2003-01-01

A population-based sample of Seventh-Day Adventists was studied to determine the relationship between vegetarian status, body mass index (BMI), obesity, diabetes mellitus (DM), and hypertension, in order to gain a better understanding of factors influencing chronic diseases in Barbados. A systematic sampling from a random start technique was used to select participants for the study. A standard questionnaire was used to collect data on demographic and lifestyle characteristics, to record anthropometrics and blood pressure measurements, and to ascertain the hypertension and diabetes status of participants. The sample population consisted of 407 Barbadian Seventh-Day Adventists (SDAs), who ranged in age from 25 to 74 years. One hundred fifty-three (37.6%) participants were male, and 254 (62.4%) were female, and 43.5% were vegetarians. The prevalence rates of diabetes and hypertension were lower among long-term vegetarians, compared to non-vegetarians, and long-term vegetarians were, on average, leaner than non-vegetarians within the same cohort. A significant association was observed between a vegetarian diet and obesity (vegetarian by definition P=.04, self-reported vegetarian P=.009) in this population. Other components of the study population lifestyle should be further analyzed to determine the roles they may plan in lessening the prevalence rates of obesity, diabetes, and hypertension.

Text Mining of the Classical Medical Literature for Medicines That Show Potential in Diabetic Nephropathy

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Lei Zhang

2014-01-01

Full Text Available Objectives. To apply modern text-mining methods to identify candidate herbs and formulae for the treatment of diabetic nephropathy. Methods. The method we developed includes three steps: (1 identification of candidate ancient terms; (2 systemic search and assessment of medical records written in classical Chinese; (3 preliminary evaluation of the effect and safety of candidates. Results. Ancient terms Xia Xiao, Shen Xiao, and Xiao Shen were determined as the most likely to correspond with diabetic nephropathy and used in text mining. A total of 80 Chinese formulae for treating conditions congruent with diabetic nephropathy recorded in medical books from Tang Dynasty to Qing Dynasty were collected. Sao si tang (also called Reeling Silk Decoction was chosen to show the process of preliminary evaluation of the candidates. It had promising potential for development as new agent for the treatment of diabetic nephropathy. However, further investigations about the safety to patients with renal insufficiency are still needed. Conclusions. The methods developed in this study offer a targeted approach to identifying traditional herbs and/or formulae as candidates for further investigation in the search for new drugs for modern disease. However, more effort is still required to improve our techniques, especially with regard to compound formulae.

Spectrally optimal illuminations for diabetic retinopathy detection in retinal imaging

Science.gov (United States)

Bartczak, Piotr; Fält, Pauli; Penttinen, Niko; Ylitepsa, Pasi; Laaksonen, Lauri; Lensu, Lasse; Hauta-Kasari, Markku; Uusitalo, Hannu

2017-04-01

Retinal photography is a standard method for recording retinal diseases for subsequent analysis and diagnosis. However, the currently used white light or red-free retinal imaging does not necessarily provide the best possible visibility of different types of retinal lesions, important when developing diagnostic tools for handheld devices, such as smartphones. Using specifically designed illumination, the visibility and contrast of retinal lesions could be improved. In this study, spectrally optimal illuminations for diabetic retinopathy lesion visualization are implemented using a spectrally tunable light source based on digital micromirror device. The applicability of this method was tested in vivo by taking retinal monochrome images from the eyes of five diabetic volunteers and two non-diabetic control subjects. For comparison to existing methods, we evaluated the contrast of retinal images taken with our method and red-free illumination. The preliminary results show that the use of optimal illuminations improved the contrast of diabetic lesions in retinal images by 30-70%, compared to the traditional red-free illumination imaging.

Postural stability effects of random vibration at the feet of construction workers in simulated elevation.

Science.gov (United States)

Simeonov, P; Hsiao, H; Powers, J; Ammons, D; Kau, T; Amendola, A

2011-07-01

The risk of falls from height on a construction site increases under conditions which degrade workers' postural control. At elevation, workers depend heavily on sensory information from their feet to maintain balance. The study tested two hypotheses: "sensory enhancement"--sub-sensory (undetectable) random mechanical vibrations at the plantar surface of the feet can improve worker's balance at elevation; and "sensory suppression"--supra-sensory (detectable) random mechanical vibrations can have a degrading effect on balance in the same experimental settings. Six young (age 20-35) and six aging (age 45-60) construction workers were tested while standing in standard and semi-tandem postures on instrumented gel insoles. The insoles applied sub- or supra-sensory levels of random mechanical vibrations to the feet. The tests were conducted in a surround-screen virtual reality system, which simulated a narrow plank at elevation on a construction site. Upper body kinematics was assessed with a motion-measurement system. Postural stability effects were evaluated by conventional and statistical mechanics sway measures, as well as trunk angular displacement parameters. Analysis of variance did not confirm the "sensory enhancement" hypothesis, but provided evidence for the "sensory suppression" hypothesis. The supra-sensory vibration had a destabilizing effect, which was considerably stronger in the semi-tandem posture and affected most of the sway variables. Sensory suppression associated with elevated vibration levels on a construction site may increase the danger of losing balance. Construction workers at elevation, e.g., on a beam or narrow plank might be at increased risk of fall if they can detect vibrations under their feet. To reduce the possibility of losing balance, mechanical vibration to supporting structures used as walking/working surfaces should be minimized when performing construction tasks at elevation. Published by Elsevier Ltd.

Elastic-Plastic Nonlinear Response of a Space Shuttle External Tank Stringer. Part 1; Stringer-Feet Imperfections and Assembly

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Knight, Norman F., Jr.; Song, Kyongchan; Elliott, Kenny B.; Raju, Ivatury S.; Warren, Jerry E.

2012-01-01

Elastic-plastic, large-deflection nonlinear stress analyses are performed for the external hat-shaped stringers (or stiffeners) on the intertank portion of the Space Shuttle s external tank. These stringers are subjected to assembly strains when the stringers are initially installed on an intertank panel. Four different stringer-feet configurations including the baseline flat-feet, the heels-up, the diving-board, and the toes-up configurations are considered. The assembly procedure is analytically simulated for each of these stringer configurations. The location, size, and amplitude of the strain field associated with the stringer assembly are sensitive to the assumed geometry and assembly procedure. The von Mises stress distributions from these simulations indicate that localized plasticity will develop around the first eight fasteners for each stringer-feet configuration examined. However, only the toes-up configuration resulted in high assembly hoop strains.

Treating infected diabetic wounds with superoxidized water as anti-septic agent: a preliminary experience

International Nuclear Information System (INIS)

Hadi, S.F.; Khaliq, T.; Zubair, M.; Saaiq, M.; Sikandar, I.

2007-01-01

To evaluate the effectiveness of superoxidized water (MicrocynTM) in diabetic patients with different wounds. One hundred known diabetic patients were enrolled. Half were randomized to the intervention group (those whose wounds were managed with superoxidized water) and half to the control group (whose wounds were treated with normal saline) using a table of random numbers. The two groups were matched for age, gender, duration of diabetes and category of wound. All patients received appropriate surgical treatment for their wounds as required. Local wound treatment was carried out daily using superoxidized water soaked gauzes on twice daily basis in the intervention group and normal saline in the control group. The treatment was continued until wound healing. The main outcome measures were duration of hospital stay, downgrading of the wound category, wound healing time and need for interventions such as amputation. Statistically significant differences were found in favour of the superoxidized water group with respect to duration of hospital stay, downgrading of the wound category and wound healing time. Although the initial results of employing superoxidized water for the management of infected diabetic wounds are encouraging, further multicentre clinical trials are warranted before this antiseptic is recommended for general use. It may offer an economical alternative to other expensive antiseptics with positive impact on the prevailing infection rates, patient outcomes and patient satisfaction. (author)

Congenital malformations of hands and feet in Smith-Lemli-Opitz syndrome

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N. A. Kovalenko-Klychkova

2013-01-01

Full Text Available Smith-Lemli-Opitz syndrome is rare genetic disorder with multiple limb malformations and neurological manifestation, caused by inborn defect of cholesterol metabolism. Congenital deformities of feet and hands are most common orthopedic symptoms in this syndrome. Description of a girl with Smith-Lemli-Opitz syndrome demonstrates specific features of this disorder and emphasize the importance of proper interpretation of orthopedic malformations for early diagnosis of genetic conditions.

A High Percentage of Beef Bull Pictures in Semen Catalogues Have Feet and Lower Legs that Are Not Visible

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Marcy K. Franks

2015-07-01

Full Text Available A total of 1379 beef bull pictures were surveyed to determine visibility of feet and legs from four American semen company websites. Five different breeds were represented: Angus, Red Angus, Hereford (polled and horned, Simmental, and Charolais. In addition to visibility, data on other variables were collected to establish frequencies and correlations. These included breed, color, material that obscured visibility, such as grass, picture taken at livestock show or outside, semen company, photographer, video, and age of bull. A foot and leg visibility score was given to each bull picture. Only 19.4% of the pictures had fully visible feet and legs. Both the hooves and dewclaws were hidden on 32.5% of the pictures. Correlation between bull’s birthdate and the first four visibility scores was statistically significant (P < 0.0001. As age increased the feet and legs were more likely to be visible in the bull’s picture. This may possibly be due to greater availability of both photo editing software and digital photography. One positive finding was that 6% of the bulls had a video of the bull walking which completely showed his feet and legs.

Knowledge, attitude, and practice of foot care in patients with diabetes at central rural India

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Bharati Amar Taksande

2017-01-01

Full Text Available Introduction: Diabetic foot syndrome is one of the common and most devastating preventable complications of diabetes mellitus (DM. It is associated with morbidity and premature mortality due to long-term complications affecting foot. The American Diabetes Association recommends that people with diabetes should have a comprehensive foot examination once per year. Most of the foot problems can be prevented with careful foot care. It may take effort and time to build up good foot care habits, but self-care is essential. Aim: The main aim of the study is to analyze the knowledge, attitude, and practice of foot care in patients with DM in central rural India. Methodology: This study was conducted at a rural educational hospital in central part of India over 200 patients who have Type 1 and Type 2 diabetes. They were evaluated for their knowledge about foot care and footwear practices. A structured and validated questionnaire was administered to cases. Results: Around 82.9% of the patients were aware of the disease and 23.2% were aware of the complications of the DM. In 63% of the patients, foot care examination and education regarding foot complications were not suggested by their treating physicians. Annual examination of feet by the physician and self-examination were not known facts to the diabetic population. Conclusion: It is necessary to firstly develop awareness of diabetes mellitus and the related complications, one amongst which is foot care. Certain educational strategies should be established for both the consultant physician and also the common man to create awareness for effective foot care.

Preliminary Results of the Influence of Duodenojejunal Bypass in a Porcine Model of Streptozotocin-Induced Diabetes Mellitus.

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Hiridis, S; Konstantinidis, K; Menenakos, E; Diamantis, Th; Papalois, A; Zografos, G

2016-04-01

Type 2 diabetic obese patients present with a normalization of plasma glucose levels shortly after most bariatric procedures, before any significant weight loss takes place. There is only scarce literature in the new field of metabolic surgery, with most experiments being performed on small animal models. Our aim is to develop a reliable large animal model for assessment of surgical correction of diabetes. Titrated doses of streptozotocin (STZ) were used for induction of diabetes mellitus. After standardization of the surgical technique to avoid any restrictive component, three groups were created, a duodenojejunal bypass (DJB; n = 4), a gastroileal conduit (GIC; n = 3) near the ileocecal valve, and a sham (control; n = 5) group. Preoperative and postoperative glycemic curves were recorded by means of intravenous glucose tolerance tests. Body weight fluctuations were recorded as well. Diabetes was successfully induced with the use of STZ in all cases. Animals in the sham group remained diabetic for 3 weeks after operation. There was normalization of blood glucose levels in the operative groups during the 3-week postoperative follow-up, without significant body weight changes. The duodenojejunal group resulted in stronger positive response of glycemia. STZ-induced diabetes in swine leads to a reliable large animal model for assessment of metabolic surgical procedures. STZ is an effective but highly toxic means for inducing stable diabetes in the sensitive porcine model. Duodenojejunal bypass, although less invasive, seems to exert better antidiabetic effects than gastroileal conduit.

A comparison of foot kinematics in people with normal- and flat-arched feet using the Oxford Foot Model.

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Levinger, Pazit; Murley, George S; Barton, Christian J; Cotchett, Matthew P; McSweeney, Simone R; Menz, Hylton B

2010-10-01

Foot posture is thought to influence predisposition to overuse injuries of the lower limb. Although the mechanisms underlying this proposed relationship are unclear, it is thought that altered foot kinematics may play a role. Therefore, this study was designed to investigate differences in foot motion between people with normal- and flat-arched feet using the Oxford Foot Model (OFM). Foot posture in 19 participants was documented as normal-arched (n=10) or flat-arched (n=9) using a foot screening protocol incorporating measurements from weightbearing antero-posterior and lateral foot radiographs. Differences between the groups in triplanar motion of the tibia, rearfoot and forefoot during walking were evaluated using a three-dimensional motion analysis system incorporating a multi-segment foot model (OFM). Participants with flat-arched feet demonstrated greater peak forefoot plantar-flexion (-13.7° ± 5.6° vs -6.5° ± 3.7°; p=0.004), forefoot abduction (-12.9° ± 6.9° vs -1.8° ± 6.3°; p=0.002), and rearfoot internal rotation (10.6° ± 7.5° vs -0.2°± 9.9°; p=0.018) compared to those with normal-arched feet. Additionally, participants with flat-arched feet demonstrated decreased peak forefoot adduction (-7.0° ± 9.2° vs 5.6° ± 7.3°; p=0.004) and a trend towards increased rearfoot eversion (-5.8° ± 4.4° vs -2.5° ± 2.6°; p=0.06). These findings support the notion that flat-arched feet have altered motion associated with greater pronation during gait; factors that may increase the risk of overuse injury. Copyright © 2010 Elsevier B.V. All rights reserved.

Ponseti's manipulation in neglected clubfoot in children more than 7 years of age: a prospective evaluation of 25 feet with long-term follow-up.

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Khan, Shah Alam; Kumar, Ashok

2010-09-01

We wanted to evaluate the efficacy of Ponseti's technique in neglected clubfoot in children more than 7 years of age. The results of Ponseti's method were evaluated in 21 children (25 feet) with neglected club feet. Patients were evaluated using the Dimeglio scoring system. All patients underwent percutaneous tenotomy of the Achilles tendon. The mean age at the time of treatment was 8.9 years. The mean follow-up period was 4.7 years. The average Dimeglio score at the start of the treatment was 14.2 compared with an average score of 0.95 at the end of the treatment at 1-year follow-up. Eighteen feet (85.7%) had full correction. Recurrence was seen in six feet (24%). At 4-year follow-up, the average Dimeglio score for 19 feet was 0.18. We recommend that Ponseti's method should be the preferred initial treatment modality for neglected clubfeet.

Tuberculosis of the joints of the hands and feet

International Nuclear Information System (INIS)

Eckel, H.; Duee, K.

1985-01-01

Eighty-nine patients with tuberculosis of joints in the hands or feet have been examined. There has been a change in the peak incidence from adolescence to adult life. The high number of incorrect diagnoses was remarkable (45% in our own patients). A previous tuberculous infection was found in 40% of the patients. Osteoporosis, or bone atrophy, are important radiological signs for the early diagnosis and follow-up of articular tuberculosis. The later phase is characterised by narrowing of joint spaces. Later still there is destruction of subchondral lamellae and fusion of the carpal and tarsal bones, resulting in changes of shape and position. (orig.) [de

The Hands and Feet of the Child: Towards a Philosophy of Habilitation

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Anthamatten, Eric

2012-01-01

Much of the history of philosophy has deployed the metaphor of sight over and above language of tactility and feeling. The body, the flesh, the hands and feet are seen as impediments to reason's upward journey towards the pure "light" of truth. But it is precisely these tactile points of contact with the world where knowledge and action begins and…

feets: feATURE eXTRACTOR for tIME sERIES

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Cabral, Juan; Sanchez, Bruno; Ramos, Felipe; Gurovich, Sebastián; Granitto, Pablo; VanderPlas, Jake

2018-06-01

feets characterizes and analyzes light-curves from astronomical photometric databases for modelling, classification, data cleaning, outlier detection and data analysis. It uses machine learning algorithms to determine the numerical descriptors that characterize and distinguish the different variability classes of light-curves; these range from basic statistical measures such as the mean or standard deviation to complex time-series characteristics such as the autocorrelation function. The library is not restricted to the astronomical field and could also be applied to any kind of time series. This project is a derivative work of FATS (ascl:1711.017).

A Modified Behavior Risk Factor Surveillance System to Assess Diabetes Self-management Behaviors and Diabetes Care in Monterrey Mexico: A Cross-sectional Study

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Francisco González-Salazar

2017-05-01

Full Text Available Type 2 diabetes mellitus (T2DM is one of the leading causes of death from worldwide non-communicable diseases. The prevalence of diabetes in the Mexico (MX–United States border states exceeds the national rate in both countries. The economic burden of diabetes, due to decreased productivity, disability, and medical costs, is staggering and increases significantly when T2DM-related complications occur. The purpose of this study was to use a modified behavioral risk factor surveillance system (BRFSS to describe the T2DM self-management behaviors, diabetes care, and health perception of a convenience sample of adults with T2DM in Monterrey, MX. This cross-sectional study design, with convenience sampling, was conducted with a convenience sample (n = 351 of adults in the metropolitan area of Monterrey, MX who self-reported a diagnosis of T2DM. Potential participants were recruited from local supermarkets. Twenty-six diabetes and health-related items were selected from the BRFSS and administered in face-to-face interviews by trained data collectors. Data analysis was conducted using descriptive statistics. The mean age was 47 years, and the mean length of time with T2DM was 12 years. The majority was taking oral medication and 34% required insulin. Daily self-monitoring of feet was performed by 56% of the participants; however, only 8.8% engaged in blood glucose self-monitoring. The mean number of health-care provider visits was 9.09 per year, and glycated hemoglobin level (HbA1c was assessed 2.6 times per year. Finally, only 40.5% of the participants recalled having a dilated eye exam. We conclude the modified BRFSS survey administered in a face-to-face interview format is an appropriate tool for assessing engagement in T2DM self-management behaviors, diabetes care, and health perception. Extension of the use of this survey in a more rigorous design with a larger scale survey is encouraged.

Foot examinations of diabetes patients by primary health care nurses in Auckland, New Zealand.

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Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Stewart, Alistair; Scragg, Robert

2014-07-01

To identify factors associated with patients receiving foot examinations by primary health care nurses. A cross-sectional survey of 287 randomly sampled primary health care nurses, from a total of 1091 in Auckland, completed a postal self-administered questionnaire and telephone interview. Biographical and diabetes management details were collected for 265 diabetes patients consulted by the nurses on a randomly selected day. A response rate of 86% was achieved. Nurses examined patient's feet in 46% of consultations. Controlling for demographic variables, foot examinations were associated with age, odds ratio (1.25, 95% CI 0.57-2.74) for patients aged 51-65 years and >66 years (2.50, 1.08-5.75) compared with those ≤50 years, consultations by district compared with practice nurses (14.23, 95% CI 3.82-53.05), special programme consultations compared with usual follow-up consults (8.81, 95% CI 2.99-25.93) and length of consultation (1.89, 0.72-4.97) for 15-30 min and (4.45, 95% CI 1.48-13.41) >30 min compared with consultations ≤15 min, or for wound care (2.58, 1.01-6.61). Diabetes foot examinations by primary health care nurses varies greatly, and are associated with characteristics of the patient (age, need for wound care) and the consultation (district nurses, diabetes programme and duration). Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Bone marrow changes on STIR MR images of asymptomatic feet and ankles

International Nuclear Information System (INIS)

Zubler, Veronika; Mengiardi, Bernard; Pfirrmann, Christian W.A.; Duc, Sylvain R.; Schmid, Marius R.; Hodler, Juerg; Zanetti, Marco

2007-01-01

The purpose of this study was to evaluate the prevalence, pattern and size of bone marrow changes on short-tau inversion recovery (STIR) magnetic resonance (MR) images of asymptomatic feet and ankles. In 78 asymptomatic volunteers (41 women, 37 men; median age 47 years; range 23-83 years) sagittal STIR MR images of hindfoot and midfoot were reviewed for various patterns of high signal changes in bone marrow. The size of these bone marrow changes was measured, and signal intensity was rated semi-quantitatively using a scale from 0 (=normal) to 10 (=fluid-like). Fifty percent (39/78) of all volunteers had at least one bone marrow change. Thirty-six percent (28/78) of all volunteers had edema-like changes, 26% (20/78) had necrosis-like changes, and 5% (4/78) had cyst-like changes. The long diameters of all changes varied between 4 mm and 16 mm (median 7.5 mm). The median signal intensity for all changes was 5.0 (range 1-10). Bone marrow changes on STIR MR images are commonly detected in asymptomatic feet and ankles. However, such changes tend to be small (<1 cm) or subtle. (orig.)

Protein Glycation in Diabetes as Determined by Mass Spectrometry

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Annunziata Lapolla

2013-01-01

Full Text Available Diabetes is a common endocrine disorder characterized by hyperglycemia leading to nonenzymatic glycation of proteins, responsible for chronic complications. The development of mass spectrometric techniques able to give highly specific and reliable results in proteome field is of wide interest for physicians, giving them new tools to monitor the disease progression and the possible complications related to diabetes, as well as the effectiveness of therapeutic treatments. This paper reports and discusses some of the data pertaining protein glycation in diabetic subjects obtained by matrix-assisted laser desorption ionization (MALDI mass spectrometry (MS. The preliminary studies carried out by in vitro protein glycation experiments show clear differences in molecular weight of glycated and unglycated proteins. Then, the attention was focused on plasma proteins human serum albumin (HSA and immunoglobulin G (IgG. Enzymatic degradation products of in vitro glycated HSA were studied in order to simulate the in vivo enzymatic digestion of glycated species by the immunological system leading to the highly reactive advanced glycation end-products (AGEs peptides. Further studies led to the evaluation of glycated Apo A-I and glycated haemoglobin levels. A different MALDI approach was employed for the identification of markers of disease in urine samples of healthy, diabetic, nephropathic, and diabetic-nephropathic subjects.

[Predisposition and phenotypes of gestational diabetes].

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Kleinwechter, H; Demandt, N; Schäfer-Graf, U

2014-05-01

Gestational diabetes (GDM) is defined as glucose intolerance first diagnosed with a 75 gram oral glucose tolerance test based on IADPSG criteria which had been recently adopted by WHO. In industrial countries GDM is one of the most frequent pregnancy complications. In 2012, in Germany GDM had been diagnosed in 4,3 % of all births, overall 27,700 cases. GDM has to be considered as a preliminary stage of type 2 diabetes with insulin resistance and inadequate β-cell-compensation. Additionally, adverse metabolic profile, associations with inflammatory parameters, with D vitamin metabolism, and insufficient decline of renal threshold for glucose had been identified in women with GDM. Within 10 years after GDM roughly 50 % of the women convert to overt diabetes, mostly type 2. GDM and type 2 diabetes share potential candidate genes. In about 1 % of GDM in Caucasian women a mutation in glucokinase gene had been found (GCK-MODY). Predisposition to GDM is predominantly characterized by family history of diabetes, previous GDM in pregnancies, factors of metabolic syndrome, and unfavorable life style. The probability for GDM rises with increasing mother's age and preconceptional BMI. Via fetal programming GDM dispones to offspring obesity as early as school entry. Prevention of GDM focus on regular physical exercise, normalizing body weight before conception, reducing excess intake of animal protein and soft drinks, planning of pregnancy in younger ages, and avoiding pollutant exposition as well as smoking cessation. © Georg Thieme Verlag KG Stuttgart · New York.

Preliminary investigation of topical nitroglycerin formulations containing natural wound healing agent in diabetes-induced foot ulcer.

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Hotkar, Mukesh S; Avachat, Amelia M; Bhosale, Sagar S; Oswal, Yogesh M

2015-04-01

Nitroglycerin (NTG) is an organic nitrate rapidly denitrated by enzymes to release free radical nitric oxide and shows improved wound healing and tissue protection from oxidative damage. The purpose of this study was to evaluate whether topical application of NTG in the form of gel/ointment along with a natural wound healing agent, aloe vera, would bring about wound healing by using diabetes-induced foot ulcer model and rat excision wound model. All these formulations were evaluated for pH, viscosity, drug content and ex vivo diffusion studies using rat skin. Based on ex vivo permeation studies, the formulation consisting of carbopol 974p as a gelling agent and aloe vera was found to be suitable. The in vivo study used streptozotocin-induced diabetic foot ulcer and rat excision wound models to analyse wound healing activity. The wound size in animals of all treated groups was significantly reduced compared with that of the diabetic control and marketed treated animals. This study showed that the gel formed with carbopol 974p (1%) and aloe vera promotes significant wound healing and closure in diabetic rats compared with the commercial product and provides a promising product to be used in diabetes-induced foot ulcer. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Negative pressure wound therapy in patients with diabetic foot.

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Ulusal, Ali Engin; Sahin, M Sükrü; Ulusal, Betül; Cakmak, Gökhan; Tuncay, Cengiz

2011-01-01

In this study our aim was to compare the results of standard dressing treatment to negative pressure wound therapy (NPWT) performed with a vacuum-assisted closure (VAC) device in patients with diabetic foot ulcers. We assessed the results of 35 patients treated for diabetic foot ulcer between 2006 and 2008. Of these cases, 20 (4 women and 16 men; mean age: 66 years; range: 52-90 years) were treated with standard wet dressings and 16 feet in 15 patients (10 men, 5 women; mean age: 58.9 years; range: 42-83 years) with VAC therapy. The success of treatment was evaluated in terms of hospitalization length and rate of limb salvation. The average hospitalization period with VAC treatment was 32 days compared to 59 days with standard dressing treatment. All patients treated with standard dressings eventually had to undergo amputation. However, the amputation rate was 37% in the VAC treated group and 88% of patients had a functional extremity at the end of treatment. VAC therapy, together with debridement and appropriate antibiotic therapy, enables a higher rate of limb salvage, especially in Wagner Grade 3 and Grade 4 ulcers.

Studies of experimental hosiery in diabetic neuropathic patients with high foot pressures.

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Veves, A; Masson, E A; Fernando, D J; Boulton, A J

1990-05-01

High plantar pressures and painless trauma are associated with the development of foot ulcers in diabetic patients. Padded hosiery has been reported to reduce plantar pressures in patients at risk of ulceration. Using the optical pedobarograph we have studied 10 patients who regularly wore experimental padded hosiery for 6 months. The hosiery continued to provide substantial and significant reduction in peak forefoot pressures at 3 months (mean reduction 15.5%, p less than 0.01) and 6 months (17.6%, p less than 0.01), although the level of reduction was less than that seen at baseline (31.3%, p less than 0.05). In addition, commercially available hosiery designed as sportswear has been tested, and compared with experimental hosiery. Although these socks (with high or medium density padding) provided significant pressure reduction versus barefoot (mean 17.4% and 10.4%, p less than 0.01), this was not as great as that seen with experimental hosiery (27%, p less than 0.05). Thus the use of socks designed to reduce pressure stress on diabetic neuropathic feet is effective, and continues to be so for a considerable period of time. Commercially available sports socks may also have a place in the management of the diabetic insensitive foot.

Comparison of Intercuneiform 1-2 Joint Mobility Between Hallux Valgus and Normal Feet Using Weightbearing Computed Tomography and 3-Dimensional Analysis.

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Kimura, Tadashi; Kubota, Makoto; Suzuki, Naoki; Hattori, Asaki; Marumo, Keishi

2018-03-01

An association has been reported between hallux valgus and hypermobility of the first ray, but subluxation of the intercuneiform 1-2 joint was also suspected in some cases. However, dynamics of the intercuneiform 1-2 joint has seldom been investigated. This study used weightbearing computed tomography (CT) and a 3-dimensional (3D) analysis system to evaluate displacement of the intercuneiform 1-2 joint, intercuneiform 2-3 joint, and second cuneonavicular joint due to weightbearing in hallux valgus and normal feet. Patients were 11 women with hallux valgus (mean age, 56 years; mean hallux valgus angle, 43 degrees; mean first-second intermetatarsal angle, 22 degrees) and 11 women with normal feet (mean age, 57 years; mean hallux valgus angle, 14 degrees; mean first-second intermetatarsal angle, 9 degrees). Each patient was placed supine with the lower limbs extended, and CT was performed under nonweightbearing and weightbearing conditions (load equivalent to body weight). 3D models reconstructed from CT images were used to compare displacement of the intermediate cuneiform relative to the medial cuneiform under nonweightbearing and weightbearing conditions. Relative to the medial cuneiform, the middle cuneiform was displaced by 0.1 and 0.8 degrees due to dorsiflexion, 0.2 and 1.0 degrees due to inversion, and 0.7 and 0.7 degrees due to abduction in normal feet and feet with hallux valgus, respectively, with the latter having significantly greater dorsiflexion ( P = .0067) and inversion ( P = .0019). There was no significant intergroup difference at the intercuneiform 2-3 joint and second cuneonavicular joint. This study clarified the detailed load-induced displacement of the cuneiform 3-dimensionally. Compared with normal feet, hallux valgus feet had significantly greater mobility of the intercuneiform 1-2 joint, suggesting hypermobility of this joint. Level III, case-control study.

Why do the Karo Batak prefer women with big feet? Flexible mate preferences and the notion that one size fits all.

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Kushnick, Geoff

2013-09-01

Men may find women with small feet relative to body size more attractive because foot size reliably indexes nubility-i.e., age and parity. I collected judgments of attractiveness in response to drawings of women with varying foot sizes from a sample of 159 Karo Batak respondents from North Sumatra, Indonesia, as part of a collaborative project on foot size and attractiveness. The data revealed a contrarian preference among the Karo Batak for women with big feet. The judgments were compared with the results of an existing cross-cultural study that found a preference for women with small feet in aggregate, but a mix of small- and large-foot preferences in the societies taken individually. Using contingency table analysis, I found that ecology and less exposure to Western media were associated with a preference for women with big feet; patriarchal values were not. The findings suggest that human mating preferences may arise in response to local ecological conditions, and may persist and spread via cultural transmission. This has implications for the concept of universality espoused in some versions of evolutionary psychology.

Efficacy of Tribulus Terrestris Extract on the Serum Glucose and Lipids of Women with Diabetes Mellitus.

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Samani, Nasrin Babadai; Jokar, Azam; Soveid, Mahmood; Heydari, Mojtaba; Mosavat, Seyed Hamdollah

2016-05-01

Considering folkloric use of Tribulus terrestris (T. terrestris) in diabetes and proven anti-hyperglycemic and anti-hyperlipidemic effects of T. terrestris in animal studies, we aimed to evaluate the efficacy of the hydro alcoholic extract of T. terrestris on the serum glucose and lipid profile of women with diabetes mellitus. Ninety-eight diabetic women were randomly allocated to receive the T. terrestris (1000 mg/day) or placebo for three months. The patients were evaluated in terms of the fasting blood glucose, 2-hour postprandial glucose, glycosylated hemoglobin and lipid profile. T. terrestris showed a significant blood glucose lowering effect in diabetic women compared to placebo (Pterrestris group was significantly reduced compared with placebo, while no significant effect was observed in the triglyceride and high-density lipoprotein levels. This study showed preliminary promising hypoglycemic effect of T. terrestris in diabetic women.

Hyaluronic acid microneedle patch for the improvement of crow's feet wrinkles.

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Choi, Sun Young; Kwon, Hyun Jung; Ahn, Ga Ram; Ko, Eun Jung; Yoo, Kwang Ho; Kim, Beom Joon; Lee, Changjin; Kim, Daegun

2017-11-01

Hyaluronic acid (HA) has an immediate volumizing effect, due to its strong water-binding potential, and stimulates fibroblasts, causing collagen synthesis, with short- and long-term effects on wrinkle improvement. We investigated the efficacy and safety of HA microneedle patches for crow's feet wrinkles. Using a randomized spilt-face design, we compared microneedle patches with a topical application containing the same active ingredients. We enrolled 34 Korean female subjects with mild to moderate crow's feet wrinkles. The wrinkle on each side of the subject's face was randomly assigned to a HA microneedle patch or HA essence application twice a week for 8 weeks. Efficacy was evaluated at weeks 2, 4, and 8. Skin wrinkles were measured as average roughness using replica and PRIMOS. Skin elasticity was assessed using a cutometer. Two independent blinded dermatologists evaluated the changes after treatment using the global visual wrinkle assessment score. Subjects assessed wrinkles using the subject global assessment score. Skin wrinkles were significantly reduced and skin elasticity significantly increased in both groups, although improvement was greater in the patch group at week 8 after treatment. In the primary and cumulative skin irritation tests, the HA microneedle patch did not induce any skin irritation. The HA microneedle patch is more effective than the HA essence for wrinkle improvement and is a safe and convenient without skin irritation. © 2017 Wiley Periodicals, Inc.

A Comparison of Foot Plantar Pressure in Badminton Players with Normal and High-Arched Feet during the Two-Way Lunge

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Parvane Bazipoor

2017-03-01

Full Text Available Background: Compared to the individuals with a normal arch structure, those with high or low arch can be at an increased risk of overuse injuries. The risk of overuse injury among athletes is high due, in part, to the repeated loading of the lower extremities. The current study aimed to determine if foot type (high-arched or normal results in differences in plantar pressure during two badminton-specific movements (right-reverse lunge and right-lateral lunge. Methods: Twenty badminton players (10 with normal feet and 10 with higharched feet completed five trials in both right-reverse and right-lateral lunge, while in-shoe pressure data were collected at 100 Hz. The peak pressure and mean pressure were analyzed among the subjects for five major anatomical regions of the foot, using the independent t test in SPSS version 20. The foot type was determined by the foot posture index (FPI (α<0.05. Results: Results showed that the plantar pressure characteristics of normal and high-arched feet were different; such that in high-arched feet, as compared to normal subjects, there were significantly fewer pressure strikes in the medial (P=0.010 and lateral (P=0.002 mid-foot in right-reverse lunge and this was significantly higher in forefoot (P=0.003 and toes (P=0.010. However, the peak (P=0.157 and mean (P=0.104 pressure in the heel was higher but not significant. In the right- lateral lunge, we found statistically lower peak pressure stroke for the lateral mid-foot (P=0.010 and forefoot (P=0.011; however, the mean pressure was lower in the lateral (P=0.010 and medial (P=0.040 mid-foot and forefoot (P=0.120, although it was not significant in the forefoot. Conclusion: Results showed that the medial longitudinal arch of the foot might cause pressure differences in the feet among the players with normal and higharched feet. As the results demonstrated, in high-arched feet, there are some regions where plantar pressure is higher and some where it is lower

FREQUENCY DEFORMITY SCOLIOSIS AND FLAT FEET IN PUPILS III, V.VII GRADE SCHOOL

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Dejаn Gojković

2013-07-01

Full Text Available Scoliosis is a lateral deviation of the spine or the angular deviation of the normal position of one or more segmenata.Funkcional curve can be fully corrected until the internal structural scoliosis are bone disorders, muscle nerve elements that support the spine, and complete correction is impossible. Static role is reflected in the foot taking kisses body weight through the bones pop and transmission and distribution of weight on the main point of support of the foot and therefore subject to various changes in the normal foot status.Dinamic role is reflected in walking, running and jumping in different forms. Because of this, the percentage of foot disorders is particularly large in the form of lowering the testing we arche.Perform o.š.Pale Pale deformities in scoliosis and flat feet in students III, V, VII grade. Our aim was to verify the extent to which physical education classes take appropriate measures in the detection and removal of poor posture and physical deformities. For testing we used: clinical method for scoliosis, a method for flat feet -Thomson method.

Hypertension and Diabetes Mellitus: A Preliminary South African Health Promotion Activity Using Service-Learning Principles.

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Srinivas, Sunitha C; Paphitis, Sharli Anne

2016-06-01

A marked increase in the chronic non-communicable diseases such as hypertension and diabetes mellitus in the South African population is in concert with global trends. A health promotion activity carried out by pharmacy students for school learners during the Sasol National Festival of Science and Technology (SciFest) in South Africa was used as a service-learning opportunity. Pilot tested quizzes on hypertension and diabetes were used to determine the level of knowledge of attendees before and after taking the computer based quiz. Posters, information leaflets and interactive models on these two conditions were also used to reach out to the larger population. Of the 203 participants for the hypertension quiz, 169 completed both the pre- and post-intervention quizzes. Similarly, 86 of the 104 participants for the diabetes quiz, completed both the pre- and post-intervention quizzes. The results show that the post-intervention quiz resulted in a significant increase in the scores from 78.2 to 85.6 % in the case of Hypertension while a marginal increase from 94.2 to 95.5 % was obtained in the case of diabetes. The knowledge of the SciFest attendees with regard to both conditions is above average and improved further after the educational intervention. Health promotion activities which include interactive educational methods and culturally appropriate materials carried out by pharmacy students during service-learning courses are important for improving the awareness on the prevention of these chronic health conditions. Heath promotion service-learning courses can assist in addressing the health care gaps which arise because of a lack of co-ordinated efforts between NGO's and local Government to address the prevention and management of non-communicable diseases such as hypertension and diabetes mellitus.

Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial.

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Pham, H; Armstrong, D G; Harvey, C; Harkless, L B; Giurini, J M; Veves, A

2000-05-01

Diabetic foot ulceration is a preventable long-term complication of diabetes. A multicenter prospective follow-up study was conducted to determine which risk factors in foot screening have a high association with the development of foot ulceration. A total of 248 patients from 3 large diabetic foot centers were enrolled in a prospective study. Neuropathy symptom score, neuropathy disability score (NDS), vibration perception threshold (VPT), Semmes-Weinstein monofilaments (SWFs), joint mobility, peak plantar foot pressures, and vascular status were evaluated in all patients at the beginning of the study. Patients were followed-up every 6 months for a mean period of 30 months (range 6-40), and all new foot ulcers were recorded. The sensitivity, specificity, and positive predictive value of each risk factor were evaluated. Foot ulcers developed in 95 feet (19%) or 73 patients (29%) during the study. Patients who developed foot ulcers were more frequently men, had diabetes for a longer duration, had nonpalpable pedal pulses, had reduced joint mobility, had a high NDS, had a high VPT, and had an inability to feel a 5.07 SWE NDS alone had the best sensitivity, whereas the combination of the NDS and the inability to feel a 5.07 SWF reached a sensitivity of 99%. On the other hand, the best specificity for a single factor was offered by foot pressures, and the best combination was that of NDS and foot pressures. Univariate logistical regression analysis yielded a statistically significant odds ratio (OR) for sex, race, duration of diabetes, palpable pulses, history of foot ulceration, high NDSs, high VPTs, high SWFs, and high foot pressures. In addition, 94 (99%) of the 95 ulcerated feet had a high NDS and/or SWF which resulted in the highest OR of 26.2 (95% CI 3.6-190). Furthermore, in multivariate logistical regression analysis, the only significant factors were high NDSs, VPTs, SWFs, and foot pressures. Clinical examination and a 5.07 SWF test are the two most sensitive

Health care among adults with self-reported diabetes mellitus in Brazil, National Health Survey, 2013.

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Malta, Deborah Carvalho; Iser, Betine Pinto Moehlecke; Chueiri, Patricia Sampaio; Stopa, Sheila Rizzato; Szwarcwald, Celia Landmann; Schmidt, Maria Inês; Duncan, Bruce Bartholow

2015-12-01

To describe the care measurements provided to patients with self-reported diabetes mellitus in Brazil. Data from the Brazilian National Health Survey (2013) were used. This is a cross-sectional population-based study in which the subjects with self-reported diabetes mellitus answered questions concerning their use of health services and access to medicine. The prevalence of self-reported diabetes mellitus was 6.2%, while 11.5% of the population had never undergone a glucose testing. From the adults with diabetes mellitus, 80.2% had taken medications two weeks before the interview, 57.4% used the Popular Pharmacy Program, 73.2% received medical care, and 47.1% were cared for in the Health Basic Units. In 65.2%, the physician who cared for them in the last appointment was the same from previous ones, 95.3% of the patients were able to perform the required complementary examinations, and 83.3% could go to the appointments with a specialist. About 35.6 and 29.1% of the subjects with diabetes mellitus reported feet and eyes examination, respectively. About 13.4% declared previous hospitalization owing to diabetes or any complications, and 7.0% mentioned limitations in their daily activities owing to the disease. In general, women and the elderly people, those with higher education levels, white, and those living in the south and southeastern regions showed a higher prevalence of the disease and greater access to services, medicine, and appointments. The care reported by patients with diabetes, which is essential to maintain their quality of life and prevent serious outcomes, seemed, in most cases, to be adequate.

Prevalence and associated factors of diabetes mellitus in Puerto Rican adults: behavioral risk factor surveillance system, 1999.

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Pérez-Cardona, C; Pérez-Perdomo, R

2001-06-01

To estimate the self-reported weighted prevalence of diabetes mellitus among different population subgroups and determine associated factors in Puerto Rico. Data gathered from the Behavioral Risk Factor Surveillance Survey (BRFSS) during 1999 was analyzed. The weighted prevalence in Puerto Rico in 1999 was 9.6% (95% CI: 8.5%-10.7%), highest than reported nationally. It was higher among individuals with increasing age, female sex, decreasing annual income, decreasing educational attainment, being non-employed, having a health care coverage, high blood pressure, high blood cholesterol, and increasing body mass index. Health behaviors and co-morbid conditions significantly associated with diabetes among individuals aged less than 65 years were high blood pressure, high blood cholesterol, obesity and low educational attainment. However, the only significant characteristic associated with diabetes in individuals aged 65 years or more was female sex. Analysis of the data gathered in the diabetes module revealed that nearly 35% were using insulin, 57.4% were using insulin once a day, 14.4% self-monitored their blood glucose one to three times per day, 18.3% reported they have heard of the glycosylated hemoglobin test, and of these, 71.8% had their test performed between one and six times within the past year. Nearly 42% reported their feet were checked and 54.1% had a dilated eye examination last year. The high prevalence of diabetes in Puerto Rico underscores the need for developing integrated management strategies for improving quality of diabetes care.

Prenatal diagnosis of isochromosome 20q in a fetus with vertebral anomaly and rocker-bottom feet

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Aline Receveur

2017-10-01

Conclusion: The data would allow establishing a phenotype–genotype correlation. Thus, we proposed to define a recognizable syndrome combining cranio-facial dysmorphism, vertebral bodies' anomalies, feet and cerebral malformations.

Iambic Feet in Paumari and the Theory of Foot Structure

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Daniel L. Everett

2003-01-01

Full Text Available This paper analyzes stress and moraic constituencies in Paumari, an endangered language of the Arawan family of the Brazilian Amazon. It argues that Paumari feet are quantity-insensitive iambs, built from right-to-left within the prosodic word. Both of these latter claims are theoretically important because they violate some proposed universals of foot structure. The paper also discusses more general implications of the Paumari data for theories of foot size and shape, proposing two constraints on foot size, Foot Maximality and Foot Minimality, to replace the less fine-tuned constraint Foot Binarity.

DISABILITIES OF HANDS, FEET AND EYES IN NEWLY-DIAGNOSED LEPROSY PATIENTS IN EASTERN NEPAL

NARCIS (Netherlands)

SCHIPPER, A; LUBBERS, WJ; HOGEWEG, M; DESOLDENHOFF, R

The objective of the study was to determine the magnitude of hand/feet/eye disabilities in newly diagnosed leprosy patients by examining all newly diagnosed leprosy patients who presented at the Eastern Leprosy Control Project (supported by The Netherlands Leprosy Relief Association), made up of a

The effects of intradermal botulinum toxin type a injections on pain symptoms of patients with diabetic neuropathy

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Majid Ghasemi

2014-01-01

Full Text Available Background: Considering the dramatic increasing rate of diabetes and consequently its related complications, most importantly diabetic peripheral neuropathy (DPN, challenges regarding proper treatment of DPN and its effect on the quality-of-life and care of diabetic patients, the aim of this current study is to evaluate the effect of intradermal botulinum toxin type A (BTX-A injections on pain symptoms of patients with diabetic neuropathic pain. Materials and Methods: In this randomized double-blind placebo-controlled clinical trial study, diabetic patients aged <70 years with neuropathic pain in both feet were enrolled. Diabetic neuropathy (DN in selected patients was diagnosed using DN4 questionnaire and nerve conduction velocity examinations. They randomized in two intervention (BTX-A injection/100 unit, N = 20 and placebo groups (normal saline injection, N = 20. The outcome of injection on diabetic neuropathic pain was assessed using neuropathy pain scale (NPS and visual analog scale (VAS score and compared in two studied groups. Results: There was no significant difference in DN4, NPS and VAS scales of studied population after intervention in the placebo group. Intradermal injection of BTX-A reduced NPS scores for all items except cold sensation (P = 0.05. It reduced DN4 scores for electric shocks, burning, pins and needles and brushing (P < 0.05. According to VAS scale 30% and 0% of patients in intervention and placebo groups have no pain after intervention (P = 0.01. Conclusion: Intradermal injection of BTX-A is a well-tolerated agent that has a significant effect on DPN pain.

Neurotrophin-3 accelerates wound healing in diabetic mice by promoting a paracrine response in mesenchymal stem cells.

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Shen, Lei; Zeng, Wen; Wu, Yang-Xiao; Hou, Chun-Li; Chen, Wen; Yang, Ming-Can; Li, Li; Zhang, Ya-Fang; Zhu, Chu-Hong

2013-01-01

Angiogenesis is a major obstacle for wound healing in patients with diabetic foot wounds. Mesenchymal stem cells (MSCs) have an important function in wound repair, and neurotrophin-3 (NT-3) can promote nerve regeneration and angiogenesis. We investigated the effect of NT-3 on accelerating wound healing in the diabetic foot by improving human bone marrow MSC (hMSC) activation. In vitro, NT-3 significantly promoted VEGF, NGF, and BDNF secretion in hMSCs. NT-3 improved activation of the hMSC conditioned medium, promoted human umbilical vein endothelial cell (HUVEC) proliferation and migration, and significantly improved the closure rate of HUVEC scratches. In addition, we produced nanofiber mesh biological tissue materials through the electrospinning technique using polylactic acid, mixed silk, and collagen. The hMSCs stimulated by NT-3 were implanted into the material. Compared with the control group, the NT-3-stimulated hMSCs in the biological tissue material significantly promoted angiogenesis in the feet of diabetic C57BL/6J mice and accelerated diabetic foot wound healing. These results suggest that NT-3 significantly promotes hMSC secretion of VEGF, NGF, and other vasoactive factors and that it accelerates wound healing by inducing angiogenesis through improved activation of vascular endothelial cells. The hMSCs stimulated by NT-3 can produce materials that accelerate wound healing in the diabetic foot and other ischemic ulcers.

FeetForward: On Blending New Classroom Technologies into Secondary School Teachers’ Routines

OpenAIRE

An , Pengcheng; Bakker , Saskia; Eggen , Berry

2017-01-01

Part 5: Interaction at the Workplace; International audience; Secondary school teachers have complex, intensive and dynamic routines in their classrooms, which makes their attentional resources limited for human-computer interaction. Leveraging principles of peripheral interaction can reduce attention demanded by technologies and interactions could blend more seamlessly into the everyday routine. We present the design and deployment of FeetForward - an open-ended, and foot-based peripheral in...

Expression of macrophage migration inhibitory factor in footpad skin lesions with diabetic neuropathy.

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Up Noh, Sun; Lee, Won-Young; Kim, Won-Serk; Lee, Yong-Taek; Jae Yoon, Kyung

2018-01-01

Background Diabetic neuropathy originating in distal lower extremities is associated with pain early in the disease course, overwhelming in the feet. However, the pathogenesis of diabetic neuropathy remains unclear. Macrophage migration inhibitory factor has been implicated in the onset of neuropathic pain and the development of diabetes. Objective of this study was to observe pain syndromes elicited in the footpad of diabetic neuropathy rat model and to assess the contributory role of migration inhibitory factor in the pathogenesis of diabetic neuropathy. Methods Diabetic neuropathy was made in Sprague Dawley rats by streptozotocin. Pain threshold was evaluated using von Frey monofilaments for 24 weeks. On comparable experiment time after streptozotocin injection, all footpads were prepared for following procedures; glutathione assay, terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling staining, immunohistochemistry staining, real-time reverse transcription polymerase chain reaction, and Western blot. Additionally, human HaCaT skin keratinocytes were treated with methylglyoxal, transfected with migration inhibitory factor/control small interfering RNA, and prepared for real-time reverse transcription polymerase chain reaction and Western blot. Results As compared to sham group, pain threshold was significantly reduced in diabetic neuropathy group, and glutathione was decreased in footpad skin, simultaneously, cell death was increased. Over-expression of migration inhibitory factor, accompanied by low expression of glyoxalase-I and intraepidermal nerve fibers, was shown on the footpad skin lesions of diabetic neuropathy. But, there was no significance in expression of neurotransmitters and inflammatory mediators such as transient receptor potential vanilloid 1, mas-related G protein coupled receptor D, nuclear factor kappa B, tumor necrosis factor-alpha, and interleukin-6 between diabetic neuropathy group and sham group. Intriguingly

Diffuse reflectance spectroscopy for monitoring diabetic foot ulcer - A pilot study

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Anand, Suresh; Sujatha, N.; Narayanamurthy, V. B.; Seshadri, V.; Poddar, Richa

2014-02-01

Foot ulceration due to diabetes mellitus is a major problem affecting 12-25% of diabetic subjects in their lifetime. An untreated ulcer further gets infected which causes necrosis leading to amputation of lower extremities. Early identification of risk factors and treatment for these chronic wounds would reduce health care costs and improve the quality of life for people with diabetes. Recent clinical investigations have shown that a series of factors including reduced oxygen delivery and disturbed metabolism have been observed on patients with foot ulceration due to diabetes. Also, these factors can impair the wound healing process. Optical techniques based on diffuse reflectance spectroscopy provide characteristic spectral finger prints shed light on tissue oxygenation levels and morphological composition of a tissue. This study deals with the application of diffuse reflectance intensity ratios based on oxyhemoglobin bands (R542/R580), ratios of oxy- and deoxy-hemoglobin bands (R580/R555), total hemoglobin concentration and hemoglobin oxygen saturation between normal and diabetic foot ulcer sites. Preliminary results obtained are found to be promising indicating the application of reflectance spectroscopy in the assessment of foot ulcer healing.

Comparison of topical capsaicin and topical turpentine oil for treatment of painful diabetic neuropathy

International Nuclear Information System (INIS)

Musharraf, M.U.; Ahmed, Z.

2017-01-01

Background: Diabetes Mellitus is a pandemic of the modern era owing to our rapidly deteriorating lifestyle. Painful diabetic neuropathy is one of the costliest and disabling complications of diabetes mellitus. No single treatment exists to prevent or reverse neuropathic changes or to provide total pain relief. Topical Capsaicin and Turpentine Oil are found to be effective in treatment of painful diabetic neuropathy. Methods: Patients of either gender with ages between 18 and 70 years having painful diabetic neuropathy already taking one oral drug for painful neuropathy and treatment for diabetes mellitus and an HbA1C less than 8.5% were included while Pregnant or lactating mothers, patients with chronic liver disease and patients with renal insufficiency (creatinine >3.0 mg/dl) and peripheral arterial disease were excluded from study. Patients were randomly divided into two groups (A and B) using computer generated random number table. Group A was given topical application of capsaicin while Group B was given topical application of commercially available turpentine oil over painful site on feet. Results: 300 patients were equally divided in two groups. The patients in group A had a Visual Analog Pain Score of 7.91±5.10 at baseline and 5.10±1.343 after 3 months of treatment (p-value 0.0001). The patients in group B had a Visual Analog Pain Score of 7.83±1.012 at baseline and 5.20±1.187 after 3 months of treatment (p-value 0.0001). Chi Square test was applied to compare efficacy of both groups. It was noted that 71 (53%) had efficacy in group A and 63 (47%) had efficacy in the group B but the difference was not statistically significant. (p-value=0.399). Conclusion: It has been concluded that turpentine oil is effective in managing diabetic neuropathic pain similar to capsaicin cream.

Burden of Illness of Diabetic Peripheral Neuropathic Pain: A Qualitative Study.

Science.gov (United States)

Brod, Meryl; Pohlman, Betsy; Blum, Steven I; Ramasamy, Abhilasha; Carson, Robyn

2015-08-01

Diabetic peripheral neuropathy (DPN) is the result of nerve damage in the toes, feet, or hands, causing loss of feeling or pain for up to 50% of patients. The purpose of this qualitative study was to assess the burden and impact of DPN pain (DPNP) symptoms on patient's functioning and well-being. Four focus groups and 47 telephone interviews were conducted to understand the experience and impacts of DPNP from the patient's perspective. All participants were over the age of 18 years, read/spoke English, had a documented diagnosis of DPNP with symptoms for 6 months and a minimum 12-month history of diabetes mellitus, and had a daily pain rating of at least 4 on an 11-point numerical rating scale. Interview transcripts were analyzed thematically based on modified grounded theory principles. There were 70 respondents--48 (68.6%) males and 22 (31.4%) females. The mean age was 54.0 years (range 26-70), and nearly all respondents had type 2 diabetes (87%). Analysis identified four major areas of impact; DPNP patients reported difficulties with: (1) physical function, i.e. walking, exercise, energy, standing, balance, bending, and mobility; (2) daily life, i.e. productivity, recreational activities, work, enjoyment, focus, and chores; (3) social/psychological, i.e. anxiety, friends/family, irritability, depression, and fear; and (4) sleep, i.e. sleep, falling asleep, waking in the night, returning to sleep, and not feeling rested upon awakening. DPNP is a significant complication of diabetes with multiple impacts for patient functioning and well-being, which increase the burden of disease.

Reduction of voltage gated sodium channel protein in DRG by vector mediated miRNA reduces pain in rats with painful diabetic neuropathy.

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Chattopadhyay, Munmun; Zhou, Zhigang; Hao, Shuanglin; Mata, Marina; Fink, David J

2012-03-22

Painful neuropathy is a common complication of diabetes. Previous studies have identified significant increases in the amount of voltage gated sodium channel isoforms Na(V)1.7 and Na(V)1.3 protein in the dorsal root ganglia (DRG) of rats with streptozotocin (STZ)-induced diabetes. We found that gene transfer-mediated release of the inhibitory neurotransmitters enkephalin or gamma amino butyric acid (GABA) from DRG neurons in diabetic animals reduced pain-related behaviors coincident with a reduction in Na(V)1.7 protein levels in DRG in vivo. To further evaluate the role of Na(V)α subunit levels in DRG in the pathogenesis of pain in diabetic neuropathy, we constructed a non-replicating herpes simplex virus (HSV)-based vector expressing a microRNA (miRNA) against Na(V)α subunits. Subcutaneous inoculation of the miRNA-expressing HSV vector into the feet of diabetic rats to transduce DRG resulted in a reduction in Na(V)α subunit levels in DRG neurons, coincident with a reduction in cold allodynia, thermal hyperalgesia and mechanical hyperalgesia. These data support the role of increased Na(V)α protein in DRG in the pathogenesis of pain in diabetic neuropathy, and provide a proof-of-principle demonstration for the development of a novel therapy that could be used to treat intractable pain in patients with diabetic neuropathy.

Dragons with Clay Feet? : Transition, sustainable land use and rural environment in China and Vietnam

NARCIS (Netherlands)

Spoor, M.; Heerink, N.; Qu, F.

2007-01-01

Dragons with Clay Feet? presents state-of-the-art research on the impact of ongoing and anticipated economic policy and institutional reforms on agricultural development and sustainable rural resource in two East-Asian transition (and developing) economies--China and Vietnam.

Scintigraphic study in peripheral osteomyelitis (diabetic foot) with MDP-Tc99m, gallium 67 and antigranulocytes antibodies Tc99m. Etude scintigraphique de l'osteomyelite peripherique (pied diabetique) avec MDP-Tc99m, gallium 67 et anticorps antigranulocytes Tc99m

Energy Technology Data Exchange (ETDEWEB)

Dominguez Gadea, L.; Martin Curto, L.M.; Bas, C.; Rioja, M.E.; Vila, T.; Mitjavila, M.; Crespo, A. (Hopital Ramon y Cajal, Madrid (Spain))

1993-04-01

With isotopic technologies, scintigraphy using technetied phosphonates is the basic exploration relating to osseous pathology. With antibodies antigranulocytes, it is a reliable method which can be used in the diagnosis of osteomyelitis of diabetic feet. It gives an anatomic and diagnostic information. 12 refs., 1 tab.

Efficacy of Tribulus Terrestris Extract on the Serum Glucose and Lipids of Women with Diabetes Mellitus

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Samani, Nasrin Babadai; Jokar, Azam; Soveid, Mahmood; Heydari, Mojtaba; Mosavat, Seyed Hamdollah

2016-01-01

Background: Considering folkloric use of Tribulus terrestris (T. terrestris) in diabetes and proven anti-hyperglycemic and anti-hyperlipidemic effects of T. terrestris in animal studies, we aimed to evaluate the efficacy of the hydro alcoholic extract of T. terrestris on the serum glucose and lipid profile of women with diabetes mellitus. Methods: Ninety-eight diabetic women were randomly allocated to receive the T. terrestris (1000 mg/day) or placebo for three months. The patients were evaluated in terms of the fasting blood glucose, 2-hour postprandial glucose, glycosylated hemoglobin and lipid profile. Results: T. terrestris showed a significant blood glucose lowering effect in diabetic women compared to placebo (Pterrestris group was significantly reduced compared with placebo, while no significant effect was observed in the triglyceride and high-density lipoprotein levels. Conclusion: This study showed preliminary promising hypoglycemic effect of T. terrestris in diabetic women. PMID:27840471

The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management.

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Househ, Mowafa S; Shubair, Mamdouh M; Yunus, Faisel; Jamal, Amr; Aldossari, Bakheet

2015-10-01

The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM). A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers' ratings collected from January 9, 2014 to February 17, 2014 were included in the study. Overall, the consumers' ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications. Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients.

Six Feet Under o la muerte nuestra de cada día

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Francisco Guillermo Medina Montaño

2015-12-01

Full Text Available A partir del modelo de análisis ADN de las series televisivas, los autores abordan la serie Six Feet Under, su estructura narrativa, su lenguaje audiovisual, así como la construcción psicológica y moral de los personajes que en ella convergen para así escudriñar los mensajes y valores de una de las obras más vistas en su tipo y en su tiempo.

Soluble ST2 associates with diabetes but not established cardiovascular risk factors: a new inflammatory pathway of relevance to diabetes?

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Ashley M Miller

Full Text Available Preliminary data mostly from animal models suggest the sST2/IL-33 pathway may have causal relevance for vascular disease and diabetes and thus point to a potential novel inflammatory link to cardiometabolic disease. However, the characterisation of sST2 levels in terms of metabolic or vascular risk in man is completely lacking. We sought to address this gap via a comprehensive analysis of risk factor and vascular correlates of sST2 in a cross-sectional study (pSoBid. We measured sST2 in plasma in 639 subjects and comprehensively related it to cardiovascular and diabetes risk factors and imaged atherosclerosis measures. Circulating sST2 levels increased with age, were lower in women and in highest earners. After adjusting for age and gender, sST2 levels associated strongly with markers of diabetes, including triglycerides [effect estimate (EE per 1 standard deviation increase in sST2:1.05 [95%CI 1.01,1.10], liver function (alanine aminotransaminase [ALT] and γ-glutamyl transferase [GGT]: EE 1.05 [1.01,1.09] and 1.13 [1.07,1.19] respectively, glucose (1.02 [1.00,1.03] and sICAM-1 (1.05 [1.02,1.07]. However, sST2 levels were not related to smoking, cholesterol, blood pressure, or atheroma (carotid intima media thickness, plaque presence. These results suggest that sST2 levels, in individuals largely without vascular disease, are related principally to markers associated with diabetes and ectopic fat and add support for a role of sST2 in diabetes. Further mechanistic studies determining how sST2 is linked to diabetes pathways may offer new insights into the inflammatory paradigm for type 2 diabetes.

Effects of alignment on the roll-over shapes of prosthetic feet.

Science.gov (United States)

Hansen, Andrew

2008-12-01

Recent work suggests that a prosthetic ankle-foot component's roll-over shape - the effective rocker it conforms to between initial contact and opposite initial contact (the 'roll-over' interval of walking) - is closely linked to its final alignment in the prosthesis (as determined by a skilled prosthetist using heuristic techniques). If true, this information may help to determine the appropriate alignment for a lower limb prosthesis before it is built, or a priori. Knowledge is needed for future models that will incorporate the roll-over shape including the relative effect of alignment on the roll-over shape's radius of curvature and arc length. The purpose of this study was to evaluate the hypotheses that: (i) Changes in prosthesis alignment alter the position and orientation of a foot's roll-over shape in prosthesis-based coordinates, and (ii) these changes occur without changing the radius of curvature or arc length of the roll-over shape. To examine the hypotheses, this study examined the effects of nine alignment settings on the roll-over shapes of two prosthetic feet. The idea that alignment changes move and rotate roll-over shapes of prosthetic feet in prosthesis coordinates is supported by this work, but the hypothesis that the radius of curvature and arc length do not change for different alignments is not strongly supported by the data. A revised approach is presented that explains some of the changes to the roll-over shape parameters due to changes in rotational alignment.

Caracterização de pessoas com diabetes em unidades de atenção primária e secundária em relação a fatores desencadeantes do pé diabético Caracterización de las personas con diabetes en unidades de atención primaria y secundaria en relación a factores desencadenantes del pié diabético Characteristics of people with diabetes regarding factors associated with the development of diabetic foot ulcer

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Kattia Ochoa-Vigo

2006-09-01

73% presentó higiene/corte de uñas inapropiados, el 63% piel reseca/descamada, el 52% uñas alteradas, el 49% callos/rajaduras y el 33% pié plano. En la clasificación de riesgo se identifico el 7.9% con insensibilidad plantar y el 6.9% con insensibilidad plantar y deformidad en los pies. CONCLUSIONES: estas alteraciones podrían ser prevenidas con intervenciones básicas y educación de cuidados con los pies.OBJECTIVE: to describe factors associated with the development of diabetic foot ulcer among patients from primary health care settings regarding demographic variables, medical history, and risk for vascular complications. METHODS: data were collected through interviews and feet examination, which consisted of dermatological, structural, circulatory, and neurological evaluation and classified according to Sims and colleagues. RESULTS: the average age of the individuals with diabetes was 58.5±8.5 years old, had diabetes for 8.7±6.7 years, and had few years of elementary education. In terms of past medical history, 73% of the patients with diabetes also had high blood pressure and 22% had high cholesterol. They had an average blood glucose levels of 159±79 mg/dl and an average glycemic control (HbA1c of 7.8±2%. Feet exam revealed that 73% of the patient had inadequate nail hygiene/trimming, 63% had dry/scaly skin, 52% had altered nail shape, 49% had corns/cracks, and 33% had flat foot. Regarding vascular risk classification, 7.9% had plantar loss of sensitivity and 6.9% had both plantar insensitivity and feet deformity. CONCLUSION: the findings suggest that such alterations could be prevented through nursing interventions and feet care education.

Hand dysfunction in type 2 diabetes mellitus: Systematic review with meta-analysis.

Science.gov (United States)

Gundmi, Shubha; Maiya, Arun G; Bhat, Anil K; Ravishankar, N; Hande, Manjunatha H; Rajagopal, K V

2018-03-01

People with type 2 diabetes mellitus frequently show complications in feet and hands. However, the literature has mostly focused on foot complications. The disease can affect the strength and dexterity of the hands, thereby reducing function. This systematic review and meta-analysis focused on identifying the existing evidence on how type 2 diabetes mellitus affects hand strength, dexterity and function. We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane central register of controlled trials for reports of studies of grip and pinch strength as well as hand dexterity and function evaluated by questionnaires comparing patients with type 2 diabetes mellitus and healthy controls that were published between 1990 and 2017. Data are reported as standardized mean difference (SMD) or mean difference (MD) and 95% confidence intervals (CIs). Among 2077 records retrieved, only 7 full-text articles were available for meta-analysis. For both the dominant and non-dominant hand, type 2 diabetes mellitus negatively affected grip strength (SMD: -1.03; 95% CI: -2.24 to 0.18 and -1.37, -3.07 to 0.33) and pinch strength (-1.09, -2.56 to 0.38 and -1.12, -2.73 to 0.49), although not significantly. Dexterity of the dominant hand did not differ between diabetes and control groups but was poorer for the non-dominant hand, although not significantly. Hand function was worse for diabetes than control groups in 2 studies (MD: -8.7; 95% CI: -16.88 to -1.52 and 4.69, 2.03 to 7.35). This systematic review with meta-analysis suggested reduced hand function, specifically grip and pinch strength, for people with type 2 diabetes mellitus versus healthy controls. However, the sample size for all studies was low. Hence, we need studies with adequate sample size and randomized controlled trials to provide statistically significant results. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome: MRI features of intraosseous fat necrosis involving the feet and knees

International Nuclear Information System (INIS)

Kang, Dong Joo; Lee, Sun Joo; Choo, Hye Jung; Her, Minyoung; Yoon, Hye Kyoung

2017-01-01

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is extremely rare and presents as a triad of the three diseases. The patient usually presents with mild or absent abdominal symptoms. Here, we report on a case of a 66-year-old male who presented with pain and swelling in both legs and mild abdominal pain. He was diagnosed with acute pancreatitis by pancreatic enzyme analysis and abdominal computed tomography (CT) and with skin lesions of panniculitis through a biopsy. Magnetic resonance imaging (MRI) revealed multifocal intraosseous fat necrosis and arthritis involving both the feet and the knees. Therefore, we report a case of PPP syndrome with intraosseous fat necrosis involving both the feet and the knees. (orig.)

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome: MRI features of intraosseous fat necrosis involving the feet and knees

Energy Technology Data Exchange (ETDEWEB)

Kang, Dong Joo; Lee, Sun Joo; Choo, Hye Jung [Busan Paik Hospital, Department of Radiology, Inje University College of Medicine, Busan (Korea, Republic of); Her, Minyoung [Busan Paik Hospital, Division of Rheumatology, Department of Internal Medicine, Inje University College of Medicine, Busan (Korea, Republic of); Yoon, Hye Kyoung [Busan Paik Hospital, Department of Pathology, Inje University College of Medicine, Busan (Korea, Republic of)

2017-02-15

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is extremely rare and presents as a triad of the three diseases. The patient usually presents with mild or absent abdominal symptoms. Here, we report on a case of a 66-year-old male who presented with pain and swelling in both legs and mild abdominal pain. He was diagnosed with acute pancreatitis by pancreatic enzyme analysis and abdominal computed tomography (CT) and with skin lesions of panniculitis through a biopsy. Magnetic resonance imaging (MRI) revealed multifocal intraosseous fat necrosis and arthritis involving both the feet and the knees. Therefore, we report a case of PPP syndrome with intraosseous fat necrosis involving both the feet and the knees. (orig.)

Subdigital setae of chameleon feet: friction-enhancing microstructures for a wide range of substrate roughness.

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Spinner, Marlene; Westhoff, Guido; Gorb, Stanislav N

2014-06-27

Hairy adhesive systems of microscopic setae with triangular flattened tips have evolved convergently in spiders, insects and arboreal lizards. The ventral sides of the feet and tails in chameleons are also covered with setae. However, chameleon setae feature strongly elongated narrow spatulae or fibrous tips. The friction enhancing function of these microstructures has so far only been demonstrated in contact with glass spheres. In the present study, the frictional properties of subdigital setae of Chamaeleo calyptratus were measured under normal forces in the physical range on plane substrates having different roughness. We showed that chameleon setae maximize friction on a wide range of substrate roughness. The highest friction was measured on asperities of 1 μm. However, our observations of the climbing ability of Ch. calyptratus on rods of different diameters revealed that also claws and grasping feet are additionally responsible for the force generation on various substrates during locomotion.

Sulodexide for kidney protection in type 2 diabetes patients with microalbuminuria

DEFF Research Database (Denmark)

Lewis, Edmund J; Lewis, Julia B; Greene, Tom

2011-01-01

Sulodexide, a heterogenous group of sulfated glycosaminoglycans, includes low-molecular-weight heparin (~80% ± 8%), high-molecular-weight heparin (~5% ± 3%), and dermatan (~20% ± 8%), with a mean molecular weight of ~9 kDa. The drug is absorbed orally and has no anticoagulant effect in the doses ...... used. Small preliminary studies consistently showed sulodexide to be associated with decreased albuminuria in patients with diabetes....

49 CFR 231.24 - Box and other house cars with roofs, 16 feet 10 inches or more above top of rail. 1

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Box and other house cars with roofs, 16 feet 10... APPLIANCE STANDARDS § 231.24 Box and other house cars with roofs, 16 feet 10 inches or more above top of.... Same as specified for “Box and Other House Cars.” (2) Dimensions. Same as specified for “Box and Other...

Gestational diabetes: How risky are the mothers of rural Bengal, India

Directory of Open Access Journals (Sweden)

Sonali Sain

2013-01-01

Full Text Available Early detection of gestational diabetes in antenatal mothers can improve both pregnancy and fetal outcome. A descriptive, cross-sectional study was conducted to find out the magnitude of gestational diabetes by selective screening using “American Diabetes Association (ADA risk approach strategy” and distribution of risk factors of gestational diabetes among the mothers attending the antenatal clinic of Singur Rural Hospital. Pregnant women with gestational age between 24-28 weeks were interviewed using a predesigned schedule adapted from American Diabetes Association and WHO guidelines and their clinical and obstetrical examination was done. Mothers identified with at least 1 risk factor were advised for screening by Glucose Challenge test (GCT. Those with a positive result were confirmed by Glucose Tolerance Test. Out of 625 antenatal mothers, majority i.e. 60.32% of the mothers were exposed to low risk for developing gestational diabetes. Among 248 (39.68% mothers who had at least one risk factor, 20.56% were GCT positive amounting to 8.16% of the total population. 11.69% of the mothers with positive risk factors were GTT positive amounting to 56.86% of GCT positive mothers. This accounted for 4.64% of the total study population. Thus this method of preliminary screening for risk factors of gestational diabetes undertaken in all antenatal mothers followed by confirmatory testing in those found to be risk factor positive can provide a feasible alternative in increasing the yield for detection of gestational diabetes articularly in a low resource setting.

EFEK PIJAT TERHADAP PERUBAHAN TEKANAN SISTOLIK ANKLE PASIEN DIABETES MELITUS TIPE 2

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Tetra Saktika Adinugraha

2015-12-01

Full Text Available Background: Peripheral blood vessels diseases in lower extremities is one of thecomplicationsof type 2diabetes mellitus. This condition requires attention from thenurse by acknowleding theankle systolicpressure and increasing thevasodilation of theperipheral blood vessels. Those can be achieved by applyinga massage usingeffleurage, petrissageor kneading lightly movement techniques. Complementary therapysuch as massage therapyhasnot beenapplied andcomprehendedfor its effect on ankle systolic pressure.Objective:To identifythedifferencesof the ankle systolic pressure changesbymassage therapy in patientswith type 2 diabetes mellitus.Methods:This study was a quasi-experiment with case-control design pretest and posttest. Population waspatients with type 2 diabetes mellitus treatedat Kota Semarang Hospital andTugurejo Semarang Hospital. Asample of 33 respondents were recruitedusing purposive sampling technique.A massagetherapyusingeffleurage,petrissage or kneading techniqueson the feet, legs, and backwas applied for 30 minutes, 2times a week for 3 weeks.TheWilcoxon test and Mann-Whitneywere employed to analyse the data.Result:There was a significant differenceon the ankle systolic pressure before and after treatment inintervention group with the p-valueof .0001 (p0.05. Conclusions:There aresignificant differences on the ankle systolic blood pressurebefore and after amassage in the intervention group. However, when compared with the control group there was not asignificant difference. This study suggests that nurses mayuse massage therapyusing effleurage andpetrissage or kneading techniques as a complementary therapyas their independent intervention.

Physical Training and Activity in People With Diabetic Peripheral Neuropathy: Paradigm Shift.

Science.gov (United States)

Kluding, Patricia M; Bareiss, Sonja K; Hastings, Mary; Marcus, Robin L; Sinacore, David R; Mueller, Michael J

2017-01-01

Diabetic peripheral neuropathy (DPN) occurs in more than 50% of people with diabetes and is an important risk factor for skin breakdown, amputation, and reduced physical mobility (ie, walking and stair climbing). Although many beneficial effects of exercise for people with diabetes have been well established, few studies have examined whether exercise provides comparable benefits to people with DPN. Until recently, DPN was considered to be a contraindication for walking or any weight-bearing exercise because of concerns about injuring a person's insensitive feet. These guidelines were recently adjusted, however, after research demonstrated that weight-bearing activities do not increase the risk of foot ulcers in people who have DPN but do not have severe foot deformity. Emerging research has revealed positive adaptations in response to overload stress in these people, including evidence for peripheral neuroplasticity in animal models and early clinical trials. This perspective article reviews the evidence for peripheral neuroplasticity in animal models and early clinical trials, as well as adaptations of the integumentary system and the musculoskeletal system in response to overload stress. These positive adaptations are proposed to promote improved function in people with DPN and to foster the paradigm shift to including weight-bearing exercise for people with DPN. This perspective article also provides specific assessment and treatment recommendations for this important, high-risk group. © 2017 American Physical Therapy Association.

Faktor Pendukung dan Penghambat Penderita Diabetes Melitus dalam Melakukan Pemeriksaan Glukosa Darah

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Rizana Fajrunni'mah

2017-12-01

Diabetes mellitus (DM is a chronic metabolic disorder marked by an increase in blood glucose levels and impaired metabolism of carbohydrates, fats, and proteins. Every year more than four million people die because diabetes and millions of people experience the ill effects of diabetes or life-threatening conditions such as heart attack, stroke, kidney failure, blindness, and amputation. The individual's ability to manage life, control and reduce the impact of the disease known as self-management is to follow a healthy diet, increasing physical activity, using the drug safely and regularly, monitoring blood sugar levels as well as maintenance feet regularly. Several studies reported only small number of DM patients examined blood glucose levels routinely. This study aim to gain a thorough understanding of individual experience with DM in examining blood glucose levels. This study used qualitative research with a phenomenological approach from July to September 2016 at Jatiwarna, Bekasi. The results identified factors supporting blood glucose examination were: psychological factors, social, educational, economic, and access to health care. The inhibiting factors were psychological factors, social, educational, drug use, attitudes toward the disease, and perceptions of health insurance. The results expected to improve the quality of education and mentoring for health workers. It will help patients improving the adaptability and the ability to blood glucose self-monitoring.

Evaluation of peripheral microcirculation improvement of foot after tarsal tunnel release in diabetic patients by transcutaneous oximetry.

Science.gov (United States)

Trignano, Emilio; Fallico, Nefer; Chen, Hung-Chi; Faenza, Mario; Bolognini, Alfonso; Armenti, Andrea; Santanelli Di Pompeo, Fabio; Rubino, Corrado; Campus, Gian Vittorio

2016-01-01

According to recent studies, peripheral nerve decompression in diabetic patients seems to not only improve nerve function, but also to increase microcirculation; thus decreasing the incidence of diabetic foot wounds and amputations. However, while the postoperative improvement of nerve function is demonstrated, the changes in peripheral microcirculation have not been demonstrated yet. The aim of this study is to assess the degree of microcirculation improvement of foot after the tarsal tunnel release in the diabetic patients by using transcutaneous oximetry. Twenty diabetic male patients aged between 43 and 72 years old (mean age 61.2 years old) suffering from diabetic peripheral neuropathy with superimposed nerve compression underwent transcutaneous oximetry (PtcO2) before and after tarsal tunnel release by placing an electrode on the skin at the level of the dorsum of the foot. Eight lower extremities presented diabetic foot wound preoperatively. Thirty-six lower extremities underwent surgical release of the tibialis posterior nerve only, whereas four lower extremities underwent the combined release of common peroneal nerve, anterior tibialis nerve, and posterior tibialis nerve. Preoperative values of transcutaneous oximetry were below the critical threshold, that is, lower than 40 mmHg (29.1 ± 5.4 mmHg). PtcO2 values at one month after surgery (45.8 ± 6.4 mmHg) were significantly higher than the preoperative ones (P = 0.01). The results of postoperative increase in PtcO2 values demonstrate that the release of the tarsal tunnel determines a relevant increase in microcirculation in the feet of diabetic patients. © 2015 Wiley Periodicals, Inc.

The role of primary health care in patient education for diabetes control.

Science.gov (United States)

Koura, M R; Khairy, A E; Abdel-Aal, N M; Mohamed, H F; Amin, G A; Sabra, A Y

2001-01-01

The major components of diabetes management are dietary therapy, exercise and drug treatment. Therefore, education of people with diabetes is the cornerstone of management. The aim of the present work was to study the role of primary health care (PHC) in patient education for diabetes control in Alexandria. Accordingly, the knowledge and perception concerning diabetes and its management of all 88 PHC physicians and 104 nurses working in the two rural health centers and two randomly chosen urban health centers of Alexandria governorate were assessed by pre-designed self-administered questionnaire. All diabetic patients over 20 years of age attending the study health facilities over a period of two months were assessed for their knowledge and attitude concerning diabetes and self-management and asked about their degree of satisfaction with the provided PHC services by a pre-designed interview questionnaire. They amounted to 560 diabetic patients. The results revealed that the PHC physicians had sufficient knowledge about causes and complications of the disease, but insufficient knowledge about diagnosis and management, as only 10.2% & 4.5% of the physicians recognized the importance of regular exercise and patient education for diabetes management. Some misconceptions and false beliefs were observed among PHC nurses, as many of them considered diabetes a contagious disease or primarily caused by stress; that liver failure, hearing impairment and splenomegaly are among the complications of diabetes and that young age and immunodeficiency disorders are among the risk factors for developing diabetes. Moreover, most of them believed that the amount of carbohydrates given to diabetic patients should be reduced or even completely restricted; that vitamins are essential for all diabetic patients and that hot-water bottles are good for providing warmth to the diabetic feet. They also disagreed on the use of artificial sweeteners as sugar substitutes. Most of the diabetic

Qualitative observation instrument to measure the quality of parent-child interactions in young children with type 1 diabetes mellitus.

Science.gov (United States)

Nieuwesteeg, Anke; Hartman, Esther; Pouwer, Frans; Emons, Wilco; Aanstoot, Henk-Jan; Van Mil, Edgar; Van Bakel, Hedwig

2014-06-10

In young children with type 1 diabetes mellitus (T1DM), parents have complete responsibility for the diabetes-management. In toddlers and (pre)schoolers, the tasks needed to achieve optimal blood glucose control may interfere with normal developmental processes and could negatively affect the quality of parent-child interaction. Several observational instruments are available to measure the quality of the parent-child interaction. However, no observational instrument for diabetes-specific situations is available. Therefore, the aim of the present study was to develop a qualitative observation instrument, to be able to assess parent-child interaction during diabetes-specific situations. First, in a pilot study (n = 15), the observation instrument was developed in four steps: (a) defining relevant diabetes-specific situations; (b) videotaping these situations; (c) describing all behaviors in a qualitative observation instrument; (d) evaluating usability and reliability. Next, we examined preliminary validity (total n = 77) by testing hypotheses about correlations between the observation instrument for diabetes-specific situations, a generic observation instrument and a behavioral questionnaire. The observation instrument to assess parent-child interaction during diabetes-specific situations, which consists of ten domains: "emotional involvement", "limit setting", "respect for autonomy", "quality of instruction", "negative behavior", "avoidance", "cooperative behavior", "child's response to injection", "emphasis on diabetes", and "mealtime structure", was developed for use during a mealtime situation (including glucose monitoring and insulin administration). The present study showed encouraging indications for the usability and inter-rater reliability (weighted kappa was 0.73) of the qualitative observation instrument. Furthermore, promising indications for the preliminary validity of the observation instrument for diabetes-specific situations were found (r ranged

Racial/Ethnic and social class differences in preventive care practices among persons with diabetes

Directory of Open Access Journals (Sweden)

Barnett Elizabeth

2006-10-01

Full Text Available Abstract Background Diabetes is the sixth leading cause of death in the United States. Persons with diabetes are at increased risk for serious complications including CVD, stroke, retinopathy, amputation, and nephropathy. Minorities have the highest incidence and prevalence of diabetes and related complications compared to other racial groups. Preventive care practices such as smoking cessation, eye examinations, feet examinations, and yearly checkups can prevent or delay the incidence and progression of diabetes related complications. The purpose of this study was to examine racial/ethnic differences in diabetes preventive care practices by several socio-demographic characteristics including social class. Methods Data from the Behavioral Risk Factor Surveillance Survey for 1998–2001 were used for analyses. The study population consisted of persons who indicated having diabetes on the BRFSS, 35 yrs and older, and Non-Hispanic Black, non-Hispanic White, or Hispanic persons. Logistic regression was used in analyses. Results Contrary to our hypotheses, Blacks and Hispanics engaged in preventive care more frequently than Whites. Whites were less likely to have seen a doctor in the previous year, less likely to have had a foot exam, more likely to smoke, and less likely to have attempted smoking cessation. Persons of lower social class were at greatest risk for not receiving preventive care regardless of race/ethnicity. Persons with no health care coverage were twice as likely to have not visited the doctor in the previous year and twice as likely to have not had an eye exam, 1.5 times more likely to have not had a foot exam or attempted smoking cessation. Conclusion This study showed that persons of lower social class and persons with no health insurance are at greatest risk for not receiving preventive services.

Effects of oral health care on salivary flow rate in patients with type 2 diabetes: preliminary study.

Science.gov (United States)

Ibayashi, Haruhisa; Nishiyama, Tomohiro; Tanaka, Masayuki; Pham, Truong-Minh; Yano, Junko; Sakai, Kazuyo; Kobayashi, Atsushi; Yakura, Naonori; Matsuda, Shinya

2009-07-01

The purpose of this study is to evaluate the effects of the authors' oral health care program on the stimulated whole salivary flow rate and buffer capacity before and after a 6-month intervention. The authors conducted the intervention study among 25 participants with diabetes. The salivary flow rate and buffer capacity were evaluated before and after this intervention. Overall, the results showed a significant increase in salivary flow rate and no significant change in buffer capacity. Also, it was likely that salivary flow rate significantly increased among patients with more than 20 remaining teeth and patients with well-controlled diabetes. The findings suggest that this program for type 2 diabetes led to an increase in the stimulated whole salivary flow rate.

The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management

Science.gov (United States)

Househ, Mowafa S.; Shubair, Mamdouh M.; Yunus, Faisel; Jamal, Amr; Aldossari, Bakheet

2015-01-01

Background: The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM). Methods: A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers’ ratings collected from January 9, 2014 to February 17, 2014 were included in the study. Results: Overall, the consumers’ ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications. Conclusions: Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients. PMID:26635437

Solutions to Address Diabetes-Related Financial Burden and Cost-Related Nonadherence: Results from a Pilot Study

Science.gov (United States)

Patel, Minal R.; Resnicow, Kenneth; Lang, Ian; Kraus, Kathleen; Heisler, Michele

2018-01-01

Background: Cost-related nonadherence (CRN) to recommended self-management behaviors among adults with chronic conditions such as diabetes is prevalent. Few behavioral interventions to mitigate CRN have been tested and evaluated. Aims: We developed a financial burden resource tool and examined its acceptability and the preliminary effects on…

What will we do with 104,000,000 cubic feet of Fernald waste?

International Nuclear Information System (INIS)

Motl, G.P.; Krieger, G.J.

1995-01-01

The Fernald Site, a Department of Energy (DOE) uranium metal production facility that ceased production in 1989, is now being remediated by the DOE under terms of a Consent Agreement with the United States Environmental Protection Agency (USEPA) and a Consent Decree with the State of Ohio. It is estimated that the cleanup will generate 104,000,000 cubic feet of low-level radioactive waste including construction debris, pit sludge, radium residue and a huge volume of uranium contaminated soil. The waste handling strategy for this huge volume of waste includes minimizing remedial waste generation, recycling material when economically feasible, free-releasing clean material and volume reduction. It is anticipated that large scale radium residue vitrification and sludge drying equipment/facilities will be constructed onsite for waste treatment prior to off-site disposal. Fernald waste disposition will include both onsite disposal (if approved under CERCLA) and off-site disposal at both commercial and DOE waste disposal facilities. The waste disposition strategy selected reflects a diverse variety of technical, political, regulatory and economic factors. This presentation will describe the current views at Fernald on open-quotes what will we do with 104,000,000 cubic feet of Fernald waste.close quotes

Need for education on footcare in diabetic patients in India.

Science.gov (United States)

Viswanathan, V; Shobhana, R; Snehalatha, C; Seena, R; Ramachandran, A

1999-11-01

The patient himself plays the crucial role in the prevention of diabetic foot disease and therefore education on foot care is important. In this study, we have evaluated the knowledge of the diabetic subjects regarding the foot problems and the care of feet in order to identify areas that require stress in the education programme. Two hundred and fifty, consecutive cases of Type 2 diabetes (M:F, 176:74, age 57.2 +/- 9.7 yrs, duration 12.9 +/- 7.9 yrs) were selected for this study from the out-patient department of our hospital. A questionnaire was filled up for each patient by personal interview. The total score was 100 and a score of women (78.5%) than in men (62.5%) (chi 2 = 5.26, P = 0.022). Low scores (women with low educational status. Significant foot problems like gangrene, foot ulcers were present in 27.2% and low scores were more common among those with these complications (82% vs 62%) (chi 2 = 8.3, P = 0.004). In general the scores on awareness of general foot care principles and basic facts about the foot complications were poor. Most of them (72%) had good knowledge about the right usage of foot wear. There was a trend to have lower scores with poor formal education (chi 2 = 51.1, P < 0.0001) and also with increasing age. There was no correlation between the scores and the number of hospital visits. Multiple linear regression analyses showed that 31.2% of the variations in the scores were explained by the level of education. This study underscores the importance of patient education on foot care principles, especially so, considering the magnitude of the problem of diabetes and the lower levels of literacy and poor socio economic status of many patients in this country.

Diabetes Drug Prescription Pattern and Awareness Among Health Care Providers in Sub-Himalayan Region of India: A Population Based Study.

Science.gov (United States)

Mokta, Jatinder; Mokta, Kiran; Ranjan, Asha; Joshi, Ivan; Garg, Mahak

2017-05-01

To determine the pattern of diabetic drug prescription and awareness about diabetes among primary health providers in the rural areas of Himachal Pradesh situated in the western Himalayas at an elevation range from 350 meters (1,148ft) to 6900 meters (22,966ft) above sea level. Study was conducted in 20 rural areas of Himachal Pradesh, located 50 to 400 Km from state capital, at 2200 to 10,000 feet altitude. Non-pregnant diabetic adults were surveyed through 31 diabetic camps. Detailed history, weight, height, waist circumference, body mass index recorded. Fasting or random blood glucose, glycated hemoglobin, lipid profile measured and blood pressure recorded. 894 diabetic patients were included in the study (59.83% male) with the mean age of 52.94±6.78 years. Two in three patients were on oral hypoglycemic agents (OHAs), and one in three on alternative approaches for diabetes control. Among OHAs, sulphonylureas (SU) were the most commonly prescribed oral agents in 76.09% of patients followed by metformin in 23.87%. Glibenclamide was the most commonly prescribed SU in 44.60%. Amlodipine and atenolol was the commonest anti-hypertensive drug prescribed in 77.85% either in combination or as individual drug. Only 10.59% were on lipid lowering therapy. For primary care providers glycemic target was the mainstay of diabetes treatment with little emphasis on blood pressure control and no emphasis on lipid reduction. Sulphonylureas were the commonest anti-diabetic drug prescribed by the primary care providers followed by metformin. Insulin was prescribed to 2.23% only. Combination of amlodipine and atenolol was the commonest anti-hypertensive drugs prescribed and only 10% of patients were prescribed statin.

Diagnostic Accuracy of Clinical Methods for Detection of Diabetic Sensory Neuropathy

International Nuclear Information System (INIS)

Arshad, A. R.; Alvi, K. Y.

2016-01-01

Objective: To determine the accuracy of clinical methods for detection of sensory neuropathy as compared to biothesiometry. Study Design: Cross-sectional analytical study. Place and Duration of Study: 1 Mountain Medical Battalion, Azad Kashmir, from October 2013 to September 2014. Methodology: Patients with type 2 diabetes were enrolled by convenience sampling. Exclusion criteria included other identifiable causes of neuropathy, extensive ulceration of feet, amputated feet, those on treatment for neuropathy and unwilling patients. Average of 3 vibration perception threshold values measured with a biothesiometer on distal hallux was calculated. Ten gm monofilament was used to examine touch sensation over dorsal surfaces of great toes. Vibration sensation was checked over the tips of great toes using 128Hz tuning fork. Ankle jerks were checked bilaterally. Result: Neuropathy (vibration perception threshold > 25 volts) was present in 34 (21.12 percentage) out of 161 patients and 93 (57.76 percentage) were symptomatic. Measures of diagnostic accuracy for monofilament, tuning fork and ankle jerks were: sensitivity 41.18 percentage, 55.88 percentage and 64.71 percentage; specificity 92.91 percentage, 93.70 percentage and 80.31 percentage; positive predictive value (PPV) 60.87 percentage, 70.37 percentage and 46.81 percentage; negative predictive value (NPV) 85.51 percentage, 88.81 percentage and 89.47 percentage; and, diagnostic accuracy 81.99 percentage, 85.71 percentage and 77.02 percentage, respectively. Values for any 1 positive sign, any 2 positive signs or all 3 positive signs were: sensitivity 35.29 percentage, 14.71 percentage and 32.35 percentage; specificity 81.89 percentage, 93.70 percentage and 99.21 percentage; PPV 34.29 percentage, 38.46 percentage and 91.67 percentage; NPV 82.54 percentage, 80.41 percentage and 84.56 percentage; and, diagnostic accuracy 72.05 percentage, 77.02 percentage and 85.09 percentage, respectively. Conclusion: Clinical methods are

Increased Number of Langerhans Cells in the Epidermis of Diabetic Foot Ulcers Correlates with Healing Outcome

Science.gov (United States)

Stojadinovic, Olivera; Yin, Natalie; Lehmann, Janin; Pastar, Irena; Kirsner, Robert S.; Tomic-Canic, Marjana

2015-01-01

Langerhans cells (LCs) are a specialized subset of epidermal dendritic cells. They represent one of the first cells of immunological barrier and play an important role during the inflammatory phase of acute wound healing. Despite considerable progress in our understanding of the immunopathology of diabetes mellitus and its associated co-morbidities such as diabetic foot ulcers (DFUs), considerable gaps in our knowledge exist. In this study, we utilized the human ex vivo wound model and confirmed the increased epidermal LCs at wound edges during early phases of wound healing. Next, we aimed to determine differences in quantity of LCs between normal human and diabetic foot skin and to learn if the presence of LCs correlates with the healing outcome in DFUs. We utilized immunofluorescence to detect CD207+ LCs in specimens from normal and diabetic foot skin and DFU wound edges. Specimens from DFUs were collected at the initial visit and 4 weeks at the time when the healing outcome was determined. DFUs that decreased in size by >50% were considered to be healing, while DFUs with a size reduction of healing. Quantitative assessment of LCs showed a higher number of LCs in healing when compared to non–healing DFU’s. Our findings provide evidence that LCs are present in higher number in diabetic feet than normal foot skin. Healing DFUs show a higher number of LCs compared to non-healing DFUs. These findings indicate that the epidermal immune barrier plays an important role in the DFU healing outcome and may offer new therapeutic avenues targeting LC in non-healing DFUs. PMID:24277309

Investigating diet and physical activity in Malaysia: Education and family history of diabetes relate to lower levels of physical activity

OpenAIRE

Cai Lian eTam; Gregory eBonn; Gregory eBonn; Si Han eYeoh; Chee Piau eWong

2014-01-01

The National Health and Morbidity Survey (NHMS, 2011), estimates that the number of Malaysian adults suffering from type 2 diabetes has increased from 8.3% to 31.2% since 1996. This study is a preliminary investigation of possible factors contributing to this epidemic. Knowledge of diabetes, health locus of control, diet and exercise habits, as well as family history, education level and other demographic factors to better understand the correlates of risky and healthy behaviours. This was do...

Investigating diet and physical activity in Malaysia: education and family history of diabetes relate to lower levels of physical activity

OpenAIRE

Tam, Cai Lian; Bonn, Gregory; Yeoh, Si Han; Wong, Chee Piau

2014-01-01

The National Health and Morbidity Survey (NHMS, 2011), estimates that the number of Malaysian adults suffering from type 2 diabetes has increased from 8.3 to 31.2% since 1996. This study is a preliminary investigation of possible factors contributing to this epidemic. Knowledge of diabetes, health locus of control, diet and exercise habits, as well as family history, education level and other demographic factors to better understand the correlates of risky and healthy behaviors. This was done...

Cloning, Characterization, and Expression Levels of the Nectin Gene from the Tube Feet of the Sea Urchin Paracentrotus Lividus.

Science.gov (United States)

Toubarro, Duarte; Gouveia, Analuce; Ribeiro, Raquel Mesquita; Simões, Nélson; da Costa, Gonçalo; Cordeiro, Carlos; Santos, Romana

2016-06-01

Marine bioadhesives perform in ways that manmade products simply cannot match, especially in wet environments. Despite their technological potential, bioadhesive molecular mechanisms are still largely understudied, and sea urchin adhesion is no exception. These animals inhabit wave-swept shores, relying on specialized adhesive organs, tube feet, composed by an adhesive disc and a motile stem. The disc encloses a duo-gland adhesive system, producing adhesive and deadhesive secretions for strong reversible substratum attachment. The disclosure of sea urchin Paracentrotus lividus tube foot disc proteome led to the identification of a secreted adhesion protein, Nectin, never before reported in adult adhesive organs but, that given its adhesive function in eggs/embryos, was pointed out as a putative substratum adhesive protein in adults. To further understand Nectin involvement in sea urchin adhesion, Nectin cDNA was amplified for the first time from P. lividus adhesive organs, showing that not only the known Nectin mRNA, called Nectin-1 (GenBank AJ578435), is expressed in the adults tube feet but also a new mRNA sequence, called Nectin-2 (GenBank KT351732), differing in 15 missense nucleotide substitutions. Nectin genomic DNA was also obtained for the first time, indicating that both Nectin-1 and Nectin-2 derive from a single gene. In addition, expression analysis showed that both Nectins are overexpressed in tube feet discs, its expression being significantly higher in tube feet discs from sea urchins just after collection from the field relative to sea urchin from aquarium. These data further advocate for Nectin involvement in sea urchin reversible adhesion, suggesting that its expression might be regulated according to the hydrodynamic conditions.

Superhydrophobic gecko feet with high adhesive forces towards water and their bio-inspired materials

Science.gov (United States)

Liu, Kesong; Du, Jiexing; Wu, Juntao; Jiang, Lei

2012-01-01

Functional integration is an inherent characteristic for multiscale structures of biological materials. In this contribution, we first investigate the liquid-solid adhesive forces between water droplets and superhydrophobic gecko feet using a high-sensitivity micro-electromechanical balance system. It was found, in addition to the well-known solid-solid adhesion, the gecko foot, with a multiscale structure, possesses both superhydrophobic functionality and a high adhesive force towards water. The origin of the high adhesive forces of gecko feet to water could be attributed to the high density nanopillars that contact the water. Inspired by this, polyimide films with gecko-like multiscale structures were constructed by using anodic aluminum oxide templates, exhibiting superhydrophobicity and a strong adhesive force towards water. The static water contact angle is larger than 150° and the adhesive force to water is about 66 μN. The resultant gecko-inspired polyimide film can be used as a ``mechanical hand'' to snatch micro-liter liquids. We expect this work will provide the inspiration to reveal the mechanism of the high-adhesive superhydrophobic of geckos and extend the practical applications of polyimide materials.

Comparison of plantar pressure distribution in subjects with normal and flat feet during gait

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Aluisio Otavio Vargas Avila

2010-06-01

Full Text Available The aim of this study was to determine the possible relationship between loss of thenormal medial longitudinal arch measured by the height of the navicular bone in a static situationand variables related to plantar pressure distribution measured in a dynamic situation. Elevenmen (21 ± 3 years, 74 ± 10 kg and 175 ± 4 cm participated in the study. The Novel Emed-ATSystem was used for the acquisition of plantar pressure distribution data (peak pressure, meanpressure, contact area, and relative load at a sampling rate of 50 Hz. The navicular drop testproposed by Brody (1982 was used to assess the height of the navicular bone for classificationof the subjects. The results were compared by the Mann-Whitney U test, with the level of significanceset at p ≤ 0.05. Differences were observed between the two groups in the mid-foot regionfor all variables studied, with the observation of higher mean values in subjects with flat feet.There were also significant differences in contact area, relative load, peak pressure, and meanpressure between groups. The present study demonstrates the importance of paying attentionto subjects with flat feet because changes in plantar pressure distribution are associated withdiscomfort and injuries.

Attitudes and behaviour of adult pakistani diabetic population towards their disease

International Nuclear Information System (INIS)

Javed, A.; Mahmood, A.

2014-01-01

To assess the variations in attitudes and behaviour towards the disease process and interaction with the social environment of the diabetic persons due to long standing disease. Methods: This cross sectional study included four hundred participants of both gender, with confirmed type II diabetes for at least 5 years. A pre-validated questionnaire was used to evaluate the effects of the disease sufferings on the attitudes and behaviours towards social environment and disease. Frequency analysis was used to analyze the data using SPSS version 16.0. Results: 31.07% of diabetic population never noticed the change in their behaviour while 43.93% and 25% sometimes and always acknowledged the change in their behaviour, respectively. Less than one third consult their physicians regularly to manage their disease. 47.5% have no hope for their cure and 40% think that they have become a liability to their co-workers. Only 25.5% realize the importance of exercise in disease management. 27.5% of people undergo depression due to diabetes. More than half of the participants had to change their lifestyles after being diagnosed for diabetes. Significantly, less people (5%) believe that their disease has affected their married life. Conclusion: Sufferings of the diabetic individuals alter their behaviour towards their social environment along with their attitude. The study provides a substantial preliminary data to evaluate the effects of disease process on one's personality which may help to manage the disease more effectively. (author)

Representações sociais do pé diabético para pessoas com diabetes mellitus tipo 2 Representaciones sociales del pie diabético para personas con diabetes mellitus tipo 2 Social representations of diabetic foot for people with type 2 diabetes Mellitus

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Maria Seloi Coelho

2009-03-01

ón del modo como los sujetos con diabetes mellitus construyen conocimientos que expresan su identidad y guían sus comportamientos, especialmente vinculado al pie diabético.This is a qualitative study with the purpose to understand the social representations of the diabetic foot for people with type 2 diabetes mellitus. Semi-structured interviews were held with ten people with diabetes mellitus, who participated in a support group. Two categories emerged from the content analysis: the foot disease with perceived alterations and present threats, and feet care, with care as a concern with the future, and non-care as a feeling of guilt. The results show that the subjects seek hopes of not developing foot disease or controlling the situation, influenced by the representations of alterations and threats. When non-care occurs, the feeling of guilt emerges, since the subjects knew about the necessary care but did not use it. The social representations contributed in the search for comprehension of how the subjects with diabetes mellitus build the knowledge that that express their identity and guide their behavior, especially regarding the diabetic foot.

Right and left support feet of the Central Barrel Yoke of the CMS Detector

CERN Multimedia

Franz Leher, DWE

2000-01-01

Fully loaded the Central Barrel will weigh 3000 tonnes. Those feet have tosupport this weight. Therefore they are made of 120 mm thick steel plates.To guarantee a maximum coverage for the muon detctor they will house a muon detector just benaeth the top plate. Weight of 1 foot is 35 tonnes.Its height is 3.5 m and it is 2.5 m large

Spatial analysis for prevalence of type 2 diabetes mellitus - A state investigation

Science.gov (United States)

Zainal, Siti Salsabilah Nabilah; Masnan, Maz Jamilah; Amin, Nor Azrita Mohd; Mohamed, Nordin

2017-11-01

Type 2 Diabetes Mellitus (T2DM) is a chronic and non-communicable disease, which is characterized as the cause of premature deaths in the world. Unfortunately, Malaysia is one of the many countries facing this epidemic. Based on the increasing current trend of T2DM patients' cases from the National Diabetes Registry (NDR) Report from 2009 to 2012, there were approximately 2.6 million adults aged 18 years and above living with diabetes disease in Malaysia. Thus, this study aims to (i) perform preliminary spatial analysis for the prevalence of T2DM patients based on some factors, (ii) map the findings of the analyses according to some spatial properties, and (iii) analyze the pattern of diagnosed T2DM patients based on the studied factors. The studied population is one of the highest prevalence states of T2DM in Malaysia. This study is expected to reveal some demographic patterns that probably significant to this alarming epidemic.

The definition and diagnosis of cold hypersensitivity in the hands and feet: Finding from the experts survey.

Science.gov (United States)

Bae, Kwang-Ho; Jeong, Young-Seok; Go, Ho-Yeon; Sun, Seung-Ho; Kim, Tae-Hoon; Jung, Ki-Yong; Song, Yun-Kyung; Ko, Seong-Gyu; Choi, You-Kyung; Park, Jong-Hyeong; Lee, Siwoo; Lee, Youngseop; Jeon, Chan-Yong

2018-03-01

Cold hypersensitivity in the hands and feet (CHHF) is a symptom patients usually feel cold in their hands and feet, but not dealt with a disease in western medicine. However, it is often appealed by patients at a clinic of Korean medicine (KM), considered to be a sort of key diagnostic indicator, and actively treated by physicians. Nevertheless, there is no standardized diagnostic definition for CHHF. Therefore, we surveyed KM experts' opinions to address the clinical definition, diagnostic criteria, and other relevant things on CHHF. We developed a survey to assess the definition, diagnosis, causes, and accompanying symptoms on CHHF. 31 experts who work at specialized university hospitals affiliated with KM hospitals consented to participation. Experts responded to survey questions by selecting multiple-choice answers or stating their opinions. Vast majority of experts (83.8%) agreed with our definition on CHHF ("a feeling of cold as a symptom; that one's hands or feet become colder than those of average people in temperatures that are not normally perceived as cold"). 77.4% of experts considered subjective symptoms on CHHF were more important than medical instrument results. Constitution or genetic factors (87.1%) and stress (64.5%) were the most common causes reported for CHHF. This study offers an expert consensus regarding the themes, opinions, and experiences of practitioners with CHHF. Our results underscore the need for standardized definitions and diagnostic criteria for CHHF.

Women and Diabetes -- Diabetes Medicines

Science.gov (United States)

... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Share Tweet Linkedin Pin it More sharing ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

Flight Lieutenant Peach's observations on Burning Feet Syndrome in Far Eastern Prisoners of War 1942-45.

Science.gov (United States)

Roocroft, N T; Mayhew, E; Parkes, M; Frankland, A W; Gill, G V; Bouhassira, D; Rice, A S C

2017-03-01

'Burning Feet Syndrome' affected up to one third of Far Eastern Prisoners of War in World War 2. Recently discovered medical records, produced by RAF Medical Officer Nowell Peach whilst in captivity, are the first to detail neurological examinations of patients with this condition. The 54 sets of case notes produced at the time were analysed using modern diagnostic criteria to determine if the syndrome can be retrospectively classed as neuropathic pain. With a history of severe malnutrition raising the possibility of a peripheral polyneuropathy, and a neuroanatomically plausible pain distribution, this analysis showed that Burning Feet Syndrome can now be described as a 'possible' neuropathic pain syndrome. After 70 years, the data painstakingly gathered under the worst of circumstances have proved to be of interest and value in modern diagnostics of neuropathic pain. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Possibilities of combined surgical treatment of pyonecrotic lesions in the neuroischemic form of diabetic foot syndrome

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Valeriy Afanas'evich Mitish

2009-03-01

Full Text Available Aim. To present results of combined surgical treatment of the ischemic form of diabetic foot syndrome complicated by pyonecrotic process. To show thatthe use of modern diagnostic tools and the choice of adequate treatment strategy permits to substantially reduce the number of above-the-knee amputations. Materials and methods. A total of 140 patients with diabetes mellitus and critical ischemia of lower extremities were under observation during 2004-2008.All of them had purulent and/or necrotic foot lesions. The patients were examined by X-ray, computed and magneto-resonance tomography of the feet,duplex scanning of lower leg vasculature, transcutaneous measurement of PO2, pelvic and lower leg arterial angiography. Results. A strategy of surgical treatment was developed to be used depending on the patients health status, clinical features and severity of pyonecroticprocesses in the foot, and the degree of involvement of the main blood vessels of lower extremities. Conclusion. Combination of endovascular surgery with various methods for plastic wound closure permits to extend the range of possibilities for the treatmentof high-risk patients, such as those with pyonecrotic lesions and neuroischemic form of diabetic foot syndrome. This approach opens up prospects fora significant decrease of percentage of above-the-knee amputations and improves the quality of life in these patients.

Determination of Efficacy of Reflexology in Managing Patients with Diabetic Neuropathy: A Randomized Controlled Clinical Trial

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Krishna Dalal

2014-01-01

Full Text Available Background. The restricted usage of existing pharmacological methods which do not seem to provide the treatment of diabetic neuropathy may lead to exploring the efficacy of a complementary therapy. In this context, this paper was devoted to evaluate the efficacy of foot reflexology. This health science works on the hypothesis that the dysfunctional states of body parts could be identified by observing certain skin features and be rectified by stimulating certain specific areas mapped on feet. Method. Subjects (N=58 with diagnosed diabetic neuropathy were randomly distributed into reflexology and control groups in which both group patients were treated with ongoing pharmacological drugs. Reflexology group patients were additionally treated holistically with the hypothesis that this therapy would bring homeostasis among body organ functions. This was a caregiver-based study with a follow-up period of 6 months. The outcome measures were pain reduction, glycemic control, nerve conductivity, and thermal and vibration sensitivities. The skin features leading to the detection of the abnormal functional states of body parts were also recorded and analyzed. Results. Reflexology group showed more improvements in all outcome measures than those of control subjects with statistical significance. Conclusion. This study exhibited the efficient utility of reflexology therapy integrated with conventional medicines in managing diabetic neuropathy.

Determination of Efficacy of Reflexology in Managing Patients with Diabetic Neuropathy: A Randomized Controlled Clinical Trial

Science.gov (United States)

Dalal, Krishna; Maran, V. Bharathi; Pandey, Ravindra M.; Tripathi, Manjari

2014-01-01

Background. The restricted usage of existing pharmacological methods which do not seem to provide the treatment of diabetic neuropathy may lead to exploring the efficacy of a complementary therapy. In this context, this paper was devoted to evaluate the efficacy of foot reflexology. This health science works on the hypothesis that the dysfunctional states of body parts could be identified by observing certain skin features and be rectified by stimulating certain specific areas mapped on feet. Method. Subjects (N = 58) with diagnosed diabetic neuropathy were randomly distributed into reflexology and control groups in which both group patients were treated with ongoing pharmacological drugs. Reflexology group patients were additionally treated holistically with the hypothesis that this therapy would bring homeostasis among body organ functions. This was a caregiver-based study with a follow-up period of 6 months. The outcome measures were pain reduction, glycemic control, nerve conductivity, and thermal and vibration sensitivities. The skin features leading to the detection of the abnormal functional states of body parts were also recorded and analyzed. Results. Reflexology group showed more improvements in all outcome measures than those of control subjects with statistical significance. Conclusion. This study exhibited the efficient utility of reflexology therapy integrated with conventional medicines in managing diabetic neuropathy. PMID:24527055

Two-layer optical model of skin for early, non-invasive detection of wound development on the diabetic foot

Science.gov (United States)

Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

2010-02-01

Foot ulceration is a debilitating comorbidity of diabetes that may result in loss of mobility and amputation. Optical detection of cutaneous tissue changes due to inflammation and necrosis at the preulcer site could constitute a preventative strategy. A commercial hyperspectral oximetry system was used to measure tissue oxygenation on the feet of diabetic patients. A previously developed predictive index was used to differentiate preulcer tissue from surrounding healthy tissue with a sensitivity of 92% and specificity of 80%. To improve prediction accuracy, an optical skin model was developed treating skin as a two-layer medium and explicitly accounting for (i) melanin content and thickness of the epidermis, (ii) blood content and hemoglobin saturation of the dermis, and (iii) tissue scattering in both layers. Using this forward model, an iterative inverse method was used to determine the skin properties from hyperspectral images of preulcerative areas. The use of this information in lowering the false positive rate was discussed.

Association of plasma fetuin-a levels with peripheral arterial disease and lower extremity arterial calcification in subjects with type 2 diabetes mellitus.

Science.gov (United States)

Eleftheriadou, Ioanna; Grigoropoulou, Pinelopi; Kokkinos, Alexander; Mourouzis, Iordanis; Perrea, Despoina; Katsilambros, Nicholas; Sfikakis, Petros P; Tentolouris, Nikolaos

2017-03-01

Fetuin-A is a hepatic glycoprotein that is involved in insulin resistance and atherosclerosis. Herein we examined the association of plasma fetuin-A levels with peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM). A total of 71 patients with T2DM and 57 non-diabetic individuals were recruited. Diagnosis of PAD was based on the absence of triphasic waveform at pedal arteries, while ankle-brachial index (ABI) was calculated. Radiographs of both feet and ankles were taken for the assessment of lower extremity arterial calcification (LEAC). Plasma fetuin-A levels were measured using ELISA. Patients with T2DM had higher fetuin-A levels than non-diabetic participants. Participants with diabetes and PAD had lower fetuin-A levels than non-PAD diabetic patients. In subjects with T2DM fetuin-A levels were associated with ABI. Multivariate analysis demonstrated that in patients with T2DM the odds of PAD increased with long diabetes duration, smoking, presence of arterial hypertension and dyslipidemia, as well as with lower fetuin-A levels. A trend towards higher fetuin-A levels in subjects with less severe LEAC was found. Plasma fetuin-A levels are lower in patients with T2DM and PAD and are associated with PAD, irrespective of traditional cardiovascular risk factors. Moreover, fetuin-A may be involved in arterial calcification. Copyright © 2016 Elsevier Inc. All rights reserved.

Feasibility of foot deformations corrective operations performing in patients with diabetes

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S. D. Shapoval

2017-08-01

Full Text Available Objective: To improve methods of early diagnosis of diabetic neuropathy and suggest options for surgical prophylaxis possible purulent and necrotic complications in patients with diabetic foot syndrome. Materials and Methods. The study involved 64 patients with complicated diabetic foot syndrome (DFS. The average age of patients - 61,9 ± 3,8 years, duration of diabetes - 11,47 ± 3,2 years. The patients had neuropathic and mixed forms of DFS, fingers or arched foot deformations with the presence of pressor venous trophic ulcers in the forefoot. Patients were randomized into two groups: the main group - 34 and comparison group - 30 patients. There were representative characteristics for all groups: age, sex, comorbidity and did not differ significantly (P> 0,05. There were no statistically significant difference between the groups of these data (χ2 = 0,05; P = 0,8195. Results. After 6 months of complex treatment the ulcers were healed in more than half of patients in both groups - 19 (63,3% of patients in the comparison group and 25 (73,5% of the main group. In 8 (26,7% patients in the comparison and 7 (20,6% of the main group positive dynamics was observed, but over a longer period of treatment . After 12 months, the number of patients whose ulcers were completely healed differed significantly by the main group (P = 0,0007; χ2 = 11,41. Also in the main group was only 1 (3,0% patient with ulcer that was not healed, in contrast to the comparison group - 7 (23,3% patients (P = 0,0373; χ2 = 4,34. Conclusions. Operations aimed at correction of fingers and feet deformations in combination with standard therapy and unloading of the lower limb, allow improving the results of patients with complicated DFS treatment by reducing the number of relapses.

MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy

International Nuclear Information System (INIS)

Marano, Riccardo; Savino, Giancarlo; Merlino, Biagio; Pirro, Federica; Rutigliano, Claudia; Santangelo, Carolina; Minoiu, Aurelian Costin; Natale, Luigi; Bonomo, Lorenzo; Pitocco, Dario; Di Stasio, Enrico; Trani, Carlo

2016-01-01

To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87 %. These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. (orig.)

MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy

Energy Technology Data Exchange (ETDEWEB)

Marano, Riccardo; Savino, Giancarlo; Merlino, Biagio; Pirro, Federica; Rutigliano, Claudia; Santangelo, Carolina; Minoiu, Aurelian Costin; Natale, Luigi; Bonomo, Lorenzo [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Radiological Sciences - Institute of Radiology, Rome (Italy); Pitocco, Dario [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Internal Medicine, Rome (Italy); Di Stasio, Enrico [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Clinical Biochemistry, Rome (Italy); Trani, Carlo [Catholic University of Rome, ' ' A. Gemelli' ' University Hospital, Department of Cardiovascular Medicine - Institute of Cardiology, Rome (Italy)

2016-03-15

To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87 %. These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. (orig.)

Diabetic foot wounds: the value of negative pressure wound therapy with instillation.

Science.gov (United States)

Dalla Paola, Luca

2013-12-01

Chronic wounds such as diabetic foot wounds are a tremendous burden to the health care system and often require a multidisciplinary approach to prevent amputations. Advanced technologies such as negative pressure wound therapy (NPWT) and bioengineered tissues have been successfully used in the treatment of these types of complex wounds. However, the introduction of NPWT with instillation (NPWTi) has provided an alternative treatment for treating complex and difficult-to-heal wounds. This article provides an overview of NPWT and the new NPWTi system and describes preliminary experience using NPWTi on patients with complicated infected diabetic foot wounds after surgical debridement and in a multidisciplinary setting. © 2013 The Author. International Wound Journal © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Healing of ulcers on the feet correlated with distal blood pressure measurements in occlusive arterial disease

DEFF Research Database (Denmark)

Holstein, P; Lassen, N A

1980-01-01

The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel...

[Clinical recommendations for sport practice in diabetic patients (RECORD Guide). Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN)].

Science.gov (United States)

Gargallo-Fernández, Manuel; Escalada San Martín, Javier; Gómez-Peralta, Fernando; Rozas Moreno, Pedro; Marco Martínez, Amparo; Botella-Serrano, Marta; Tejera Pérez, Cristina; López Fernández, Judith

2015-01-01

Sporting activity is becoming a common practice in patients with diabetes mellitus (DM). This situation requires both a preliminary medical assessment and a wide range of changes in treatment which have scarcely been addressed in medical literature. To prepare a clinical guideline on the medical approach to patients with diabetes who practice sport regularly. An expert panel from the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) reviewed the most relevant literature in each of the sections. Based both on this review and on data from the experience of a number of athletes with DM, a number of recommendations were agreed within each section. Finally, the Working Group and representatives of the SEEN jointly discussed all these recommendations. The guideline provides recommendations ranging from medical assessment before patients with DM start to practice sport to actions during and after physical activity. Recommendations are also given on aspects such as the impact of sport on blood glucose control, training schemes, or special risk situations. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Protocol for a systematic review and individual patient data meta-analysis of prognostic factors of foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS).

Science.gov (United States)

Crawford, Fay; Anandan, Chantelle; Chappell, Francesca M; Murray, Gordon D; Price, Jacqueline F; Sheikh, Aziz; Simpson, Colin R; Maxwell, Martin; Stansby, Gerard P; Young, Matthew J; Abbott, Caroline A; Boulton, Andrew J M; Boyko, Edward J; Kastenbauer, Thomas; Leese, Graham P; Monami, Matteo; Monteiro-Soares, Matilde; Rith-Najarian, Stephen J; Veves, Aristidis; Coates, Nikki; Jeffcoate, William J; Leech, Nicola; Fahey, Tom; Tierney, Jayne

2013-02-15

multi-level mixed model, using "study" as one of the levels. Such a model can also allow for the within-patient clustering that occurs if a patient contributes data from both feet, although to aid interpretation, we prefer to use patients rather than feet as the unit of analysis. We intend to only attempt this analysis if the results of the investigation of heterogeneity do not rule it out and the model diagnostics are acceptable. This review is central to the development of a global evidence-based strategy for the risk assessment of the foot in patients with diabetes, ensuring future recommendations are valid and can reliably inform international clinical guidelines.

Assessment of two culturally competent diabetes education methods: individual versus individual plus group education in Canadian Portuguese adults with type 2 diabetes.

Science.gov (United States)

Gucciardi, Enza; Demelo, Margaret; Lee, Ruth N; Grace, Sherry L

2007-04-01

To examine the impact of two culturally competent diabetes education methods, individual counselling and individual counselling in conjunction with group education, on nutrition adherence and glycemic control in Portuguese Canadian adults with type 2 diabetes over a three-month period. The Diabetes Education Centre is located in the urban multicultural city of Toronto, Ontario, Canada. We used a three-month randomized controlled trial design. Eligible Portuguese-speaking adults with type 2 diabetes were randomly assigned to receive either diabetes education counselling only (control group) or counselling in conjunction with group education (intervention group). Of the 61 patients who completed the study, 36 were in the counselling only and 25 in the counselling with group education intervention. We used a per-protocol analysis to examine the efficacy of the two educational approaches on nutrition adherence and glycemic control; paired t-tests to compare results within groups and analysis of covariance (ACOVA) to compare outcomes between groups adjusting for baseline measures. The Theory of Planned Behaviour was used to describe the behavioural mechanisms that influenced nutrition adherence. Attitudes, subjective norms, perceived behaviour control, and intentions towards nutrition adherence, self-reported nutrition adherence and glycemic control significantly improved in both groups, over the three-month study period. Yet, those receiving individual counselling with group education showed greater improvement in all measures with the exception of glycemic control, where no significant difference was found between the two groups at three months. Our study findings provide preliminary evidence that culturally competent group education in conjunction with individual counselling may be more efficacious in shaping eating behaviours than individual counselling alone for Canadian Portuguese adults with type 2 diabetes. However, larger longitudinal studies are needed to

Diabetic Complications and Amputation Prevention

Science.gov (United States)

... become exposed. They can be caused by excess pressure due to ill... Ulcers Ulcers, which are open sores in the skin, occur when the outer layers of the skin are injured and the deeper tissues become exposed. They can be caused by excess pressure due to ill... Tingly Feet Tingly feet can ...

Ultrasound-guided plantar fascia release technique: a retrospective study of 46 feet.

Science.gov (United States)

Vohra, Praveen K; Japour, Christopher J

2009-01-01

Ultrasound-guided plantar fascia release offers the surgeon clear visualization of anatomy at the surgical site. This technique uses small arthroscopic dissecting instruments through a 0.5-cm incision, allowing the surgeon to avoid the larger and more tissue-disruptive incision that is traditionally used for plantar heel spur resection and plantar fascia releases. Forty-one patients (46 feet) were selected for the study. The mean patient age was 47 years. Twenty-nine were considered obese with a body mass index greater than 30 kg/m(2). Patients were functionally and subjectively evaluated 4 weeks after surgery using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Rating Scale. Results from the study show a significant improvement (P = .05 confidence level) 4 weeks postoperatively for the 41 patients (46 feet), compared to their preoperative condition. The mean pretest score was 33.6 (range 10-52); this score improved to 88.0 (range 50-100), 4 weeks postoperatively. There were no postoperative infections or complications. The ultrasound-guided plantar fascia release technique is a practical surgical procedure for the relief of chronic plantar fascia pain because the surgeon is able to clearly visualize the plantar fascia by ultrasound. In addition, there is minimal disruption to surrounding tissue because small instruments are passed through a small 0.5-cm incision. The traditional open method of heel spur surgery, in contrast, uses a larger skin incision of 3 to 5 cm, followed by larger instruments to dissect to the plantar fascia.

Vertical illusory self-motion through haptic stimulation of the feet

DEFF Research Database (Denmark)

Nordahl, Rolf; Nilsson, Niels Christian; Turchet, Luca

2012-01-01

Circular and linear self-motion illusions induced through visual and auditory stimuli have been studied rather extensively. While the ability of haptic stimuli to augment such illusions has been investigated, the self-motion illusions which primarily are induced by stimulation of the haptic...... to generate the haptic feedback while the final condition included no haptic feedback. Analysis of self-reports were used to assess the participants' experience of illusory self-motion. The results indicate that such illusions are indeed possible. Significant differences were found between the condition...... modality remain relatively unexplored. In this paper, we present an experiment performed with the intention of investigating whether it is possible to use haptic stimulation of the main supporting areas of the feet to induce vertical illusory self-motion on behalf of unrestrained participants during...

Using psychological theory to understand the clinical management of type 2 diabetes in Primary Care: a comparison across two European countries.

Science.gov (United States)

Hrisos, Susan; Eccles, Martin P; Francis, Jill J; Bosch, Marije; Dijkstra, Rob; Johnston, Marie; Grol, Richard; Kaner, Eileen F S; Steen, Ian N

2009-08-05

Long term management of patients with Type 2 diabetes is well established within Primary Care. However, despite extensive efforts to implement high quality care both service provision and patient health outcomes remain sub-optimal. Several recent studies suggest that psychological theories about individuals' behaviour can provide a valuable framework for understanding generalisable factors underlying health professionals' clinical behaviour. In the context of the team management of chronic disease such as diabetes, however, the application of such models is less well established. The aim of this study was to identify motivational factors underlying health professional teams' clinical management of diabetes using a psychological model of human behaviour. A predictive questionnaire based on the Theory of Planned Behaviour (TPB) investigated health professionals' (HPs') cognitions (e.g., beliefs, attitudes and intentions) about the provision of two aspects of care for patients with diabetes: prescribing statins and inspecting feet.General practitioners and practice nurses in England and the Netherlands completed parallel questionnaires, cross-validated for equivalence in English and Dutch. Behavioural data were practice-level patient-reported rates of foot examination and use of statin medication. Relationships between the cognitive antecedents of behaviour proposed by the TPB and healthcare teams' clinical behaviour were explored using multiple regression. In both countries, attitude and subjective norm were important predictors of health professionals' intention to inspect feet (Attitude: beta = .40; Subjective Norm: beta = .28; Adjusted R2 = .34, p < 0.01), and their intention to prescribe statins (Attitude: beta = .44; Adjusted R2 = .40, p < 0.01). Individuals' self-reported intention did not predict practice-level performance of either clinical behaviour. Using the TPB, we identified modifiable factors underlying health professionals' intentions to perform two

[Multicenter evaluation of the Nutri-Expert Telematic System in diabetic patients].

Science.gov (United States)

Turnin, M C; Bolzonella-Pene, C; Dumoulin, S; Cerf, I; Charpentier, G; Sandre-Banon, D; Valensi, P; Grenier, J L; Cathelineau, G; Mattei, C

1995-02-01

Nutri-Expert is a system for self-monitoring and dietetic education, accessible through Minitel. A preliminary randomised evaluation of one hundred diabetic patients in the Midi-Pyrénées region showed that Nutri-Expert improved dietetic knowledge, dietary habits and metabolic balance. The aim of the present study was to show that the system can be successfully prescribed to patients by physicians outside the center which originated it, indicating the benefit of a wider use of Nutri-Expert, among the diabetic population. One hundred and fifty-five patients, recruited by six French centres of diabetology, used Nutri-Expert from their homes for six months. Clinical examination, tests of dietetic knowledge and biological tests, including lipid fractions, were carried out before and after six months of use. After six months, there was a significant improvement in the patients' dietetic knowledge and in some biological parameters. Nutri-Expert is thus useful even when prescribed by a centre other than the hospital which devised the system. It is an additional beneficial tool in the ambulatory management of diabetic patients.

Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability.

Science.gov (United States)

Burkow, Tatjana M; Vognild, Lars K; Østengen, Geir; Johnsen, Elin; Risberg, Marijke Jongsma; Bratvold, Astrid; Hagen, Tord; Brattvoll, Morten; Krogstad, Trine; Hjalmarsen, Audhild

2013-03-05

The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user's own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home

A rectangle-type linear ultrasonic motor using longitudinal vibration transducers with four driving feet.

Science.gov (United States)

Liu, Yingxiang; Chen, Weishan; Liu, Junkao; Shi, Shengjun

2013-04-01

To make full use of the vibrational energy of a longitudinal transducer, a rectangle-type linear ultrasonic motor with four driving feet is proposed in this paper. This new motor consists of four longitudinal vibration transducers which are arranged in a rectangle and form an enclosed construction. Lead zirconate titanate ceramics are embedded into the middle of the transducer and fastened by a wedge-caulking mechanism. Each transducer includes an exponentially shaped horn located on each end. The horns of the vertical transducers intersect at the base of the horizontal transducers' horns; the tip ends of the horizontal transducers' horns are used as the driving feet. Longitudinal vibrations are superimposed in the motor and generate elliptical movements at the tip ends of the horns. The working principle of the proposed motor is analyzed. The resonance frequencies of two working modes are tuned to be close to each other by adjusting the structural parameters. Transient analysis is developed to gain the vibration characteristics of the motor. A prototype motor is fabricated and measured. The vibration test results verify the feasibility of the proposed design. Typical output of the prototype is a no-load speed of 928 mm/s and maximum thrust force of 60 N at a voltage of 200 Vrms.

Increasing incidence of diabetes after gestational diabetes

DEFF Research Database (Denmark)

Lauenborg, Jeannet; Hansen, Torben; Jensen, Dorte Møller

2004-01-01

To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes.......To study the incidence of diabetes among women with previous diet-treated gestational diabetes mellitus (GDM) in the light of the general increasing incidence of overweight and diabetes and to identify risk factors for the development of diabetes....

Factors Associated With Callus in Patients with Diabetes, Focused on Plantar Shear Stress During Gait.

Science.gov (United States)

Hamatani, Masako; Mori, Taketoshi; Oe, Makoto; Noguchi, Hiroshi; Takehara, Kimie; Amemiya, Ayumi; Ohashi, Yumiko; Ueki, Kohjiro; Kadowaki, Takashi; Sanada, Hiromi

2016-11-01

The aim of this study is to identify whether plantar shear stress in neuropathic patients with diabetes with callus is increased compared with those without callus. The differences in foot deformity, limited joint mobility, repetitive stress of walking, and ill-fitting shoes between patients with callus and those without callus were also determined. Subjects were recruited from the Diabetic Foot Outpatient Clinic. A newly developed in-shoe measurement system, which has flexible and thin insoles, enabled measurement of both plantar pressure and shear stress simultaneously when subjects walked as usual on a 10 m walkway. It was found that plantar shear stress adjusted for weight during the push-off phase was increased by 1.32 times in patients with callus compared with those without callus (mean ± SD: 0.0500 ± 0.0160 vs 0.0380 ± 0.0144, P = .031). Moreover, hallux valgus deformity, reduction in dorsiflexion of the ankle joint and increase in plantar flexion were showed in feet with callus. Increased plantar shear stress may be caused by gait change that patients having callus push off with the metatarsal head instead of the toe as a result of foot deformity and limited joint mobility. It was found that plantar shear stress adjusted for weight during the push-off phase was increased in patients with callus compared with those without callus by using the newly developed measurement system. These results suggest that reduction of plantar shear stress during the push-off phase can prevent callus formation in neuropathic patients with diabetes. © 2016 Diabetes Technology Society.

Gait alterations in the UAE population with and without diabetic complications using both traditional and entropy measures.

Science.gov (United States)

Khalaf, Kinda; Al-Angari, Haitham M; Khandoker, Ahsan H; Lee, Sungmun; Almahmeed, Wael; Al Safar, Habiba S; Jelinek, Herbert F

2017-10-01

Diabetic foot, one of the most common and debilitating manifestations of type 2 diabetes mellitus (T2DM), is the leading cause of worldwide non-traumatic lower extremity amputations. Diabetics who are at risk of ulceration are currently mainly identified by a thorough clinical examination of the feet, which typically does not show clear symptoms during the early stages of disease progression. In this study, we used a non-linear dynamics tool, gait entropy (GaitEN), in addition to traditional linear gait analysis methods, to investigate gait alterations amongst diabetic patients with combinations of three types of T2DM related complications: retinopathy, diabetic peripheral neuropathy (DPN) and nephropathy. Peak plantar pressure (PPP) was not significantly different in the group with DPN as compared to the control group (diabetics with no complications, CONT) in the forefoot region (DPN: mean±SD: 396±69.4kPa, CONT: 409±68.9kPa), although it was significantly lower in the heel region (DPN: mean±SD: 285±43.1.4kPa, CONT: 295±61.8kPa). On the other hand, gait entropy was significantly lower for the DPN compared to CONT group (DPN: 0.95±0.34, CONT: 1.03±0.28, pentropy was maintained when neuropathy was combined with either retinopathy or nephropathy. For the group with all three complications (ALL-C), the entropy was higher than CONT (ALL-C: 1.07±0.26). This may indicate an intrinsic sensorimotor feedback mechanism for the DPN patients to regulate their gait. However, this feedback gets weaker as patients develop multiple complications. Further analysis with longer walking time and different speeds is needed to verify the entropy results. Copyright © 2017 Elsevier B.V. All rights reserved.

[Footwear according to the "business dress code", and the health condition of women's feet--computer-assisted holistic evaluation].

Science.gov (United States)

Lorkowski, Jacek; Mrzygłód, Mirosław; Kotela, Ireneusz; Kiełbasiewicz-Lorkowska, Ewa; Teul, Iwona

2013-01-01

According to the verdict of the Supreme Court in 2005, an employer may dismiss an employee if their conduct (including dress) exposes the employer to losses or threatens his interests. The aim of the study was a holistic assessment of the pleiotropic effects of high-heeled pointed shoes on the health condition of women's feet, wearing them at work, in accordance with the existing rules of the "business dress code". A holistic multidisciplinary analysis was performed. It takes into account: 1) women employees of banks and other large corporations (82 persons); 2) 2D FEM computer model developed by the authors of foot deformed by pointed high-heeled shoes; 3) web site found after entering the code "business dress code". Over 60% of women in the office wore high-heeled shoes. The following has been found among people walking to work in high heels: 1) reduction in the quality of life in about 70% of cases, through periodic occurrence of pain and reduction of functional capacity of the feet; 2) increase in the pressure on the plantar side of the forefoot at least twice; 3) the continued effects the forces deforming the forefoot. 1. An evolutionary change of "dress code" shoes is necessary in order to lead to a reduction in non-physiological overload of feet and the consequence of their disability. 2. These changes are particularly urgent in patients with so-called "sensitive foot".

State of patients’ knowledge about treatment and proceedings in type 2 diabetes

Directory of Open Access Journals (Sweden)

Rafal Filip

2014-06-01

Full Text Available objective. The aim of the research was to evaluate the level of patients’ knowledge about type 2 diabetes, treatment and proceedings in the case of the disease. materials and method. 100 patients suffering from type 2 diabetes were included in the research, aged 40–90 years (64% and 36%, who lived in the countryside (54% and in the city (46%, hospitalized in the internal and geriatric wards in provincial hospitals of the Podkarpacie Region in south-eastern Poland. The research method was a diagnostic survey conducted by use of a questionnaire that consisted of 31 both multiple choice and open questions. Among the respondents, 64% were women and 36% men. Among them, 18% were aged from 40–50, 20% aged from 51–60, 28% from 61–70, 24% from 71–80-years-old, and 10% of respondents were aged over 80. Among the examined, 12% were treated only by diet, 24% by insulin, 18% by insulin and diet. results. From among respondents cured by insulin, 52% of them administered their own injections, 36% had the injections administered by a family member, and 12% had the injections administered by a nurse. From among the patients, 70% knew the symptoms of hypo- and hyperglycaemia, 84% knew how to react in the case of hypoglycaemia, but only 56% knew how to react in the case of hyperglycaemia. From among respondents, 68% controlled the skin if the feet. conclusions. Over a half of the respondents (70% know the symptoms of diabetes and mentioned frequent urination (77% and increased thirst (65%, but 30% had no knowledge of the symptoms of diabetes. The state of the patients’ knowledge about different complications of the disease was in insufficient.

Social Ecology and Diabetes Self-Management among Pacific Islanders in Arkansas.

Science.gov (United States)

McElfish, Pearl Anna; Moore, Ramey; Woodring, David; Purvis, Rachel S; Maskarinec, Gregory G; Bing, Williamina Ioanna; Hudson, Jonell; Kohler, Peter O; Goulden, Peter A

2016-01-01

Chronic diseases disproportionately affect ethnic and racial minorities. Pacific Islanders, including the Marshallese, experience some of the highest documented rates of type 2 diabetes. Northwest Arkansas is home to the largest population of Marshallese outside of the Republic of the Marshall Islands, and many migrants are employed by the local poultry industry. This migrant population continues to increase because of climate change, limited health care and educational infrastructure in the Marshall Islands, and the ongoing health effects of US nuclear testing. The US nuclear weapons testing program had extensive social, economic, and ecological consequences for the Marshallese and many of the health disparities they face are related to the nuclear fallout. Beginning in 2013, researchers using a community-based participatory (CBPR) approach began working with the local Marshallese community to address diabetes through the development and implementation of culturally appropriate diabetes self-management education in a family setting. Preliminary research captured numerous and significant environmental barriers that constrain self-management behaviors. At the request of our CBPR stakeholders, researchers have documented the ecological barriers faced by the Marshallese living in Arkansas through a series of qualitative research projects. Using the Social Ecological Model as a framework, this research provides an analysis of Marshallese health that expands the traditional diabetes self-management perspective. Participants identified barriers at the organizational, community, and policy levels that constrain their efforts to achieve diabetes self-management. We offer practice and policy recommendations to address barriers at the community, organizational, and policy level.

Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-Onset Diabetes of the Young

Science.gov (United States)

... After Your Baby is Born Monogenic Diabetes Monogenic Diabetes (Neonatal Diabetes Mellitus & MODY) The most common forms of diabetes, ... from each parent. What are monogenic forms of diabetes? Some rare forms of diabetes result from mutations ...

Teenage pregnancy in type 1 diabetes mellitus.

LENUS (Irish Health Repository)

Carmody, David

2010-03-01

Younger maternal age at delivery has been linked to adverse reproductive outcomes. Pregnancy complicated by type 1 diabetes mellitus (T1DM) is also associated with adverse pregnancy outcomes. Optimising diabetic glycaemic control prior to pregnancy is known to reduce the rate of congenital abnormalities and improve pregnancy outcomes. Teenage pregnancies are not usually planned and little data exist on teenage pregnancy complicated by T1DM. We sought to identify the glycemic control achieved in teenage pregnancy with T1DM and to clarify if there is an associated increase in adverse pregnancy outcomes compared to those seen in older women with T1DM. We compared outcomes in 18 teenagers (TG) with 582 older women with T1DM (CON) from 1995-2007. TG booked to the combined diabetes-obstetrical service at a median gestational age of 11 weeks (range 6-22) compared to 7 weeks in CON (range 4-40, p < 0.02). Glycaemic was worse in TG compared to CON at 13, 26 and 35 weeks gestation, despite higher insulin doses. First trimester miscarriage rate did not differ between groups. Major congenital anomaly rate was 6.2% (1\\/16) compared to 3.2% in CON. This preliminary study has demonstrated that pregnant teenage women with T1DM book later to specialised care and have worse glycaemic control in pregnancy compared to older women with T1DM. This group also appear to be more insulin resistant than older women in early pregnancy. Our data would suggest that teenagers with type 1 diabetes mellitus may constitute a high-risk group for adverse pregnancy outcomes.

Development and validation of a questionnaire to evaluate patient satisfaction with diabetes disease management.

Science.gov (United States)

Paddock, L E; Veloski, J; Chatterton, M L; Gevirtz, F O; Nash, D B

2000-07-01

To develop a reliable and valid questionnaire to measure patient satisfaction with diabetes disease management programs. Questions related to structure, process, and outcomes were categorized into 14 domains defining the essential elements of diabetes disease management. Health professionals confirmed the content validity. Face validity was established by a patient focus group. The questionnaire was mailed to 711 patients with diabetes who participated in a disease management program. To reduce the number of questionnaire items, a principal components analysis was performed using a varimax rotation. The Scree test was used to select significant components. To further assess reliability and validity; Cronbach's alpha and product-moment correlations were calculated for components having > or =3 items with loadings >0.50. The validated 73-item mailed satisfaction survey had a 34.1% response rate. Principal components analysis yielded 13 components with eigenvalues > 1.0. The Scree test proposed a 6-component solution (39 items), which explained 59% of the total variation. Internal consistency reliabilities computed for the first 6 components (alpha = 0.79-0.95) were acceptable. The final questionnaire, the Diabetes Management Evaluation Tool (DMET), was designed to assess patient satisfaction with diabetes disease management programs. Although more extensive testing of the questionnaire is appropriate, preliminary reliability and validity of the DMET has been demonstrated.

Risk predictive modelling for diabetes and cardiovascular disease.

Science.gov (United States)

Kengne, Andre Pascal; Masconi, Katya; Mbanya, Vivian Nchanchou; Lekoubou, Alain; Echouffo-Tcheugui, Justin Basile; Matsha, Tandi E

2014-02-01

Absolute risk models or clinical prediction models have been incorporated in guidelines, and are increasingly advocated as tools to assist risk stratification and guide prevention and treatments decisions relating to common health conditions such as cardiovascular disease (CVD) and diabetes mellitus. We have reviewed the historical development and principles of prediction research, including their statistical underpinning, as well as implications for routine practice, with a focus on predictive modelling for CVD and diabetes. Predictive modelling for CVD risk, which has developed over the last five decades, has been largely influenced by the Framingham Heart Study investigators, while it is only ∼20 years ago that similar efforts were started in the field of diabetes. Identification of predictive factors is an important preliminary step which provides the knowledge base on potential predictors to be tested for inclusion during the statistical derivation of the final model. The derived models must then be tested both on the development sample (internal validation) and on other populations in different settings (external validation). Updating procedures (e.g. recalibration) should be used to improve the performance of models that fail the tests of external validation. Ultimately, the effect of introducing validated models in routine practice on the process and outcomes of care as well as its cost-effectiveness should be tested in impact studies before wide dissemination of models beyond the research context. Several predictions models have been developed for CVD or diabetes, but very few have been externally validated or tested in impact studies, and their comparative performance has yet to be fully assessed. A shift of focus from developing new CVD or diabetes prediction models to validating the existing ones will improve their adoption in routine practice.

Undiagnosed Diabetes and Pre-Diabetes in Health Disparities.

Directory of Open Access Journals (Sweden)

Susan P Fisher-Hoch

Full Text Available Globally half of all diabetes mellitus is undiagnosed. We sought to determine the extent and characteristics of undiagnosed type 2 diabetes mellitus and pre-diabetes in Mexican Americans residing in the United States. This disadvantaged population with 50% lifetime risk of diabetes is a microcosm of the current pandemic. We accessed baseline data between 2004 and 2014 from 2,838 adults recruited to our Cameron County Hispanic Cohort (CCHC; a two-stage randomly selected 'Framingham-like' cohort of Mexican Americans on the US Mexico border with severe health disparities. We examined prevalence, risk factors and metabolic health in diagnosed and undiagnosed diabetes and pre-diabetes. Two thirds of this Mexican American population has diabetes or pre-diabetes. Diabetes prevalence was 28.0%, nearly half undiagnosed, and pre-diabetes 31.6%. Mean BMI among those with diabetes was 33.5 kg/m2 compared with 29.0 kg/m2 for those without diabetes. Significant risk factors were low income and educational levels. Most with diabetes had increased waist/hip ratio. Lack of insurance and access to health services played a decisive role in failure to have diabetes diagnosed. Participants with undiagnosed diabetes and pre-diabetes had similar measures of poor metabolic health similar but generally not as severe as those with diagnosed diabetes. More than 50% of a minority Mexican American population in South Texas has diabetes or pre-diabetes and is metabolically unhealthy. Only a third of diabetes cases were diagnosed. Sustained efforts are imperative to identify, diagnose and treat individuals in underserved communities.

COMPARATIVE CHARACTERISTICS OF MORPHOMETRIC PARAMETERS OF DIFFERENT FORMS OF GIRLS FEET AGED 17-19

Directory of Open Access Journals (Sweden)

O.V. Konnova

2009-03-01

Full Text Available During examination of plantograms of the girls (n = 242 three forms of feet: egiptal, rectangular and greek have been distinguished, statistically characterized by reliable distinctions of separate linear and angular parameters and coefficient of the anterior part of the foot. Coefficients used for examination of the pathology of the foot fornix do not possess sufficient information and need additional examination of the dimensions of the angels of ankle-bone, calcaneal and navicular bones.

Planary bone scintigraphy of the foot in the diabetics with peripheral macroangiopathy, treated with Sulodexide (Vessel Due F)

International Nuclear Information System (INIS)

Klisarova, A.; Bihchelian, H.; Koeva, L.

2000-01-01

It is the purpose of the paper to assay the effect of Sulodexide (Vessel Due F) on some semi-quantitative parameters of bone scintigraphy of the foot in diabetics with peripheral vascular disease. Fifteen patients with diabet type II and peripheral macroangiopathy (6 women and 9 men, mean age 57 ±3.7 y, and mean body mass index 29.8 ±2.7 kg/m 3 ) are studied. The investigation is carried out after informed consent and in state of adequate glycemic control. Vessel Due F is administrated im for 10 days - 600 lypoproteinli pase releasing units (LSU), followed by 500 LSU per os for further 60 days. Before and after treatment, planar foot bone scintigraphy with 99m Tc - MDP is carried out. The fixation indices are measured through comparison of radionuclide accumulation in symmetrical zones of the right and left foot. Prior to treatment the fixation indices are increased, and after treatment they are significantly decreased (p< 0.05). The semiquantitative scintigraphic parameters adopted are used for dynamic measurement of the bone metabolism level in the feet of patients with diabet and peripheral macroangiopathy. After Sulodexide (Vessel Due F) treatment, a positive effect on radionuclide fixation indices is documented. (author)

Organic Nitrates and Nitrate Resistance in Diabetes: The Role of Vascular Dysfunction and Oxidative Stress with Emphasis on Antioxidant Properties of Pentaerithrityl Tetranitrate

Directory of Open Access Journals (Sweden)

Matthias Oelze

2010-01-01

Full Text Available Organic nitrates represent a class of drugs which are clinically used for treatment of ischemic symptoms of angina as well as for congestive heart failure based on the idea to overcome the impaired NO bioavailability by “NO” replacement therapy. The present paper is focused on parallels between diabetes mellitus and nitrate tolerance, and aims to discuss the mechanisms underlying nitrate resistance in the setting of diabetes. Since oxidative stress was identified as an important factor in the development of tolerance to organic nitrates, but also represents a hallmark of diabetic complications, this may represent a common principle for both disorders where therapeutic intervention should start. This paper examines the evidence supporting the hypothesis that pentaerithrityl tetranitrate may represent a nitrate for treatment of ischemia in diabetic patients. This evidence is based on the considerations of parallels between diabetes mellitus and nitrate tolerance as well as on preliminary data from experimental diabetes studies.

Organic Nitrates and Nitrate Resistance in Diabetes: The Role of Vascular Dysfunction and Oxidative Stress with Emphasis on Antioxidant Properties of Pentaerithrityl Tetranitrate

Science.gov (United States)

Oelze, Matthias; Schuhmacher, Swenja; Daiber, Andreas

2010-01-01

Organic nitrates represent a class of drugs which are clinically used for treatment of ischemic symptoms of angina as well as for congestive heart failure based on the idea to overcome the impaired NO bioavailability by “NO” replacement therapy. The present paper is focused on parallels between diabetes mellitus and nitrate tolerance, and aims to discuss the mechanisms underlying nitrate resistance in the setting of diabetes. Since oxidative stress was identified as an important factor in the development of tolerance to organic nitrates, but also represents a hallmark of diabetic complications, this may represent a common principle for both disorders where therapeutic intervention should start. This paper examines the evidence supporting the hypothesis that pentaerithrityl tetranitrate may represent a nitrate for treatment of ischemia in diabetic patients. This evidence is based on the considerations of parallels between diabetes mellitus and nitrate tolerance as well as on preliminary data from experimental diabetes studies. PMID:21234399

Role of Serum Adiponectin and Vitamin D in Prediabetes and Diabetes Mellitus.

Science.gov (United States)

Banerjee, Anindita; Khemka, Vineet Kumar; Roy, Debashree; Poddar, Jit; Roy, Tapan Kumar Sinha; Karnam, Srikanth Arliganur

2017-06-01

The roles of deficient or deranged insulin, adiponectin and 25 hydroxy vitamin D (25[OH]D) levels regulating food intake, energy metabolism, glucose and lipid metabolism and body weight have been reported in the pathogenesis of prediabetes and type 2 diabetes mellitus. However, their congruity in the etiology of diabetes mellitus is unknown. Thus, the aim of the study was to investigate the roles of these parameters together and to establish their interrelationship in patients with prediabetes and diabetes. The preliminary cross-sectional study included 77 persons with type 2 diabetes who were matched for age, sex and body mass index (BMI); 73 persons with prediabetes; and 52 healthy control subjects. Fasting serum levels of adiponectin, insulin and 25(OH)D were measured by commercially available immune assay kits, and routine biochemical parameters were analyzed in all study groups. The results show statistically significant lower levels of serum adiponectin and serum 25(OH)D and higher serum insulin levels in persons with prediabetes or type 2 diabetes with respect to controls. The changes in the serum adiponectin or serum 25(OH)D in persons with prediabetes and type 2 diabetes were found to be inversely correlated with the serum levels of insulin. Moreover, multiple linear regression analysis, with 25(OH)D, insulin and homeostatic model assessment-insulin resistance (HOMA-IR) as the variables, revealed that serum adiponectin levels might be an independent risk factor for the progression of prediabetes and type 2 diabetes in subjects. The association of these hormones might act as a significant predictor of progression of prediabetes to type 2 diabetes. Decreased serum adiponectin levels might be an independent risk factor for progression to prediabetes and type 2 diabetes, which may help in developing experimental models of the disease or in identifying biomarkers or disease-modifying drugs. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All

Ethnomedicines used in Trinidad and Tobago for urinary problems and diabetes mellitus

OpenAIRE

Lans Cheryl A

2006-01-01

Abstract Background This paper is based on ethnobotanical interviews conducted from 1996–2000 in Trinidad and Tobago with thirty male and female respondents. Methods A non-experimental validation was conducted on the plants used for urinary problems and diabetes mellitus: This is a preliminary step to establish that the plants used are safe or effective, to help direct clinical trials, and to inform Caribbean physicians of the plants' known properties to avoid counter-prescribing. Results The...

ISSUES OF INTEGRATION OF SKILLS FAVOURABLE TO HEALTH IN PERSONS WITH DIABETES MELLITUS

Directory of Open Access Journals (Sweden)

Vida Gudžinskienė

2018-05-01

; and whether they follow the principles of a healthy lifestyle. Empirical research revealed that there are short-term training courses for patients with diabetes mellitus organized in Lithuania. The majority of participants noted that trainings are carried out for several hours or 7 days. Training courses that are carried out for patients with diabetes cover topics of a healthy lifestyles: balanced diet, physical activity, personal hygiene, blood sugar monitoring and insulin use; however, participants emphasize that such trainings should include more health aspects and that they prefer to have regular training courses. The research revealed that most training courses for patients with diabetes mellitus are carried out by a nurse, an endocrinologist and a dietician. Medical staff provides patients with diabetes with basic knowledge about health that includes a healthy lifestyle, foot care and recommendations for treatment (monitoring of blood suga,insulin use. It has been determined that patients with diabetes mellitus partially adapt the received knowledge. The research revealed that only 23.8 percent of participants with diabetes keep to a healthy diet plan, only 14.3 percent are physically active, and 39.7 percent care for their feet. Participants of the research lack knowledge about a healthy lifestyle and skills favourable to health that help to prevent complications. Only a small number of participants of the research with diabetes mellitus behave consciously and are prone to preserve their health by following recommendations of doctors. Therefore, patients with diabetes in Lithuania need regular and continuous training programs that would cover aspects of a healthy lifestyle (healthy and balanced diet, promotion of physical activity, personal hygiene. It is recommended to develop training programs that would include active training methods and videos, which would help patients with diabetes mellitus to more easily and independently acquire necessary health skills.

Improving Diabetes-Related Parent-Adolescent Communication With Individualized Feedback.

Science.gov (United States)

May, Dana K K; Ellis, Deborah A; Cano, Annmarie; Dekelbab, Bassem

2017-11-01

To pilot a brief individualized feedback intervention to improve the communication skills of parents with an adolescent with type 1 diabetes. Parent-adolescent dyads (N = 79) discussed a diabetes-related problem, while an interventionist rated the parent's communication skills to give feedback to the parents. Parents were then randomized to a brief feedback session to target person-centered communication skills or an educational session. Dyads discussed another diabetes care problem to assess for change in communication skills. Independent raters coded parent communication skills from video recordings to rate behaviors in the service of examining possible changes in communication skills. Dyads completed ratings of perceived closeness and empathy after each conversation. Controlling for overall positive communication at baseline, parents who received feedback showed more improvement in specific person-centered communication skills than parents in the control group. Adolescents in the feedback group reported greater increases in parental empathy and intimacy from pre- to postmanipulation than the control. The feedback intervention showed preliminary efficacy for increasing person-centered communication skills and perceived empathy and intimacy. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Comparison of iron status and insulin resistance between non-diabetic offspring of type 2 diabetics and non-diabetic offspring of non-diabetics

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Zafar, U.; Qureshi, H.J.

2015-01-01

Insulin resistance is positively correlated with body iron. It is unclear whether iron is a cause or an outcome of insulin resistance. Insulin resistance precedes type 2 diabetes mellitus. Offspring of type 2 diabetics are insulin resistant as compared to those of the non-diabetics. The present study was designed to compare and correlate insulin resistance with iron parameters (including serum ferritin, transferrin saturation and blood haemoglobin) in non-diabetic offspring of type 2 diabetics and non-diabetic offspring of non-diabetics. Methods: It was a cross-sectional study, conducted on one hundred and twenty male subjects 20-40 years of age. They were divided into two groups, each group having 60 subjects. Group A included non-diabetic offspring of type 2 diabetics, while Group B included non-diabetic offspring of non-diabetics. Fasting blood sample was taken and examined for glucose, haemoglobin, insulin, iron, TIBC and ferritin. Data was analysed by SPSS-17. Results: Insulin resistance and iron parameters were significantly higher (p<0.05) in non-diabetic offspring of type 2 diabetics as compared to those of the non-diabetics. There was significant positive correlation (p=0.027) between insulin resistance and serum iron in non-diabetic offspring of type 2 diabetics. There was also significant positive correlation between insulin resistance and serum iron, transferrin saturation and haemoglobin in non-diabetic offspring of non-diabetics. Conclusion: Non-diabetic offspring of type 2 diabetics have iron load and insulin resistance, that predispose them to the development of type 2 diabetes. (author)

Reducing patient drug acquisition costs can lower diabetes health claims.

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Mahoney, John J

2005-08-01

Concerned about rising prevalence and costs of diabetes among its employees, Pitney Bowes Inc recently revamped its drug benefit design to synergize with ongoing efforts in its disease management and patient education programs. Specifically, based on a predictive model showing that low medication adherence was linked to subsequent increases in healthcare costs in patients with diabetes, the company shifted all diabetes drugs and devices from tier 2 or 3 formulary status to tier 1. The rationale was that reducing patient out-of-pocket costs would eliminate financial barriers to preventive care, and thereby increase adherence, reduce costly complications, and slow the overall rate of rising healthcare costs. This single change in pharmaceutical benefit design immediately made critical brand-name drugs available to most Pitney Bowes employees and their covered dependents for 10% coinsurance, the same coinsurance level as for generic drugs, versus the previous cost share of 25% to 50%. After 2 to 3 years, preliminary results in plan participants with diabetes indicate that medication possession rates have increased significantly, use of fixed-combination drugs has increased (possibly related to easier adherence), average total pharmacy costs have decreased by 7%, and emergency department visits have decreased by 26%. Hospital admission rates, although increasing slightly, remain below the demographically adjusted Medstat benchmark. Overall direct healthcare costs per plan participant with diabetes decreased by 6%. In addition, the rate of increase in overall per-plan-participant health costs at Pitney Bowes has slowed markedly, with net per-plan-participant costs in 2003 at about 4000 dollars per year versus 6500 dollars for the industry benchmark. This recent moderation in overall corporate health costs may be related to these strategic changes in drug benefit design for diabetes, asthma, and hypertension and also to ongoing enhancements in the company's disease

Alteração do arco longitudinal medial na neuropatia periférica diabética Medial longitudinal arch change in diabetic peripheral neuropathy

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Isabel de Camargo Neves Sacco

2009-01-01

Full Text Available OBJETIVO: Descrever e comparar as características antropométricas dos pés de sujeitos saudáveis e diabéticos neuropatas por meio de índices classificatórios do Arco Longitudinal Medial (ALM: Índice do Arco (IA, Índice de Chippaux-Cmirak (CSI e Ângulo  ( e comparar a classificação destes métodos nestes grupos. MATERIAIS E MÉTODO: Grupo controle (GC composto por 21 sujeitos saudáveis, e grupo diabético (GD, formado por 46 diabéticos portadores de neuropatia diabética. Pela impressão plantar foram calculados os índices. RESULTADOS: Houve maior proporção de pés planos no GD para os três índices (IA: 32,2%, CSI: 59,7%, A: 17,5%, enquanto os pés cavos comportaram-se de forma contrária. Os grupos foram estatisticamente diferentes em relação à proporção de pés planos no IA (p=0,0080 e no CSI (p=0,0000 e de pés cavos no  (p=0,0036. Houve diferença significativa quando comparados GC e GD para os três índices: IA (p=0,0027, CSI (p=0,0064,  (p=0,0296. CONCLUSÃO: Os dados demonstram alterações motoras e ortopédicas decorrentes da neuropatia periférica, responsável pela desestruturação do pé, levando ao desabamento do ALM. Observou-se que o ângulo A destoou fortemente da classificação do arco feita pelos outros dois índices, e com isso destacamos que sua utilização merece cuidado.OBJECTIVE: To describe and compare foot anthropometry in healthy and diabetic subjects using Medial Longitudinal Arch (MLA classificatory indexes: Arch Index (AI, Chippaux-Smirak Index (CSI and  Angle (Â, as well as to compare the classification of these methods in each group. MATERIALS AND METHODS: Control Group (CG composed by 21 healthy subjects and Diabetic Group (DG, with 46 diabetic neuropathy subjects. The indexes were calculated from footprints. RESULTS: A larger proportion of flat feet was seen in DG for the three indexes (AI: 32,2%, CSI: 59,7%, A: 17,5%, while highly arched feet acted oppositely. The groups were

Characterizing problematic hypoglycaemia: iterative design and preliminary psychometric validation of the Hypoglycaemia Awareness Questionnaire (HypoA-Q).

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Speight, J; Barendse, S M; Singh, H; Little, S A; Inkster, B; Frier, B M; Heller, S R; Rutter, M K; Shaw, J A M

2016-03-01

To design and conduct preliminary validation of a measure of hypoglycaemia awareness and problematic hypoglycaemia, the Hypoglycaemia Awareness Questionnaire. Exploratory and cognitive debriefing interviews were conducted with 17 adults (nine of whom were women) with Type 1 diabetes (mean ± sd age 48 ± 10 years). Questionnaire items were modified in consultation with diabetologists/psychologists. Psychometric validation was undertaken using data from 120 adults (53 women) with Type 1 diabetes (mean ± sd age 44 ± 16 years; 50% with clinically diagnosed impaired awareness of hypoglycaemia), who completed the following questionnaires: the Hypoglycaemia Awareness Questionnaire, the Gold score, the Clarke questionnaire and the Problem Areas in Diabetes questionnaire. Iterative design resulted in 33 items eliciting responses about awareness of hypoglycaemia when awake/asleep and hypoglycaemia frequency, severity and impact (healthcare utilization). Psychometric analysis identified three subscales reflecting 'impaired awareness', 'symptom level' and 'symptom frequency'. Convergent validity was indicated by strong correlations between the 'impaired awareness' subscale and existing measures of awareness: (Gold: rs =0.75, P Questionnaire has robust face and content validity; satisfactory structure; internal reliability; convergent, divergent and known groups validity. The impaired awareness subscale and other items contribute significantly to models explaining recall of severe and nocturnal hypoglycaemia. Prospective validation, including determination of a threshold to identify impaired awareness, is now warranted. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Preliminary bathymetry of Northwestern Fiord and Neoglacial changes of Northwestern Glacier

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Post, Austin

1980-01-01

The first preliminary bathymetry (at 1:20,000 scale) and other scientific investigations of Northwestern Fiord, Alaska, were conducted by the Research Vessel Growler in 1978, disclosing this 10.5-mile-long branched waterway to be a deep basin enclosed by a terminal-moraine shoal. The basin was formerly filled by Northwestern Glacier, which began a drastic retreat around 1909 and reached the head of the main arm around 1960. Soundings and profiles show the main channel to be as much as 970 feet deep and to have the typical U shape of a severely glacially eroded valley; since the glacier 's retreat, sediments have formed nearly level deposits in the deepest reaches, while the rest of the basin has a hard, rocky bottom. Preneoglacial forest debris dated by carbon-14 indicates Northwestern Glacier to have advanced into the fiord prior to 1,385 years before present (B.P.); a branch glacier evidently advanced into forest 1,635 years B.P. The combined glaciers from several arms culminated on the present terminal-moraine shoal around 1894. (USGS)

Mütoloogilisest mõtlemisest kahe-jalaga-maa-peal-seletustes. On mythological thinking in the representation of the concept two-feet-on-the-ground

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Mari-Liis Madisson

2012-06-01

Full Text Available This article focuses on the simultaneous co-existence of mythological and descriptive thinking in common sense discourse. Specifically, it concentrates on the synthesis of types of thought in those understandings that are characterized by the well-known expression having (one’s two-feet-on-the-ground. In order to provide concreteness for the meaning of the expression, I investigated Estonian cyberspace as one of the most prevalent arenas of common sense discourse, and it appeared that two-feet-on-the-ground is used to refer to rationality, sanity and practicality as opposed to, for example, dreamers, bohemians and people who talk about karma or believe in UFOs. People who use having (one’s two-feet-on-the-ground as a key element in their self-description assume that the way they understand the world is more rational and closer to reality than that of bohemians and spiritualists. Behind the above-mentioned two notions, which in themselves are not easy to define, there is a gleam of a more general tendency of Western thought. This is the conclusion reached by Rein Vihalemm, who has argued that what is accepted as truthful knowledge on the level of common sense is usually understood as being synonymous with scientific knowledge; in turn, the notion of the scientific is usually connected with inductive-empirical science. This article argues that the understandings that are posited as having two-feet-on-the-ground are mixed with categories that cannot be considered as belonging to inductive-empirical logic. The question of values, metaphysics and teleology is always (at least implicitly present in those representations. That idea seems to be natural in academic discourse but is not as self-evident on the common-sense level. Those who describe themselves as standing with their two-feet-on-the-ground usually think of metaphysics and teleology as being subjective, useless and distant. In describing the specificity of the logic of two-feet

The symptoms of depression and anxiety in patients with diabetic foot treated with hyperbaric oxygen - preliminary results

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Koźmin-Burzyńska Agnieszka

2016-03-01

Full Text Available The aim of the study was to assess the level of anxiety and depressiveness in patients who had qualified for hyperbaric oxygen therapy (HBOT for the treatment of ulcerative lesions in the lower limbs, occurring as a result of diabetic foot syndrome (DFS,. A total of 50 patients with type 2 diabetes and diabetic foot syndrome were enrolled to the study. All patients have received 30 sessions of HBOT. During the therapy blood glucose was measured and photographic documentation was carried out. All patients underwent the following procedures: medical history and socioeconomic interview, psychiatric examination, self-report and objective psychometric tests to measure anxiety and depressiveness. Based on the obtained results, we reported that patients with a greater degree of tissue damage had higher levels of depressive symptoms in the self-report tests as well as in the objective evaluation of the investigator. In terms of location of ulcerative lesions - the level of depressiveness was greater when the affected area included toes, and the level of anxiety was increased when it concerned the heel. Regarding other parameters, statistically significant correlations were not observed.

Trajectory Correction and Locomotion Analysis of a Hexapod Walking Robot with Semi-Round Rigid Feet

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Zhu, Yaguang; Jin, Bo; Wu, Yongsheng; Guo, Tong; Zhao, Xiangmo

2016-01-01

Aimed at solving the misplaced body trajectory problem caused by the rolling of semi-round rigid feet when a robot is walking, a legged kinematic trajectory correction methodology based on the Least Squares Support Vector Machine (LS-SVM) is proposed. The concept of ideal foothold is put forward for the three-dimensional kinematic model modification of a robot leg, and the deviation value between the ideal foothold and real foothold is analyzed. The forward/inverse kinematic solutions between the ideal foothold and joint angular vectors are formulated and the problem of direct/inverse kinematic nonlinear mapping is solved by using the LS-SVM. Compared with the previous approximation method, this correction methodology has better accuracy and faster calculation speed with regards to inverse kinematics solutions. Experiments on a leg platform and a hexapod walking robot are conducted with multi-sensors for the analysis of foot tip trajectory, base joint vibration, contact force impact, direction deviation, and power consumption, respectively. The comparative analysis shows that the trajectory correction methodology can effectively correct the joint trajectory, thus eliminating the contact force influence of semi-round rigid feet, significantly improving the locomotion of the walking robot and reducing the total power consumption of the system. PMID:27589766

Are human hands and feet affected by climate? A test of Allen's rule.

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Betti, Lia; Lycett, Stephen J; von Cramon-Taubadel, Noreen; Pearson, Osbjorn M

2015-09-01

In recent years, several studies have shown that populations from cold, high-latitude regions tend to have relatively shorter limbs than populations from tropical regions, with most of the difference due to the relative length of the zeugopods (i.e., radius, ulna, tibia, fibula). This pattern has been explained either as the consequence of long-term climatic selection or of phenotypic plasticity, with temperature having a direct effect on bone growth during development. The aims of this study were to test whether this pattern of intra-limb proportions extended to the bones of the hands and feet, and to determine whether the pattern remained significant after taking into account the effects of neutral evolutionary processes related to population history. Measurements of the limb bones, including the first metatarsal and metacarpal, were collected for 393 individuals from 10 globally distributed human populations. The relationship between intra-limb indices and minimum temperature was tested using generalized least squares regression, correcting for spatial autocorrelation. The results confirmed previous observations of a temperature-related gradient in intra-limb proportions, even accounting for population history. This pattern extends to the hands, with populations from cold regions displaying a relatively shorter and stockier first metacarpal; however, the first metatarsal appears to be wider but not shorter in cold-adapted populations. The results suggest that climatic adaptation played a role in shaping variation in limb proportions between human populations. The different patterns shown by the hands and feet might be due to the presence of evolutionary constraints on the foot to maintain efficient bipedal locomotion. © 2015 Wiley Periodicals, Inc.

Design and Usability Evaluation of Social Mobile Diabetes Management System in the Gulf Region.

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Alanzi, Turki; Istepanian, Robert; Philip, Nada

2016-09-26

The prevalence of diabetes in the Gulf States is one of the highest globally. It is estimated that 20% of the population in the region has been diagnosed with diabetes and according to the International Diabetes Federation (IDF), five of the IDF's "top 10" countries for diabetes prevalence in 2011 and projected for 2030 are in this region. In recent years, there have been an increasing number of clinical studies advocating the use of mobile phone technology for diabetes self-management with improved clinical outcomes. However, there are few studies to date addressing the application of mobile diabetes management in the Gulf region, particularly in the Kingdom of Saudi Arabia (KSA), where there is exponential increase in mobile phone usage and access to social networking. The objective of this paper is to present the design and development of a new mobile health system for social behavioral change and management tailored for Saudi patients with diabetes called Saudi Arabia Networking for Aiding Diabetes (SANAD). A usability study for the SANAD system is presented to validate the acceptability of using mobile technologies among patients with diabetes in the KSA and the Gulf region. The SANAD system was developed using mobile phone technology with diabetes management and social networking modules. For the usability study the Questionnaire for User Interaction Satisfaction was used to evaluate the usability aspect of the SANAD system. A total of 33 users with type 2 diabetes participated in the study. The key modules of the SANAD system consist of (1) a mobile diabetes management module; (2) a social networking module; and (3) a cognitive behavioral therapy module for behavioral change issues. The preliminary results of the usability study indicated general acceptance of the patients in using the system with higher usability rating in patients with type 2 diabetes. We found that the acceptability of the system was high among Saudi patients with diabetes, and ongoing

Changes of dendritic cells and fractalkine in type 2 diabetic patients with unstable angina pectoris: a preliminary report

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Qian Juying

2011-06-01

Full Text Available Abstract Background It has been shown that dendritic cells (DCs and fractalkine play a role in accelerating progression of the inflamed atherosclerotic lesions and plaque rupture. We evaluated the numbers and functional changes of DCs and its subsets in human type 2 diabetes with or without unstable angina pectoris (UAP. Methods The study population consisted of 39 diabetic patients (DM:18 without CAD; DM + UAP: 21 with UAP, 18 non-diabetic UAP patients (UAP, and 15 healthy control (Normal. Peripheral blood DCs and its subsets were measured by three color flow cytometry. Serum levels of fractalkine, IL-12, and IFN-α were also measured. The functional status of the monocyte-derived DCs was analyzed by flow cytometry and allogeneic mixed T lymphocytes reaction. Results The percent and absolute numbers of DCs and mDC within the total leukocyte population was similar for Normal and DM, while significantly lower in DM + UAP. pDC numbers were not significantly altered. Serum fractalkine in DM + UAP was highest among the four groups (p = 0.04 vs. UAP, p = 0.0003 vs. DM, p p = 0.01 level. Compared with DM and UAP, the costimulatory molecules CD86 and proliferation of T cells stimulated by DCs were significantly increased in DM + UAP group. Conclusions Our study suggested that increases in the fractalkine level and the number and functional changes of blood DCs might contribute to diabetic coronary atherosclerosis and plaque destabilization.

Diabetes Nutrition: Eating Out When You Have Diabetes

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Diabetes nutrition: Eating out when you have diabetes Diabetes nutrition — Make restaurant meals a healthy part of your diabetes ... have diabetes, eating out while sticking to your nutrition plan has gotten easier. Many restaurants offer healthy ...

Preliminary evaluation of the encapsulation of new antidiabetic sulphonylhydrazone and antitumor N-acylhydrazone derivatives using PLGA nanoparticles

International Nuclear Information System (INIS)

Costa, F N; Ibiapino, A L; De Figueiredo, L P; De Castro, C E; Giacomelli, F C; Ferreira, F F; Barreiro, E J; Lima, L M; Do Amaral, D N

2015-01-01

It has been demonstrated the feasibly of using PLGA nanoparticles to promote the encapsulation of novel anti-diabetic sulphonylhydrazone and antitumor N-acylhydrazone derivatives. The motivation is to further demonstrate the possibility of long-term release of anti-diabetic as well as higher accumulation of the antitumor derivative by using the nanotechnology-based production. The produced nanoparticles were obtained by the nanoprecipitation method, which revealed to be effective in the encapsulation of the bioactive compounds. The determined sizes were in the range of ∼100 nm, which are supposed to be suitable for both potential applications. The preliminary experimental data demonstrated the formation of stable nanosystems and further experiments are underway in order to determine the loading content, encapsulation efficiency and release profile of the hydrophobic bioactive compounds. (paper)

Three cases of feet and hand amputation from Medieval Estremoz, Portugal.

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Fernandes, Teresa; Liberato, Marco; Marques, Carina; Cunha, Eugénia

2017-09-01

Peri-mortem limb amputations are rarely reported in the paleopathological literature. The cases reported here concern severing of both hands and feet observed in three adult male skeletons, exhumed from the medieval Portuguese necropolis of Rossio do Marquês de Pombal, Estremoz, Portugal. The fact that they were found in the same site, in graves placed side by side, that all are young males, and that the three skeletons show similar perimortem injuries, make this a unique case meriting detailed analysis. Considering the lesions' location and pattern, as well as historical data, we hypothesize that this is a case of amputation as a consequence of judicial punishment. Estremoz was an important city in sustaining the Royal power at a regional scale during the medieval period. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of aluminum hinged shoes on the structure of contracted feet in Thoroughbred yearlings

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TANAKA, Kousuke; HIRAGA, Atsushi; TAKAHASHI, Toshiyuki; KUWANO, Atsutoshi; MORRISON, Scott Edward

2015-01-01

ABSTRACT We applied aluminum hinged shoes (AHSs) to the club foot-associated contracted feet of 11 Thoroughbred yearlings to examine the effects of the shoes on the shape of the hoof and third phalanx (P III). After 3 months of AHS use, the size of the affected hooves increased significantly, reaching the approximate size of the healthy contralateral hooves with respect to the maximum lateral width of the foot, the mean ratio of the bearing border width to the coronary band width, and the mea...

A profitable use of by-products of the poultry slaughter. The tanning of hen’s feet skins

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Juan Iade Vergara

2013-01-01

Full Text Available The aim of this development is to add value to one of the by-products of the poultry slaughtery, the chicken’s feet. The process began with the skinning of the chicken’s feet, which underwent a tanning process to obtain a leather characterised for its similarity with exotic leathers such as the reptile ones. To facilitate its possible production by artisanal means we designed a more environmental-friendly process, eliminating the use of sodium sulfide in the stages corresponding to dehairing and liming, followed by a chromium-free tanning based on a combination of vegetable tannins and synthetic retanning agents. Confirmation of the tanning of the skins was performed by measuring the shrinkage temperature of leathers, obtaining a value of 80 °C, higher than those of the raw hides. Physical properties were evaluated to characterize the product, obtaining tensile strength values of 0,65 kg/mm2 and a tear resistance of 2,10 kg/mm.

Buried chip skin grafting in neuropathic diabetic foot ulcers following vacuum-assisted wound bed preparation: enhancing a classic surgical tool with novel technologies.

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Kopp, Jürgen; Kneser, Ulrich; Bach, Alexander D; Horch, Raymund E

2004-09-01

In patients with diabetes mellitus, complications such as polyneuropathy and peripheral angiopathy inevitably lead to diabetic foot complications including foot ulcers, gangrene, and osteoarthropathy. These conditions necessitate minor or major amputation as part of treatment. In patients with Charcot's arthropathy and predominant neuropathy, recurrent foot ulcers are common in areas of high pressure. Such high pressure is caused by the degrading of the architecture of the foot and inadequate footwear. These patients are a clinical challenge. A select group of such patients may benefit from free surgical tissue transfer, though free or local flap surgery is often difficult or even impossible owing to an impaired arterial circulation. In such wounds, surgical debridement followed by skin grafts often fail due to bacterial burden in the wounds. To circumvent these problems, the authors developed a therapeutic approach using buried chip skin grafting to close granulation wound beds in diabetic feet. Locally applied vacuum therapy (VAC) for wound bed preparation of chronic, nonresponsive foot ulcers and subsequent grafting using the burying technique with a minute fraction of skin was used. Firm closure was achieved. The closed wound was resistant to mechanical irritation.

The skin landscape in diabetes mellitus. Focus on dermocosmetic management

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Piérard GE

2013-05-01

Full Text Available Gérald E Piérard,1 Sophie Seité,2 Trinh Hermanns-Lê,3 Philippe Delvenne,3 André Scheen,4 Claudine Piérard-Franchimont3 1Laboratory of Skin Bioengineering and Imaging (LABIC, University of Liège, Liège, Belgium; 2La Roche-Posay Pharmaceutical Laboratories, Asnières, France; 3Department of Dermatopathology, Unilab Lg, Liège University Hospital, Liège, Belgium; 4Department of Diabetology, Nutrition and Metabolic Diseases, and Clinical Pharmacology Unit, Liège University Hospital, Liège, Belgium Background: Some relationships are established between diabetes mellitus (DM and a series of cutaneous disorders. Specific dermatoses are markers for undiagnosed DM. Other disorders represent supervening complications in an already treated DM patient. Objective: To review the information about dermocosmetic care products and their appropriate use in the management and prevention of dermatoses related to DM. Method: The peer-reviewed literature and empiric findings are covered. Owing to the limited clinical evidence available for the use of dermocosmetics, a review of the routine practices and common therapies in DM-related dermatoses was conducted. Results: Some DM-related dermatoses (acanthosis nigricans, pigmented purpuric dermatosis are markers of macrovascular complications. The same disorders and some others (xerosis, Dupuytren's disease have been found to be more frequently associated with microangiopathy. Other skin diseases (alopecia areata, vitiligo were found to be markers of autoimmunity, particularly in type 1 DM. Unsurprisingly, using dermocosmetics and appropriate skin care has shown objective improvements of some DM-related dermatoses, such effects improve the quality of life. The most common skin manifestations of DM fall along continuum between "dry skin," xerosis, and acquired ichthyosis, occurring predominately on the shins and feet. Dermocosmetic products improve the feeling of well-being for DM patients. Keywords: diabetes

Use of medicinal plants for diabetes in Trinidad and Tobago Uso de plantas medicinales para la diabetes en Trinidad y Tabago

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D. Mahabir

1997-03-01

Full Text Available Use of herbal remedies from medicinal plants (bush medicines was studied in 622 people with diabetes mellitus attending 17 government health centers on the island of Trinidad, Trinidad and Tobago. Bush medicines were used by 42% of patients surveyed and were used for diabetes by 24%. Bush medicine use was more frequent in Afro-Trinidadians and in those of mixed ethnicity than in Indo-Trinidadians, and was also more prevalent in those with lower educational attainment. Most patients using bush medicines (214/264, or 81% reported gathering the plants themselves, and 107/264 (41% took them more frequently than once a week. Patients taking bush medicines mentioned 103 different plants used in remedies. Among the 12 most frequently mentioned, caraili, aloes, olive-bush, and seed-under-leaf were preferentially used for diabetes. Vervine, chandilay, soursop, fever grass, and orange peel were preferentially used for other indications. Patients who reported burning or numbness in the feet or feelings of tiredness, weakness, giddiness, or dizziness used bush medicines for diabetes more frequently than did patients who reported a range of other diabetes-related symptoms. Insulin-treated patients were less frequent users of bush medicines. It is concluded that bush medicines are taken regularly by many patients with diabetes in Trinidad. Plants most frequently used as remedies for diabetes have recognized hypoglycemic activity. Patients' culture, educational background, type of symptoms, and formal medical treatment may also influence the selection and use of bush medicines.El uso de remedios a base de plantas medicinales (medicinas herbolarias se estudió en 622 personas con diabetes mellitus que asistían a 17 centros de salud gubernamentales en la isla de Trinidad, en Trinidad y Tabago. Se observó el uso de medicinas herbolarias en 42% de los pacientes encuestados y su utilización para la diabetes se observó en 24%. El empleo de estas medicinas fue m

Evaluation of antidiabetic, antihyperlipidemic and antioxidant effects of Boehmeria nivea (L. Gaudich., Urticaceae, root extract in streptozotocin-induced diabetic rats

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Shruti Sancheti

2011-02-01

Full Text Available The potential role of 80% methanolic extract of Boehmeria nivea (L. Gaudich., Urticaceae, root in the treatment of diabetes, along with its antihyperlipidemic and antioxidant effects, was studied in streptozotocin-induced diabetic male Wistar rats. Preliminary screening of the extract revealed the presence of polyphenolics and flavonoids. The animal study was conducted with variable doses of 125, 250 and 500 mg/kg of extract for 21 days in diabetic rats. A significant effect was observed at a dose of 500 mg/kg, which was comparable to the standard drug, glibenclamide. Administration of the extract at a 500 mg/kg dose resulted in a significant reduction of fasting blood glucose, total cholesterol, triglycerides, blood urea, alanine aminotransferase, aspartate aminotransferase, urine sugar and urine ketone levels in diabetic rats in comparison with the diabetic control group. Additionally, this dose significantly increased body weight, hemoglobin, plasma total protein, high density lipoprotein cholesterol, liver glycogen content, superoxide dismutase, reduced glutathione and catalase levels in diabetic rats at the end of 21 days of treatment. Therefore, dietary supplementation with Boehmeria nivea root extract could be beneficial for correcting hyperglycemia, hyperlipidemia and enhancing the antioxidant defense system.

'Focus on feet'--the effects of systemic lupus erythematosus: a narrative review of the literature.

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Williams, A E; Crofts, G; Teh, L S

2013-09-01

The manifestations of systemic lupus erythematosus (SLE) vary between individuals, from the severe and life-threatening renal and central nervous system involvement, to the involvement of skin, musculoskeletal and vascular system, and the complications of infection influencing the quality of life. However, as specific manifestations affecting the lower limb are perceived as receiving little focus, the purpose of this narrative literature review is to identify the specific factors associated with SLE that may have implications for lower limb and foot morbidity. A structured search of databases was conducted. The inclusion was restricted to publications in the English language, those that specifically investigate the feet as affected with SLE. No restriction on year of publication was imposed to reduce publication bias and to capture as many publication in relation to feet. Eleven papers fulfilled the inclusion criteria. There were seven additional papers that made observations related to the articular or vascular complications of the feet. This narrative review provides some information on how SLE affects the lower limb and foot in relation to the musculoskeletal and vascular systems. However, there is a lack of literature that specifically focuses on all the manifestations of SLE and the complications associated with its management. There are indications that SLE affects lower limb and foot morbidity but the scale of these problems is unclear and this is partly because of the absence of research and the lack of a 'gold standard' framework for the assessment of the lower limb and foot. In addition to clinical foot health assessment, ultrasonography may be a useful alternative to plain film radiography or magnetic resonance imaging (MRI) in capturing the extent of articular and extra-articular manifestations. Further, the Ankle Brachial Pressure Index (ABPI) may be useful in identifying those with atherosclerosis and ischaemia. There are indications that SLE affects

Preliminary delineation and description of the regional aquifers of Tennessee : the Central Basin system

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Brahana, J.V.; Bradley, M.W.

1986-01-01

A sand and gravel aquifer about 65 feet thick underlies Wurtsmith Air Force Base in northeastern lower Michigan. The water table ranges in depth from 10 feet to 25 feet below land surface. Mathematical models indicate that ground-water flow ranges from 0.8 feet per day in the eastern part of the Base to 0.3 feet per day in the western part. Trichlorethylene leaked from a buried storage tank in the southeastern part of the Base and moved northeastward in a plume, contaminating Base water-supply wells. Concentrations exceed 1,000 micrograms per liter in the most highly contaminated part of the plume. Purge pumping removed some of the trichloroethylene and seems to have arrested its eastward movement. Pumping of additional purge wells could increase the rate of removal. (USGS)

Diabetes - resources

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Resources - diabetes ... The following sites provide further information on diabetes: American Diabetes Association -- www.diabetes.org Juvenile Diabetes Research Foundation International -- www.jdrf.org National Center for Chronic Disease Prevention and Health Promotion -- ...

Lateral Sesamoid Position Relative to the Second Metatarsal in Feet With and Without Hallux Valgus: A Prospective Study.

Science.gov (United States)

Geng, Xiang; Zhang, Chao; Ma, Xin; Wang, Xu; Huang, Jiazhang; Xu, Jian; Wang, Chen

2016-01-01

We sought to determine whether hallux valgus displaces the sesamoid bones laterally away from a stationary first metatarsal or whether the first metatarsal head is displaced medially from the stationary sesamoids, which remain in position relative to the rest of the forefoot. We reviewed weightbearing radiographs in the dorsal plantar view of 128 consecutive patients (149 feet) seen over 2 months in 2014. Of these, 82 feet (55%) had a hallux valgus angle of >15° (hallux valgus group) and 67 feet (45%) had an angle of no more than 15° (control group). We measured the absolute distances from the center of the lateral sesamoid and the first metatarsal head to the long axis of the second metatarsal. Next, the relative distances, defined as the ratio of these 2 absolute distances to the length of the second metatarsal, were calculated to adjust for foot size. Both the absolute and the relative distances from the center of the first metatarsal head to the second metatarsal differed significantly between the 2 groups and correlated positively with the hallux valgus angle and first intermetatarsal angle. However, neither the absolute nor the relative distance to the lateral sesamoid bone differed significantly between the groups, nor did they correlate with either of the 2 angles. Thus, despite medial shifting of the first metatarsal in hallux valgus, the lateral sesamoid retains its relationship to the second metatarsal in transverse plane. Its apparent lateral movement is a radiographic misinterpretation. Awareness of this misinterpretation should improve the success of corrective surgery. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Case report: 16-Year-old male with autistic disorder with preoccupation with female feet.

Science.gov (United States)

Early, Maureen C; Erickson, Craig A; Wink, Logan K; McDougle, Christopher J; Scott, Eric L

2012-06-01

This paper highlights clinical challenges faced when diagnosing and then treating an individual presenting to a child and adolescent psychiatry clinic because of unwelcome comments he made to female peers about their feet. Novel use of exposure therapy helped him effectively decrease his comments from 1 to 2 times per month to once every 6 months. Conceptualizing this case as the individual's failed attempts toward relationships with females instead of sexual harassment led to diminution of problematic behavior. Implications for diagnosis and treatment of individuals with Autistic Disorder displaying problematic behaviors are presented.

Diabetes Care: 10 Ways to Avoid Diabetes Complications

Science.gov (United States)

Diabetes care: 10 ways to avoid complications Diabetes care is a lifelong responsibility. Consider 10 strategies to prevent diabetes complications. By Mayo Clinic Staff Diabetes is a serious disease. Following ...

Treatment of diabetic mice with undenatured whey protein accelerates the wound healing process by enhancing the expression of MIP-1α, MIP-2, KC, CX3CL1 and TGF-β in wounded tissue

Directory of Open Access Journals (Sweden)

Badr Gamal

2012-06-01

Full Text Available Abstract Background Continuous diabetes-associated complications are a major source of immune system exhaustion and an increased incidence of infection. Diabetes can cause poor circulation in the feet, increasing the likelihood of ulcers forming when the skin is damaged and slowing the healing of the ulcers. Whey proteins (WPs enhance immunity during childhood and have a protective effect on some immune disorders. Therefore, in this study, we investigated the effects of camel WP on the healing and closure of diabetic wounds in a streptozotocin (STZ-induced type I diabetic mouse model. Results Diabetic mice exhibited delayed wound closure characterized by a significant decrease in an anti-inflammatory cytokine (namely, IL-10 and a prolonged elevation of the levels of inflammatory cytokines (TNF-α, IL-1β and IL-6 in wound tissue. Moreover, aberrant expression of chemokines that regulate wound healing (MIP-1α, MIP-2, KC and CX3CL1 and growth factors (TGF-β were observed in the wound tissue of diabetic mice compared with control nondiabetic mice. Interestingly, compared with untreated diabetic mice, supplementation with WP significantly accelerated the closure of diabetic wounds by limiting inflammatory stimuli via the restoration of normal IL-10, TNF-α, IL-1β and IL-6 levels. Most importantly, the supplementation of diabetic mice with WP significantly modulated the expression of MIP-1α, MIP-2, KC, CX3CL1 and TGF-β in wound tissue compared with untreated diabetic mice. Conclusion Our data demonstrate the benefits of WP supplementation for improving the healing and closure of diabetic wounds and restoring the immune response in diabetic mice.

49 CFR 228.105 - Additional requirements; construction within one-third mile (1,760 feet) (536 meters) of certain...

Science.gov (United States)

2010-10-01

... employee safety from toxic gases or explosions such as employee training and evacuation plans, availability... TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Construction of Employee Sleeping Quarters § 228.105... within 3 miles (15,840 feet) (4,827 meters) of the reporting point for the employees who are to be housed...

Automated microaneurysm detection in diabetic retinopathy using curvelet transform

Science.gov (United States)

Ali Shah, Syed Ayaz; Laude, Augustinus; Faye, Ibrahima; Tang, Tong Boon

2016-10-01

Microaneurysms (MAs) are known to be the early signs of diabetic retinopathy (DR). An automated MA detection system based on curvelet transform is proposed for color fundus image analysis. Candidates of MA were extracted in two parallel steps. In step one, blood vessels were removed from preprocessed green band image and preliminary MA candidates were selected by local thresholding technique. In step two, based on statistical features, the image background was estimated. The results from the two steps allowed us to identify preliminary MA candidates which were also present in the image foreground. A collection set of features was fed to a rule-based classifier to divide the candidates into MAs and non-MAs. The proposed system was tested with Retinopathy Online Challenge database. The automated system detected 162 MAs out of 336, thus achieved a sensitivity of 48.21% with 65 false positives per image. Counting MA is a means to measure the progression of DR. Hence, the proposed system may be deployed to monitor the progression of DR at early stage in population studies.

Selected Physical Therapy Modalities for the treatment of Diabetic Polyneuropathy

International Nuclear Information System (INIS)

Sawan, S.; Sayed, N.; Al-Gazzar, S.

2006-01-01

The purpose of this study was to examine the effect of using selected physical therapy modalities for the treatment of diabetic polyneuropathy. Thirty patients participated in this study. Patients were randomly divided into study group (ten males and five females) and control group (six males and nine females). The study group received interferential current on the lumbosacral region, followed by repeated contraction as specific technique of proprioceptive neuromuscular facilitation (PNF) to the anterior tibial group muscles. The control group did not receive physical therapy treatment. The treatment for the study group was conducted three times per week, for a period of six weeks. The patients were assessed for intensity of pain, manual muscle testing of the anterior tibial group muscles, and the level of superficial sensation on their feet. Patients were assessed the beginning of the treatment session and after the last session. The result of this study showed a significant decrease in the pain intensity, increase anterior tibial group muscles strength and increase level of superficial sensation in patients of study group in comparison to the control group at the end of the treatment. The control group did not show significant changes. It can be concluded that the combination of interferential current and repeated contraction (specific technique of PNF to the anterior tibial group muscles) is effective in decreasing the pain, increasing anterior tibial group muscles strength and the level of superficial sensation in patients suffering from diabetic polyneuropathy. (author)

Gram-negative diabetic foot osteomyelitis: risk factors and clinical presentation.

Science.gov (United States)

Aragón-Sánchez, Javier; Lipsky, Benjamin A; Lázaro-Martínez, Jose L

2013-03-01

Osteomyelitis frequently complicates infections in the feet of patients with diabetes. Gram-positive cocci, especially Staphylococcus aureus, are the most commonly isolated pathogens, but gram-negative bacteria also cause some cases of diabetic foot osteomyelitis (DFO). These gram-negatives require different antibiotic regimens than those commonly directed at gram-positives. There are, however, few data on factors related to their presence and how they influence the clinical picture. We conducted a retrospective study to determine the variables associated with the isolation of gram-negative bacteria from bone samples in cases of DFO and the clinical presentation of these infections. Among 341 cases of DFO, 150 had a gram-negative isolate (alone or combined with a gram-positive isolate) comprising 44.0% of all patients and 50.8% of those with a positive bone culture. Compared with gram-positive infections, wounds with gram-negative organisms more often had a fetid odor, necrotic tissue, signs of soft tissue infection accompanying osteomyelitis, and clinically severe infection. By multivariate analysis, the predictive variables related to an increased likelihood of isolating gram-negatives from bone samples were glycated hemoglobin gram-negatives had a statistically significantly higher prevalence of leukocytosis and higher white blood cell counts than those without gram-negatives. In conclusion, gram-negative organisms were isolated in nearly half of our cases of DFO and were associated with more severe infections, higher white blood cell counts, lower glycated hemoglobin levels, and wounds of traumatic etiology.

Preliminary interpretations of geologic results obtained from boreholes UE25a-4, -5, -6, and -7, Yucca Mountain, Nevada Test Site

International Nuclear Information System (INIS)

Spengler, R.W.; Rosenbaum, J.G.

1980-01-01

Since 1978, the USGS (US Geological Survey) has been providing technical assistance in characterizing suitable rock masses at or contiguous to the NTS (Nevada Test Site) for long-term storage of high-level nuclear waste. Current efforts have been focused on investigating Yucca Mountain, a volcanic highland situated along the western boundary of NTS in southern Nevada. Detailed stratigraphic and structural studies have been in progress along a northeastern segment of the highland in a wedge-shaped area bounded by Basin and Range faults, most of which trend north-northeast. A series of four locally steep-walled, nearly parallel, linear washes transect the northeastern half of the area of interest and display trends similar to major faults to the northeast. Prior to the present study, drill hole UE25a-1, located about 1600 feet southeast of the edge of the area of interest, was cored to a depth of 2500 feet. Subsurface information derived from the upper 500 feet of this drill hole is included in this report to compare with recently acquired data. Surface electrical surveys have been conducted by both the University of Utah and the USGS perpendicular to the trend of the washes in an attempt to better understand factors that have influenced the present drainage pattern. Preliminary data of both pole-dipole and dipole-dipole resistivity/IP electrical methods indicate numerous vertical and horizontal discontinuities between adjacent resistive bodies that strongly suggest a broad zone of faulting, fracturing, and (or) brecciation. To verify the existence of structural discontinuities suggested by the linear washes and electrical anomalies, a drilling program was initiated in June 1979, to obtain geologic information within the southernmost of four northwest-trending washes

Diabetes insipidus: main aspects and comparative analysis with diabetes mellitus Diabetes insipidus: principais aspectos e análise comparativa com diabetes mellitus

Directory of Open Access Journals (Sweden)

Flávia Lúcia Abreu Rabelo

2009-01-01

Full Text Available Diabetes mellitus is a disease characterized by the excess of sugar in the blood and urine. The two most common types of diabetes are insulin-dependent diabetes mellitus and insulin-resistant diabetes mellitus, both presenting glycemic regulation-damage caused by insulin. Nevertheless, there is another type of diabetes that is less known but not less important, the diabetes insipidus, which is characterized by a problem with the synthesis, secretion or action of the ADH (anti-diuretic hormone that can result in polyuric syndromes with increased excretion of hypotonic urine. Physiologically, variations in the osmotic pressure activate osmoceptors that stimulate the ADH secretion, increasing water reabsorption in the kidney collection tubes. This article intends to revise a wide-ranging study on diabetes insipidus, aiming at a comparative analysis of the incidence, diagnosis, causes, types, treatment and consequences between diabetes insidipus and diabetes mellitus. Diabetes mellitus and insipidus are two different pathologies with a single similarity that is the diabetes itself, that is, the polyuria established. The knowledge of the significant differences between the pathologies studied is important once diabetes insipidus is less known, but can lead to serious complications if not properly treated. O diabetes mellitus é uma doença caracterizada pelo excesso de açúcar no sangue e na urina. Os dois tipos mais comuns de diabetes são diabetes mellitus insulino-dependente e diabetes mellitus insulino – resistente, e que ambos apresentam comprometimento da regulação da glicemia por ação da insulina. No entanto, existe outra forma de diabetes menos conhecida, mas não menos importante, o diabetes insipidus, que é caracterizado por um distúrbio na síntese, secreção ou ação do ADH (hormônio antidiurético, que pode resultar em síndromes poliúricas com excreção aumentada de urina hipotônica. Fisiologicamente, variações na press

Patients' Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA).

Science.gov (United States)

Paton, Joanne S; Roberts, Anne; Bruce, Graham K; Marsden, Jonathan

2014-02-22

Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear therapeutic footwear is driven by the

Patients’ Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA)

Science.gov (United States)

2014-01-01

Background Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. Methods An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. Findings Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. Conclusion For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear

Intimal permeability evaluated in a short-term organ culture of diabetic guinea pig aorta

International Nuclear Information System (INIS)

Schlosser, M.J.; Verlangieri, A.J.

1988-01-01

A novel short-term organ culture system was used to evaluate intimal permeability changes by measuring aortic [ 14 C]methylated albumin accumulation. Aortic plugs were removed from the upper thoracic aorta of male guinea pigs and maintained in serum-free media. The accumulation of [ 14 C]albumin in the intimal-medial layer was determined after a 5 h incubation. In preliminary studies, albumin recovered from intimal-injured aortic plugs was significantly greater than those from non-injured plugs. Aortic plugs from streptozotocin-treated guinea pigs, diabetic for 3 weeks, also accumulated significantly more [ 14 C]albumin than plugs from nondiabetic controls. Histological changes were not observed in the aorta of either the diabetic or control group. A strong significant inverse correlation was found between plasma ascorbic acid levels and [ 14 C]-activity recovered from aortic plugs. This study demonstrates a simple and rapid method for assessing aortic permeability changes under a well-defined in vitro system, and suggests that vascular permeability changes in the streptozotocin-diabetic guinea pig may be associated with an ascorbic acid deficit

Training Cambodian Village Health Support Guides in Diabetes Prevention: Effects on Guides' Knowledge and Teaching Activities Over 6 Months.

Science.gov (United States)

Wagner, Julie; Keuky, Lim; Fraser-King, Lorraine; Kuoch, Theanvy; Scully, Mary

2016-04-01

Type 2 diabetes is a pressing public health concern in Cambodia, a country with limited human resource capacity due to genocide. Cambodian village health support guides (Guides) promote health at the local level. This paper reports preliminary results of training Guides in diabetes prevention. The curriculum, called Eat, Walk, Sleep was delivered to Guides in Siem Reap province once over 3 h. Participants completed a pretest and posttest on diabetes knowledge. Guides were offered continuing education through Eat, Walk, Sleep resources and were encouraged to teach Eat, Walk, Sleep in their villages. For each of 6 months following their training, Guides completed a checklist regarding their activities. One hundred eighty-five Guides attended one of ten trainings. Knowledge scores increased significantly from pretest to posttest. During 6 months of follow-up, n = 159 Guides (85 %) completed at least one monthly checklist. Guides reported high rates of uptake and delivery of the Eat, Walk, Sleep curriculum and moderate rates of continuing education about diabetes. Diabetes prevention in Cambodia is nascent. Guides show excellent uptake and dissemination of the curriculum. Future research should examine effect of support for Guide activities and the effect of the curriculum on villager health behaviors, and ultimately, on rates of type 2 diabetes.

[PERCUTANEOUS CORRECTION OF FOREFOOT DEFORMITIES IN DIABETIC PATIENTS IN ORDER TO PREVENT PRESSURE SORES - TECHNIQUE AND RESULTS IN 20 CONSECUTIVE PATIENTS].

Science.gov (United States)

Yassin, Mustafa; Garti, Avraham; Heller, Eyal; Weissbrot, Moshe; Robinson, Dror

2017-04-01

Diabetes mellitus is a 21st century pandemic. Due to life-span prolongation combined with the increased rate of diabetes, a growing population of patients is afflicted with neuropathic foot deformities. Traditional operative repair of these deformities is associated with a high complication rate and relatively common infection incidence. In recent years, in order to prevent these complications, percutaneous deformity correction methods were developed. Description of experience accumulated in treating 20 consecutive patients with diabetic neuropathic foot deformities treated in a percutaneous fashion. A consecutive series of patients treated at our institute for neuropathic foot deformity was assessed according to a standard protocol using the AOFAS forefoot score and the LUMT score performed at baseline as well as at 6 months and 12 months. Treatment related complications were monitored. All procedures were performed in an ambulatory setting using local anesthesia. A total of 12 patients had soft tissue corrections, and 8 had a combined soft tissue and bone correction. Baseline AOFAS score was 48±7 and improved to 73±9 at six months and 75±7 at one year. LUMT score in 11 patients with a chronic wound decreased from 22±4 to 2±1 at one year post-op. One patient required hospitalization due to post-op bleeding. Percutaneous techniques allow deformity correction of diabetic feet, including those with open wounds in an ambulatory setting with a low complication rate.

Diabetes and Pregnancy: Gestational Diabetes

Centers for Disease Control (CDC) Podcasts

2007-11-14

Gestational diabetes happens in a woman who develops diabetes during pregnancy. This podcast discusses its potential effects and action steps to avoid complications.  Created: 11/14/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT) and National Center on Birth Defects and Developmental Disabilities (NCBDDD), Prevention Research Branch.   Date Released: 11/27/2007.

Comparison of association of diabetes mellitus in hepatitis C virus infection and hepatitis B virus infection

International Nuclear Information System (INIS)

Khan, I.A.; Bukhari, M.H.; Khokhar, M.S.

2013-01-01

Background: While patients with liver disease are known to have a higher prevalence of glucose intolerance, preliminary studies suggest that hepatitis C virus (HCV) infection may be an additional risk factor for the development of diabetes mellitus (DM). Objective: The presented study was aimed to study and determine a relationship between the relative proportions of Diabetes Mellitus in patients suffering from HCV infection. Study Design: This cross sectional study. Study Settings: Patients were registered from outdoor as well as indoor departments of different teaching hospitals (Services hospital Lahore and medical departments in Jinnah hospital, Mayo hospital, Sir Ganga Ram hospital) in Lahore, Pakistan. Methods: This cross sectional study was comprised of age and sex matched 258 patients of viral hepatitis B infection and viral hepatitis C infection, conducted at Hepatitis Clinic Services Hospital, affiliated with Post Graduate Medical Institute, Lahore. Diagnosis of HBV was made with evidence of hepatitis B surface antigen, HCV infection was diagnosed if patient was sero positive for anti HCV (ELISA methods) and HCV - RNA (By PCR). Diabetes Mellitus was diagnosed after fulfilling the American Diabetic Association Criteria, from November, 2000 to September, 2002. Results: A total of 318 patients were registered, out of which 258 cases fulfilled the inclusion criteria, 164 hepatitis C infected and 94 hepatitis B infected cases, 16.46% hepatitis C infected cases were diagnosed as diabetics while 4.25% hepatitis B infected cases were diagnosed as diabetics. Conclusion: This study concludes that there is high Association and relationship of Diabetes Mellitus with Hepatitis C virus infection as compared with Hepatitis B virus infection. (author)

[Preliminary analysis of the relationship between peripheral arterial disease and other atherosclerosis markers and diabetic nephropathy].

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Rioja, José; Moreno, Tamara; Coca, Inmaculada; Jiménez-Villodres, Manuel; Rodríguez-Morata, Alejandro; Valdivielso, Pedro

2014-01-01

To determine lipid serum levels, lipoproteins and other markers related to nephropathy and peripheral arterial disease (PAD) in a type 2 diabetes population stratified according to their level of renal dysfunction. A cross-sectional study was conducted on 72 type 2 diabetic patients followed-up in outpatient clinics. Patients were divided into 4 groups according to their estimated glomerular filtration rate (eGFR, mL/min) and albumin/creatinine ratio (ACR, mg/g) (eGFR > 60 and ACR 60 and ACR > 30 [n = 12], eGFR30-60 [n = 23] and eGFR < 30 [n = 14]). Clinical and anthropometric characteristic of all patients were recorded. Fasting lipids and apolipoproteins, as well as renal and hematology parameters were measured. Finally, a multivariate Wald stepwise logistic regression statistic analysis was performed to determine variables independently associated with the presence of renal dysfunction. The univariate statistical analysis showed that the higher renal dysfunction, the higher the prevalence of hypertension, smoking habit and triglycerides levels, and the lower hemoglobin levels (P < .05). The multivariate statistical analysis showed that only triglycerides levels (OR: 1.019, 95% CI: 1.004-1.034) and hemoglobin levels (OR: 0.516 95% CI: 0.292-0.914) were independently associated to the presence of renal dysfunction (eGFR < 60 mL/min.). The further inclusion of the presence of PAD in the statistical model did not modify those associations. The results confirm the relationship between triglycerides levels and diabetic nephropathy, independently of the presence of PAD. Copyright © 2013 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

The response of diabetic foot to a new type of dressing

Directory of Open Access Journals (Sweden)

Skórkowska-Telichowska Katarzyna

2012-12-01

Full Text Available Abstract Background FlaxAid is a newly developed type of dressing enriched in particular flavonoids through genetic engineering of flax plants that exhibit health-promoting activities due to their strong antioxidant properties. The purpose of the current study was to assess the clinical efficacy of the FlaxAid bandage therapy for a patient affected with a diabetic foot ulcer which was unresponsive to previous treatments. The patient was treated with FlaxAid bandages for 12 weeks and the size and properties of the wound were routinely observed and recorded. Due to the the clinical picture of the wound study design was adopted whereby the comparative treatment was cotton gauze wetted with isotonic salt solution. Findings Following therapy, the foot ulcer decreased in size, despite the decompensation of advanced diabetes. It is believed that the beneficial nature of FlaxAid is derived from its high level and broad spectrum of antioxidants. Conclusions The FlaxAid dressing provides a novel and effective method for the treatment of diabetic foot ulcers. This study presents a preliminary pilot investigation and a larger number of subjects need to be included within the study in order to draw firm clinical conclusions. Efforts to this effect are currently under way.

Race/Ethnic Difference in Diabetes and Diabetic Complications

OpenAIRE

Spanakis, Elias K.; Golden, Sherita Hill

2013-01-01

Health disparities in diabetes and its complications and co-morbidities exist globally. A recent Endocrine Society Scientific Statement described the Health Disparities in several endocrine disorders, including type 2 diabetes. In this review we summarize that statement and provide novel updates on race/ethnic differences in children and adults with type 1 diabetes, children with type 2 diabetes and in Latino subpopulations. We also review race/ethnic differences in the epidemiology of diabet...

Cardiovascular Response Of Diabetic And Non-Diabetic Nigerian ...

African Journals Online (AJOL)

This study assessed the cardiovascular responses of diabetic and non-diabetic subjects to a single bout of bicycle ergometry. Ten male volunteer diabetics and ten male non-diabetic healthy subjects constituted the study and control groups respectively. The subjects exercised for ten minutes on a bicycle ergometer.

Retinal changes in diabetic patients without diabetic retinopathy.

Science.gov (United States)

Dumitrescu, Alina Gabriela; Istrate, Sinziana Luminita; Iancu, Raluca Claudia; Guta, Oana Maria; Ciuluvica, Radu; Voinea, Liliana

2017-01-01

The purpose of this study was to measure retinal vessel caliber and to examine early changes in macular thickness using optical coherence tomography (OCT). We evaluated to what extend vascular caliber and macular thickness differed between patients with type 2 diabetes mellitus without diabetic retinopathy compared with healthy individuals. 26 diabetic patients without diabetic retinopathy and 26 normal participants without any retinal and optic nerve diseases underwent ophthalmic examination, fundus photography, and OCT imaging. Temporal inferior retinal vessel diameters were measured using OCT. Also, we measured macular thickness in nine ETDRS subfields using Cirrus OCT. The mean age in the diabetic group was 61.5 years and in the control group, 55.5 years. Wider retinal arterioles and venules were found in patients with diabetes compared with healthy subjects (120 µm versus 96 µm, pdiabetes mellitus, central macular thickness was significantly thinner than that of control eyes (243.5 µm versus 269.9 µm, p value diabetes without diabetic retinopathy.

Awareness of diabetic retinopathy among patients with diabetes ...

African Journals Online (AJOL)

Background: Diabetic retinopathy is a major cause of blindness worldwide. The associated loss of productivity and quality of life of the patients with diabetic retinopathy will lead to additional socioeconomic burden. This study aims to determine the level of awareness of diabetic retinopathy among diabetic patients. Materials ...

Diabetes Technologies and Their Role in Diabetes Management

Science.gov (United States)

Kollipara, Sobha; Silverstein, Janet H.; Marschilok, Katie

2009-01-01

The 1993 Diabetes Complications and Control Trial (DCCT) showed that controlling blood glucose prevents and delays the progression of long term complications of diabetes. New diabetes technologies can make control of diabetes possible and safer. This paper reviews these technologies used to monitor blood glucose, administer insulin and evaluate…

Curcumin Alleviates Diabetic Retinopathy in Experimental Diabetic Rats.

Science.gov (United States)

Yang, Fang; Yu, Jinqiang; Ke, Feng; Lan, Mei; Li, Dekun; Tan, Ke; Ling, Jiaojiao; Wang, Ying; Wu, Kaili; Li, Dai

2018-03-29

To investigate the potential protective effects of curcumin on the retina in diabetic rats. An experimental diabetic rat model was induced by a low dose of streptozotocin combined with a high-energy diet. Rats which had blood glucose levels ≥11.6 mmol/L were used as diabetic rats. The diabetic rats were randomly divided into 3 groups: diabetic rats with no treatment (DM), diabetic rats treated with 100 mg/kg curcumin (DM + Cur 100 mg/kg), and diabetic rats treated with 200 mg/kg curcumin (DM + Cur 200 mg/kg). Curcumin was orally administered daily for 16 weeks. After 16 weeks of administration, the rats were euthanized, and eyes were dissected. Retinal histology was examined, and the thickness of the retina was measured. Ultrastructural changes of retinal ganglion cells, inner layer cells, retinal capillary, and membranous disks were observed by electron microscopy. Malondialdehyde, superoxide dismutase, and total antioxidant capacity were measured by ELISA. Expression levels of vascular endothelial growth factor (VEGF) in retina tissues were examined by immunohistochemical staining and ELISA. Expression levels of Bax and Bcl-2 in retina tissues were determined by immunohistochemical staining and Western blotting. Curcumin reduced the blood glucose levels of diabetic rats and decreased diabetes-induced body weight loss. Curcumin prevented attenuation of the retina in diabetic rats and ameliorated diabetes-induced ultrastructure changes of the retina, including thinning of the retina, apoptosis of the retinal ganglion cells and inner nuclear layer cells, thickening of retinal capillary basement membrane and disturbance of photoreceptor cell membranous disks. We also found that curcumin has a strong antioxidative ability in the retina of diabetic rats. It was observed that curcumin attenuated the expression of VEGF in the retina of diabetic rats. We also discovered that curcumin had an antiapoptotic effect by upregulating the expression of Bcl-2 and downregulating

Year in diabetes 2012: The diabetes tsunami.

Science.gov (United States)

Sherwin, R; Jastreboff, A M

2012-12-01

Diabetes affects more than 300 million individuals globally, contributing to significant morbidity and mortality worldwide. As the incidence and prevalence of diabetes continue to escalate with the force of an approaching tsunami, it is imperative that we better define the biological mechanisms causing both obesity and diabetes and identify optimal prevention and treatment strategies that will enable a healthier environment and calmer waters. New guidelines from the American Diabetes Association/European Association of the Study of Diabetes and The Endocrine Society encourage individualized care for each patient with diabetes, both in the outpatient and inpatient setting. Recent data suggest that restoration of normal glucose metabolism in people with prediabetes may delay progression to type 2 diabetes (T2DM). However, several large clinical trials have underscored the limitations of current treatment options once T2DM has developed, particularly in obese children with the disease. Prospects for reversing new-onset type 1 diabetes also appear limited, although recent clinical trials indicate that immunotherapy can delay the loss of β-cell function, suggesting potential benefits if treatment is initiated earlier. Research demonstrating a role for the central nervous system in the development of obesity and T2DM, the identification of a new hormone that simulates some of the benefits of exercise, and the development of new β-cell imaging techniques may provide novel therapeutic targets and biomarkers of early diabetes detection for optimization of interventions. Today's message is that a diabetes tsunami is imminent, and the only way to minimize the damage is to create an early warning system and improve interventions to protect those in its path.

Shoulder dystocia in diabetic and non-diabetic pregnancies.

Science.gov (United States)

Malinowska-Polubiec, Aneta; Romejko-Wolniewicz, Ewa; Szostak, Oksana; Dobrowolska-Redo, Agnieszka; Tolloczko, Justyna; Zareba-Szczudlik, Julia; Smolarczyk, Roman; Czajkowski, Krzysztof

2014-01-01

Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of the major risk factors for shoulder dystocia. The aim of this study was to analyze antepartum and peripartum risk factors and complications of shoulder dystocia in diabetic and non-diabetic women. We performed a retrospective analysis of 48 shoulder dystocia cases out of 28,485 vaginal deliveries of singleton, live-born infants over a 13 year period: 13 cases were diagnosed in diabetic women and 35 cases in non-diabetic women. The study was conducted in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, from January 2000 to December 2012. Compared to non-diabetic women, diabetic patients had significantly higher pre-pregnancy body weight (83.4±23.8 kg vs. 62.5±10.9 kg, p=0.002), higher pre-pregnancy BMI (30.2±6.8 kg/m2 vs. 22.9±4.3 kg/m2, p=0.0003), and lower gestational weight gain (11.4±6.2 kg vs. 16.0±4.7 kg, p=0.01). Diabetic women with shoulder dystocia were more likely to deliver before completion of the 38th week of gestation (30.8% vs. 5.7%, p=0.02) and had a higher incidence of 1st and 2nd stage perineal tears compared with the non-diabetic group (23.1% vs. 0%, p=0.02). There were two cases of symphysis pubis dehiscence in non-diabetic women. Children of diabetic mothers had a significantly higher birth weight (4,425.4±561.6 g vs. 4,006.9±452.8 g, p=0.03). Children of diabetic mothers with dystocia were at significantly higher risk of peripartum injuries (92.3% vs. 45.7%). A significant difference was observed in the percentage of brachial plexus palsy (61.5% vs. 17.1%). Children of diabetic women experiencing shoulder dystocia were more frequently affected by Erb's brachial plexus palsy and respiratory disturbances. These children had an increased likelihood of birth weights above the 90th percentile (not necessarily reaching 4,000 g) compared to children born to non-diabetic mothers. Shoulder dystocia in women with

Short- and long-term effects of a quality improvement collaborative on diabetes management

Directory of Open Access Journals (Sweden)

Niessen Louis W

2010-11-01

Full Text Available Abstract Introduction This study examined the short- and long-term effects of a quality improvement collaborative on patient outcomes, professional performance, and structural aspects of chronic care management of type 2 diabetes in an integrated care setting. Methods Controlled pre- and post-intervention study assessing patient outcomes (hemoglobin A1c, cholesterol, blood pressure, weight, blood lipid levels, and smoking status, professional performance (guideline adherence, and structural aspects of chronic care management from baseline up to 24 months. Analyses were based on 1,861 patients with diabetes in six intervention and nine control regions representing 37 general practices and 13 outpatient clinics. Results Modest but significant improvement was seen in mean systolic blood pressure (decrease by 4.0 mm Hg versus 1.6 mm Hg and mean high density lipoprotein levels (increase by 0.12 versus 0.03 points at two-year follow up. Positive but insignificant differences were found in hemoglobin A1c (0.3%, cholesterol, and blood lipid levels. The intervention group showed significant improvement in the percentage of patients receiving advice and instruction to examine feet, and smaller reductions in the percentage of patients receiving instruction to monitor blood glucose and visiting a dietician annually. Structural aspects of self-management and decision support also improved significantly. Conclusions At a time of heightened national attention toward diabetes care, our results demonstrate a modest benefit of participation in a multi-institutional quality improvement collaborative focusing on integrated, patient-centered care. The effects persisted for at least 12 months after the intervention was completed. Trial number http://clinicaltrials.gov Identifier: NCT 00160017

[Effect of high-intensity interval training on the reduction of glycosylated hemoglobin in type-2 diabetic adult patients].

Science.gov (United States)

Aguilera Eguía, Raúl Alberto; Russell Guzmán, Javier Antonio; Soto Muñoz, Marcelo Enrique; Villegas González, Bastián Eduardo; Poblete Aro, Carlos Emilio; Ibacache Palma, Alejandro

2015-03-05

Type 2 diabetes mellitus is one of the major non-communicable chronic diseases in the world. Its prevalence in Chile is significant, and complications associated with this disease involve great costs, which is why prevention and treatment of this condition are essential. Physical exercise is an effective means for prevention and treatment of type 2 diabetes mellitus. The emergence of new forms of physical training, such as "high intensity interval training", presents novel therapeutic alternatives for patients and health care professionals. To assess the validity and applicability of the results regarding the effectiveness of high intensity interval training in reducing glycosylated hemoglobin in adult patients with type 2 diabetes mellitus and answer the following question: In subjects with type 2 diabetes, can the method of high intensity interval training compared to moderate intensity exercise decrease glycosylated hemoglobin? We performed a critical analysis of the article "Feasibility and preliminary effectiveness of high intensity interval training in type 2 diabetes". We found no significant differences in the amount of glycosylated hemoglobin between groups of high intensity interval training and moderate-intensity exercise upon completion of the study (p>0.05). In adult patients with type 2 diabetes mellitus, high intensity interval training does not significantly improve glycosylated hemoglobin levels. Despite this, the high intensity interval training method shows as much improvement in body composition and physical condition as the moderate intensity exercise program.

Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish group report.

Science.gov (United States)

Goenka, N; Turner, B; Vora, J

2011-12-01

The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

Comparative analysis of diabetic nephropathy and non-diabetic nephropathy disease.

Science.gov (United States)

Chen, Qiuxiang; Zhu, Aimin; Wang, Junsheng; Huan, Xuelai

2017-12-01

Clinical symptoms of diabetic nephropathy patients and non-diabetic nephropathy are compared and analyzed, hemodialysis effect and quality of life of two kinds of nephrotic patients are analyzed. Respectively extract 1300 cases of diabetic nephropathy and non-diabetic nephropathy patients admitted to different hospitals during December 2011-December 2014. Based on whether the patient suffers from diabetes, they were divided into diabetic group and control group. Hemodialysis of two groups of patients were followed up to observe effectiveness of blood treatment, and complications were observed after one year of follow-up. Hematodialysis effectiveness of diabetic nephropathy patients is significantly lower than that of non-diabetic nephropathy group. After 1 year's follow-up, it can be found that survival rate of diabetic nephropathy patients is much lower than that of control group. In statistical comparison of data involved in the two groups of patients, P diabetic nephropathy patients is relatively poor compared to that of non-diabetic patients. In clinics, management and prevention of diabetic patients should be strengthened to avoid complication of nephropathy which brings serious injury to patients.

Women and Diabetes

Medline Plus

Full Text Available ... Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... talk with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

Monogenic Diabetes

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... but can return later in life How are MODY and neonatal diabetes diagnosed? Because monogenic diabetes is rare, this diagnosis ... type 1 or type 2 diabetes and identify MODY or neonatal diabetes. Blood tests Blood tests of glucose levels, and ...

A multi-segment foot model based on anatomically registered technical coordinate systems: method repeatability and sensitivity in pediatric planovalgus feet.

Science.gov (United States)

Saraswat, Prabhav; MacWilliams, Bruce A; Davis, Roy B; D'Astous, Jacques L

2013-01-01

Several multisegment foot models have been proposed and some have been used to study foot pathologies. These models have been tested and validated on typically developed populations; however application of such models to feet with significant deformities presents an additional set of challenges. For the first time, in this study, a multisegment foot model is tested for repeatability in a population of children with symptomatic abnormal feet. The results from this population are compared to the same metrics collected from an age matched (8-14 years) typically developing population. The modified Shriners Hospitals for Children, Greenville (mSHCG) foot model was applied to ten typically developing children and eleven children with planovalgus feet by two clinicians. Five subjects in each group were retested by both clinicians after 4-6 weeks. Both intra-clinician and inter-clinician repeatability were evaluated using static and dynamic measures. A plaster mold method was used to quantify variability arising from marker placement error. Dynamic variability was measured by examining trial differences from the same subjects when multiple clinicians carried out the data collection multiple times. For hindfoot and forefoot angles, static and dynamic variability in both groups was found to be less than 4° and 6° respectively. The mSHCG model strategy of minimal reliance on anatomical markers for dynamic measures and inherent flexibility enabled by separate anatomical and technical coordinate systems resulted in a model equally repeatable in typically developing and planovalgus populations. Copyright © 2012 Elsevier B.V. All rights reserved.

Testing an integrated model of eating disorders in paediatric type 1 diabetes mellitus.

Science.gov (United States)

Wilson, Charlotte E; Smith, Emma L; Coker, Sian E; Hobbis, Imogen Ca; Acerini, Carlo L

2015-11-01

Eating disorders in young people with type 1 diabetes mellitus confer additional health risks beyond those conferred by the disease itself. Risk factors for developing eating disorders are poorly understood. The current study aimed to examine risk factors for eating disturbance in young people with type 1 diabetes mellitus. Both diabetes specific risk factors, such as body mass index (BMI), glycaemic control and diabetes-related conflict, and also more general risk factors such as dysfunctional perfectionism and low self-esteem were assessed. Fifty young people aged 14-16 and their primary caregiver were asked to complete interviews and questionnaires about their eating attitudes and behaviours, dysfunctional perfectionism, self-esteem, family conflict, and general mental health symptoms. Recent weight and height and glycaemic control were extracted from the medical file. Different factors distinguished those young people who displayed eating disorder attitudes from those who did not (higher BMI-z, poorer glycaemic control, and lower self-esteem) and those young people who displayed eating disorder behaviour from those who did not (lower self-esteem and higher diabetes-related family conflict). The results of the current study suggest that there might be different factors associated with eating disorders (ED) attitudes and ED behaviours, but that food/eating-related factors, family factors, and intra-personal factors are all important. Furthermore there are some gender differences in the presence of ED attitudes and behaviours and preliminary evidence that higher body mass indexes (BMIs) impact on girls more than they do on boys. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Diabetic Retinopathy

Science.gov (United States)

... pregnancy may have rapid onset or worsening of diabetic retinopathy. Symptoms and Detection What are the symptoms of diabetic retinopathy and ... with diabetes protect their vision? Vision lost to diabetic retinopathy is ... However, early detection and treatment can reduce the risk of blindness ...

Accessory bones of the feet: Radiological analysis of frequency

Directory of Open Access Journals (Sweden)

Vasiljević Vladica

2010-01-01

Full Text Available Background/Aim. Accessory bones are most commonly found on the feet and they represent an anatomic variant. They occur when there is a failure in the formation of a unique bone from separated centre of ossification. The aim of this study was to establish their frequency and medical significance. Methods. Anteroposterior and lateral foot radiography was performed in 270 patients aged of 20-80 years with a history of trauma (180 and rheumatology disease (90. The presence and distribution of accessory bones was analysed in relation to the total number of patients and their gender. The results are expressed in numeric values and in terms of percentage. Results. Accessory bones were identified in 62 (22.96% patients: 29 (10.74% of them were found in female patients and 33 (12.22% in males. The most common accessory bones were as follows: os tibiale externum 50%, os peroneum 29.03%, ostrigonum 11.29%, os vaselianum 9.68%. Conclusion. Accessory bones found in 23% of patients with trauma and some of rheumatological diseases. Their significance is demonstrated in the differential diagnosis among degenerative diseases, avulsion fractures, muscle and tendon trauma and other types of injuries which can cause painful affection of the foot, as well as in forensic practice.

A Multiethnic Study of Pre-Diabetes and Diabetes in LMIC.

Science.gov (United States)

Shen, Jia; Kondal, Dimple; Rubinstein, Adolfo; Irazola, Vilma; Gutierrez, Laura; Miranda, J Jaime; Bernabé-Ortiz, Antonio; Lazo-Porras, María; Levitt, Naomi; Steyn, Krisela; Bobrow, Kirsten; Ali, Mohammed K; Prabhakaran, Dorairaj; Tandon, Nikhil

2016-03-01

Diabetes mellitus is one of the leading causes of death and disability worldwide. Approximately three-quarters of people with diabetes live in low- and middle-income countries, and these countries are projected to experience the greatest increase in diabetes burden. We sought to compare the prevalence, awareness, treatment, and control of diabetes in 3 urban and periurban regions: the Southern Cone of Latin America and Peru, South Asia, and South Africa. In addition, we examined the relationship between diabetes and pre-diabetes with known cardiovascular and metabolic risk factors. A total of 26,680 participants (mean age, 47.7 ± 14.0 years; 45.9% male) were enrolled in 4 sites (Southern Cone of Latin America = 7,524; Peru = 3,601; South Asia = 11,907; South Africa = 1,099). Detailed demographic, anthropometric, and biochemical data were collected. Diabetes and pre-diabetes were defined as a fasting plasma glucose ≥126 mg/dl and 100 to 125 mg/dl, respectively. Diabetes control was defined as fasting plasma glucose diabetes and pre-diabetes was 14.0% (95% confidence interval [CI]: 13.2% to 14.8%) and 17.8% (95% CI: 17.0% to 18.7%) in the Southern Cone of Latin America, 9.8% (95% CI: 8.8% to 10.9%) and 17.1% (95% CI: 15.9% to 18.5%) in Peru, 19.0% (95% CI: 18.4% to 19.8%) and 24.0% (95% CI: 23.2% to 24.7%) in South Asia, and 13.8% (95% CI: 11.9% to 16.0%) and 9.9% (95% CI: 8.3% to 11.8%) in South Africa. The age- and sex-specific prevalence of diabetes and pre-diabetes for all countries increased with age (p Peru, and South Africa the prevalence of pre-diabetes rose sharply at 35 to 44 years. In South Asia, the sharpest rise in pre-diabetes prevalence occurred younger at 25 to 34 years. The prevalence of diabetes rose sharply at 45 to 54 years in the Southern Cone of Latin America, Peru, and South Africa, and at 35 to 44 years in South Asia. Diabetes and pre-diabetes prevalence increased with body mass index. South Asians had the highest prevalence of diabetes and

An Analysis of Flow in Rotating Passage of Large Radial-Inlet Centrifugal Compressor at Tip Speed of 700 Feet Per Second

National Research Council Canada - National Science Library

Prian, Vasily

1951-01-01

An analysis was made of the flow in the rotating passages of a 48-inch diameter radial-inlet centrifugal impeller at a tip speed of 700 feet per second in order to provide more knowledge on the flow...

Knowledge of diabetic complications in patients with diabetes mellitus

International Nuclear Information System (INIS)

Ullah, F.; Afridi, A.K.; Rahim, F.; Ashfaq, M.; Khan, S.

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. Methods: This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Results: Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 ± 10.821 years while the mean duration of diabetes mellitus was 9.75 ± 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Conclusions: Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus. (author)

KNOWLEDGE OF DIABETIC COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS.

Science.gov (United States)

Ullah, Fahim; Afridi, Ayesha Khan; Rahim, Fawad; Ashfaq, Muhammad; Khan, Sheema; Shabbier, Ghulam; Rahman, Sadiq Ur

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 +/- 10.821 years while the mean duration of diabetes mellitus was 9.75 +/- 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus.

Diabetes knowledge among Greek Type 2 Diabetes Mellitus patients.

Science.gov (United States)

Poulimeneas, Dimitrios; Grammatikopoulou, Maria G; Bougioukli, Vasiliki; Iosifidou, Parthena; Vasiloglou, Maria F; Gerama, Maria-Assimina; Mitsos, Dimitrios; Chrysanthakopoulou, Ioanna; Tsigga, Maria; Kazakos, Kyriakos

2016-01-01

Diabetes knowledge has been shown to improve glycemic control and associate with several demographic parameters. In Greece, a country with high obesity rates, disease knowledge has never been evaluated in diabetic patients. This cross sectional study aimed to assess diabetes knowledge and its associations between social and demographic parameters, among Greek type 2 diabetes mellitus (T2DM) patients. One hundred fifty nine patients with T2DM were recruited from an urban and a rural clinic in Greece. Diabetes knowledge was assessed with the Brief Diabetes Knowledge Test (DKT). Basic anthropometry was performed. Data regarding glycemic control and sociodemographic characteristics were collected from the patients' medical files. Greek T2DM patients demonstrated poor disease knowledge (mean DKT score 8.3±2.2/14.0 and mean DKT as a percent of correct answers 59.6±15.8%). No differences were observed between sex, place of residence, or glycemic control, among subjects. Patients with higher education demonstrated greater diabetes knowledge. Simple obesity with concurrent central obesity or suboptimal glycemic control decreased diabetes knowledge among participants. Additionally, waist circumference was inversely correlated to diabetes knowledge. Based on the DKT, Greek patients exhibit poor diabetes knowledge. This study provides evidence for the need for better diabetes education in order to ameliorate disease outcome. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Atlantic DIP: Diabetes in Pregnancy: a comparative study of stress and wellbeing in women with established diabetes, gestational diabetes, and those without diabetes

LENUS (Irish Health Repository)

Lydon, K

2011-09-15

Background and aims: Diabetes in pregnancy increases the risk of maternal and perinatal morbidity and mortality. The experience of diabetes during pregnancy may be a significant source of stress, both because of the impact of the illness and associated treatments on the expectant mother and because of concern about the impact on the unborn child. In order to examine stress associated with diabetes during pregnancy, we carried out a prospective study in women with pre-existing (Type 1 or Type 2) Diabetes (PDM), Gestational Diabetes Mellitus (GDM), and non-diabetic pregnant controls (NDM).\\r\

Diabetes - foot ulcers

Science.gov (United States)

... learn more about taking care of your feet . Debridement Debridement is the process to remove dead skin and ... A visiting nurse may also help you. Other types of dressings are: Dressing that contains medicine Skin ...

Diabetes distress among type 2 diabetic patients

African Journals Online (AJOL)

McRoy

Key words: Diabetes mellitus, diabetes distress, HbA1c, glycaemic status ... [3] The management of diabetes mellitus and the ... morbidity and mortality risks associated with ... appropriate policy for prevention, control and ..... Mellitus and its Association Risk Indicators in a ... collaborative Research on Internal Medicine and.

Assessment of the Prevalence and Risk Factors Associated With Glucocorticoid-Induced Diabetes Mellitus in Pemphigus Vulgaris Patients.

Science.gov (United States)

Darjani, Abbas; Nickhah, Nahid; Hedayati Emami, Mohammad Hassan; Alizadeh, Narges; Rafiei, Rana; Eftekhari, Hojat; Gharaei Nejad, Kaveh

2017-06-01

Pemphigus vulgaris is a chronic autoimmune disease and glucocorticoids are one of the main treatments. Our study investigates the prevalence and associated factors of glucocorticoid-induced diabetes mellitus in these patients under different glucocorticoid regimens. 36 patients with first diagnosed Pemphigus vulgaris based on pathological and direct immunofluorescence findings who had received different glucocorticoid regimens (1-2 mg/kg oral or 1-2 mg/kg oral with 1g methylprednisolone pulse daily for 3 consecutive days with or without azathioprine) were evaluated during 2014-2016. Our study found that 22.2% of patients had impaired fasting glucose and incidence of corticosteroid-induced diabetes mellitus was 22.2% with no difference between oral and pulse therapy of corticosteroid. The first day after pulse therapy 19 patients of 21 had post bolus hyperglycemia that 36% of them became diabetic after 8 weeks. None of the variables, including age, BMI, HbA1c, LDL, HDL, TG, cholesterol, family history and blood pressure were associated with diabetes. Pretreatment FBS was the factor that would increase the likelihood of glucocorticoid-induced diabetes mellitus, 42.2% of patients with pretreatment FBS 100-126 developed diabetes in comparison with 17.2% in normal pretreatment FBS. Although the group who received azathioprine was associated with increased incidence of diabetes, the overall corticosteroid dose in this group was significantly higher than the other group (P=0.012), and controversy with other studies could be because of difference in corticosteroid dosage and small number of patients. The incidence of diabetes was not different between the group with glucocorticoid pulses and oral prednisolone without pulse therapy. Higher pretreatment FBS can be related to increased incidence of diabetes, but results from this study due to small number of patients are preliminary and multicenter studies are needed.

Evaluation of First-Ray Mobility in Patients with Hallux Valgus Using Weight-Bearing CT and a 3-D Analysis System: A Comparison with Normal Feet.

Science.gov (United States)

Kimura, Tadashi; Kubota, Makoto; Taguchi, Tetsuya; Suzuki, Naoki; Hattori, Asaki; Marumo, Keishi

2017-02-01

Some physicians report that patients with hallux valgus have hypermobility at the tarsometatarsal (TMT) joint of the first ray and 3-dimensional (3-D) deformity. With use of non-weight-bearing and weight-bearing computed tomography (CT), we evaluated the 3-D mobility of each joint of the first ray in feet with hallux valgus compared with normal feet. Ten feet of 10 patients with hallux valgus and 10 feet of 10 healthy volunteers with no foot disorders were examined. All participants were women. Weight-bearing (a load equivalent to body weight) and non-weight-bearing CT scans were made with use of a device that we developed. Orthogonal coordinate axes were set and a 3-D model was reconstructed. Each joint of the first ray was aligned with the respective proximal bone, and 3-D displacement of the distal bone relative to the proximal bone under loading was quantified. At the talonavicular joint, significantly greater dorsiflexion of the navicular relative to the talus was observed in the hallux valgus group compared with the control group. At the medial cuneonavicular joint, the hallux valgus group showed significantly greater eversion and abduction of the medial cuneiform relative to the navicular. At the first TMT joint, the hallux valgus group showed significantly greater dorsiflexion, inversion, and adduction of the first metatarsal relative to the medial cuneiform. At the first metatarsophalangeal joint, the hallux valgus group showed significantly greater eversion and abduction of the first proximal phalanx relative to the first metatarsal (all p hallux valgus.

Flat feet, happy feet? Comparison of the dynamic plantar pressure distribution and static medial foot geometry between Malawian and Dutch adults.

Directory of Open Access Journals (Sweden)

Niki M Stolwijk

Full Text Available In contrast to western countries, foot complaints are rare in Africa. This is remarkable, as many African adults walk many hours each day, often barefoot or with worn-out shoes. The reason why Africans can withstand such loading without developing foot complaints might be related to the way the foot is loaded. Therefore, static foot geometry and dynamic plantar pressure distribution of 77 adults from Malawi were compared to 77 adults from the Netherlands. None of the subjects had a history of foot complaints. The plantar pressure pattern as well as the Arch Index (AI and the trajectory of the center of pressure during the stance phase were calculated and compared between both groups. Standardized pictures were taken from the feet to assess the height of the Medial Longitudinal Arch (MLA. We found that Malawian adults: (1 loaded the midfoot for a longer and the forefoot for a shorter period during roll off, (2 had significantly lower plantar pressures under the heel and a part of the forefoot, and (3 had a larger AI and a lower MLA compared to the Dutch. These findings demonstrate that differences in static foot geometry, foot loading, and roll off technique exist between the two groups. The advantage of the foot loading pattern as shown by the Malawian group is that the plantar pressure is distributed more equally over the foot. This might prevent foot complaints.

Diabetes eye exams

Science.gov (United States)

Diabetic retinopathy - eye exams; Diabetes - eye exams; Glaucoma - diabetic eye exam; Macular edema - diabetic eye exam ... if the doctor who takes care of your diabetes checks your eyes, you need an eye exam ...

Types of Diabetes

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... Diabetes, Sexual, & Bladder Problems Clinical Trials What is Diabetes? Diabetes is a disease that occurs when your ... is serious. What are the different types of diabetes? The most common types of diabetes are type ...

Living With Diabetes

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... Problems Diabetes, Sexual, & Bladder Problems Clinical Trials Managing Diabetes You can manage your diabetes and live a ... you have diabetes. How can I manage my diabetes? With the help of your health care team, ...

The Diabetes Pearl: Diabetes biobanking in The Netherlands

Directory of Open Access Journals (Sweden)

van’t Riet Esther

2012-11-01

Full Text Available Abstract Background Type 2 diabetes is associated with considerable comorbidity and severe complications, which reduce quality of life of the patients and require high levels of healthcare. The Diabetes Pearl is a large cohort of patients diagnosed with type 2 diabetes, covering different geographical areas in the Netherlands. The aim of the study is to create a research infrastructure that will allow the study of risk factors, including biomarkers and genetic determinants for severe diabetes complications. Methods/design Baseline examinations began November 2009 and will continue through 2012. By the end of 2012, it is expected that 7000 patients with type 2 diabetes will be included in the Diabetes Pearl cohort. To ensure quality of the data collected, standard operation procedures were developed and used in all 8 recruitment centers. From all patients who provide informed consent, the following information is collected: personal information, medication use, physical examination (antropometry, blood pressure, electrocardiography (ECG, retina photographs, ankle-brachial index, peripheral vibration perception, self-report questionnaire (socio-economic status, lifestyle, (family history of disease, and psychosocial well-being, laboratory measurements (glucose, A1c, lipid profile, kidney function, biobank material (storage of urine and blood samples and isolated DNA. All gathered clinical data and biobank information is uploaded to a database for storage on a national level. Biobanks are maintained locally at all recruitment centers. Discussion The Diabetes Pearl is large-scale cohort of type 2 diabetes patients in the Netherlands aiming to study risk factors, including biomarkers and genetic markers, for disease deterioration and the development of severe diabetes complications. As a result of the well-designed research design and the national coverage, the Diabetes Pearl data can be of great value to national and international researchers with

diabetic patients

Directory of Open Access Journals (Sweden)

Mehraban Falahati

2016-09-01

candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c ≥8, and acidic urine pH (P<0.05. Conclusion: Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted.

The abrupt temperature changes in the plantar skin thermogram of the diabetic patient: looking in to prevent the insidious ulcers.

Science.gov (United States)

Renero-C, Francisco-J

2018-01-01

Background: One of the complications of the diabetes mellitus is the amputation of the lower limbs. This complication may be developed after an insidious ulcer, that may be raised by the peripheral neuropathy or the ischaemic limb, and that the ulcer get infected. That is, to develop an ulcer, in the diabetic patient, three factors should be taken into the account, the autonomic nervous system, the blood supply and the inmune system. Methods: In this work, the thermogram is used to identify regions on the plantar skin with blood supply deficiencies and the behaviour of the thermoregulation process. Within the thermogram of the plantar skin, it can be identify local regions with low and high temperatures that corresponds to ischemic or inflammatory process on that part of the skin. Results: The findings within the 186 thermograms of diabetic patients, obtained from three hospitals and from INAOE facilities, showed, first, the thermograms of the plantar skin of two diabetic patients, acquired in two different times show that the temperature distribution and the average temperatures, vary slightly for a period of weeks. Second, the thermograms of two patients, who both developed insidious ulcers which evolved favourable, demonstrated the importance of the immune system and the drug therapy. These patients are, one who has a Charcot foot, and in the second one, the patient had loss the sensibility of the feet. Finally, the thermograms of two patients, showing abrupt temperature change within small regions in the plantar skin, are discussed. Conclusion: A diabetic patient, with an asymmetric thermogram, as physiological interpretation of the thermoregulation, may indicate a decrease of the blood supply, which may be corroborated by vascular ultrasound. The regions of abrupt temperature change, cold or hot spots, may correspond to ischaemic or inflammatory processes.

Comparison of diabetics and non-diabetics presenting with acute myocardial infraction

International Nuclear Information System (INIS)

Naseem, A.; Moin, S.

2002-01-01

Objective: To identify differences in incidence and clinical manifestations of acute myocardial infarction (AMI) and prevalence of coronary disease risk factors in diabetic and non-diabetics. Design: A prospective longitudinal survey. Place and duration of study: The study was carried out in Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD) Rawalpindi, over a period of one month (1st August to 1st September, 1994). Subject and Methods: After fulfilling the inclusion criteria, a total of 100 patients were included in the study. Fifty patients had diabetes and AMI while 50 patients had AMI but were not diabetic. All the patients were studies for at least 15 days in hospital and data collected on a pre-designed proforma. Results: Among diabetic patients, 84% were not insulin-dependant, while remaining 16% were on insulin therapy. Duration of diabetes was over 20 years in 18% between 10 and 20 years in 62% and less than 10 years in 8%. Male to female ratio was 7.3:1 in non-diabetic group while in diabetic group it was 4.5:1. Mean age at the time of the first AMI was 54.6 years in non-diabetic group and 52.8 years in diabetic group, with women in diabetic group having mean age of 51.9 years, men 53.2 years, while non-diabetic women had a mean age of 54.2 years and the men 55 years. Incidence of hypertension was 32% among diabetic patients and 24% among non-diabetics. Lipid abnormalities were 44% in diabetic group and 36% in non-diabetic group the most common mode of presentation in both groups was chest pain or chest discomfort, but one-fourth of the diabetics presented without any chest pain. Q-wave AMI of the anterior wall of the myocardium predominated in both group, but non-Q wave infarctions were more frequent in the diabetic group (28% vs. 16%). Diabetic group tended to be identified later and only half the diabetics with AMI qualified for thrombolytic therapy as compared to more than 2/3 cases of the non-diabetic group

Brain expansion in patients with type II diabetes following insulin therapy: a preliminary study with longitudinal voxel-based morphometry.

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Chen, Zhiye; Li, Jinfeng; Sun, Jie; Ma, Lin

2014-01-01

We performed a longitudinal analysis based on magnetic resonance (MR) imaging to investigate the brain structural and perfusion changes caused by insulin therapy in patients with type II diabetes. High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo images and flow-sensitive alternating inversion recovery (FAIR) images were obtained from 11 patients with type II diabetes before and 1 year after initiation of insulin therapy and 11 normal controls. Brain volume changes were investigated by a longitudinal voxel-based morphometry (VBM), and perfusion changes were evaluated by FAIR imaging between baseline and follow-up data. Significant regional gray matter (GM) expansion located in bilateral frontal, parietal, and left occipital lobes, and regional white matter (WM) expansion was shown in left precentral subcortical WM and right angular subcortical WM after insulin therapy (P Brain hyperperfusion was detected in bilateral frontal cortex, left occipital cortex, and right temporal cortex after insulin therapy (P brain expansion and hyperperfusion were demonstrated 1 year after initiation of insulin therapy, and insulin therapy could contribute to the brain volume gainment in the patients with type II diabetes. Copyright © 2013 by the American Society of Neuroimaging.

Hospital Guidelines for Diabetes Management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification.

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Arnold, Pamela; Scheurer, Danielle; Dake, Andrew W; Hedgpeth, Angela; Hutto, Amy; Colquitt, Caroline; Hermayer, Kathie L

2016-04-01

The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association's Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes. On a daily basis at the Medical University of South Carolina (MUSC) Medical Center, there are approximately 130-150 inpatients with a diagnosis of diabetes. The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, medical record identification of diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes. The major clinical components to develop, implement, and evaluate an inpatient diabetes care program are: I. Program management, II. Delivering or facilitating clinical care, III. Supporting self-management, IV. Clinical information management and V. performance measurement. The standards receive guidance from a Disease-Specific Care Certification Advisory Committee, and the Standards and Survey Procedures Committee of the Joint Commission Board of Commissioners. The Joint Commission-ADA Advanced Inpatient Diabetes Certification represents a clinical program of excellence, improved processes of care, means to enhance contract negotiations with providers, ability to create an environment of teamwork, and heightened communication within the organization. Published by Elsevier Inc.

Type 1 diabetes

Science.gov (United States)

Insulin-dependent diabetes; Juvenile onset diabetes; Diabetes - type 1; High blood sugar - type 1 diabetes ... Type 1 diabetes can occur at any age. It is most often diagnosed in children, adolescents, or young adults. Insulin is ...

Genetics of Diabetes

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... A A A Listen En Español Genetics of Diabetes You've probably wondered how you developed diabetes. ... to develop diabetes than others. What Leads to Diabetes? Type 1 and type 2 diabetes have different ...

Women and Diabetes

Medline Plus

Full Text Available ... has lots of free information to help you manage your diabetes. General Tips Diabetes Treatments Diabetes and ... Check these resources for tips to help you manage your diabetes. Food Safety for People with Diabetes ...

Women and Diabetes

Medline Plus

Full Text Available ... How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need to take diabetes ... with your health care provider about your diabetes treatment. Diabetes Medicines - easy-to-read booklet for women ...

Women and Diabetes

Medline Plus

Full Text Available ... diabetes. Food Safety for People with Diabetes Your Glucose Meter - easy-to-read booklet for women Other ... Information on Diabetes How to Report Problems with Glucose Meters Diabetes Treatments Some people with diabetes need ...

Diabetic retinopathy

DEFF Research Database (Denmark)

Wong, Tien Y; Cheung, Chui Ming Gemmy; Larsen, Michael

2016-01-01

Diabetic retinopathy (DR) is a common complication of diabetes mellitus and is a major cause of vision loss in middle-aged and elderly people. One-third of people with diabetes have DR. Severe stages of DR include proliferative DR, caused by the abnormal growth of new retinal blood vessels......, and diabetic macular oedema, in which there is exudation and oedema in the central part of the retina. DR is strongly associated with a prolonged duration of diabetes, hyperglycaemia and hypertension. It is traditionally regarded as a microvascular disease, but retinal neurodegeneration is also involved...... (VEGF). Optimal control of blood glucose and blood pressure in individuals with diabetes remains the cornerstone for preventing the development and arresting the progression of DR. Anti-VEGF therapy is currently indicated for diabetic macular oedema associated with vision loss, whereas laser...

The effects of transverse rotation angle on compression and effective lever arm of prosthetic feet during simulated stance.

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Major, Matthew J; Howard, David; Jones, Rebecca; Twiste, Martin

2012-06-01

Unlike sagittal plane prosthesis alignment, few studies have observed the effects of transverse plane alignment on gait and prosthesis behaviour. Changes in transverse plane rotation angle will rotate the points of loading on the prosthesis during stance and may alter its mechanical behaviour. This study observed the effects of increasing the external transverse plane rotation angle, or toe-out, on foot compression and effective lever arm of three commonly prescribed prosthetic feet. The roll-over shape of a SACH, Flex and single-axis foot was measured at four external rotation angle conditions (0°, 5°, 7° and 12° relative to neutral). Differences in foot compression between conditions were measured as average distance between roll-over shapes. Increasing the transverse plane rotation angle did not affect foot compression. However, it did affect the effective lever arm, which was maximized with the 5° condition, although differences between conditions were small. Increasing the transverse plane rotation angle of prosthetic feet by up to 12° beyond neutral has minimal effects on their mechanical behaviour in the plane of walking progression during weight-bearing.

Diabetes Australia position statement. A new language for diabetes: improving communications with and about people with diabetes.

Science.gov (United States)

Speight, J; Conn, J; Dunning, T; Skinner, T C

2012-09-01

Diabetes is the fastest growing chronic condition in Australia, affecting 1.7 million Australians, requiring daily self-care, and known to reduce quantity and quality of life. On average, people with diabetes experience greater emotional distress than those without diabetes. One source of distress can be the language used to refer to diabetes, its management and the person with diabetes. The way verbal and written language is used reflects and shapes people's thoughts, beliefs and behaviours. Language has the power to persuade, change or reinforce beliefs and stereotypes - for better or worse. Words do more than reflect people's reality: they create reality and affect how people view the world and their diabetes. Language needs to engage people with diabetes and support their self-care efforts. Importantly, language that de-motivates or induces fear, guilt or distress needs to be avoided and countered. Diabetes Australia believes optimal communication increases the motivation, health and well-being of people with diabetes, and that careless or negative language can be de-motivating, is often inaccurate, and can be harmful. Diabetes Australia developed this position statement to encourage greater awareness of the language surrounding diabetes and provide recommendations for more careful and positive language use. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Sex differences in step count-blood pressure association: a preliminary study in type 2 diabetes.

Directory of Open Access Journals (Sweden)

Priya Manjoo

Full Text Available BACKGROUND: Walking and cardiovascular mortality are inversely associated in type 2 diabetes, but few studies have objectively measured associations of walking with individual cardiovascular risk factors. Such information would be useful for "dosing" daily steps in clinical practice. This study aimed to quantify decrements in blood pressure and glycated hemoglobin (A1C per 1,000 daily step increments. METHODOLOGY/PRINCIPAL FINDINGS: Two hundred and one subjects with type 2 diabetes underwent assessments of step counts (pedometer-measured, blood pressure, A1C and anthropometric parameters. Due to missing data, the final analysis was conducted on 83 women and 102 men, with a mean age of 60 years. Associations of daily steps with blood pressure and A1C were evaluated using sex-specific multivariate linear regression models (adjusted for age, ethnicity, and BMI. Potential sex differences were confirmed in a combined model (women and men with interaction terms. Mean values for daily steps, blood pressure, A1C and BMI were 5,357 steps/day; 137/80 mm Hg; 7.7% and 30.4 kg/m(2 respectively. A 1,000 daily step increment among women was associated with a -2.6 (95% CI: -4.1 to -1.1 mm Hg change in systolic and a -1.4 (95% CI: -2.2 to -0.6 mm Hg change in diastolic blood pressure. Among men, corresponding changes were -0.7 (95% CI: -2.1 to 0.7 and -0.6 (95% CI: -1.4 to 0.3 mm Hg, respectively. Sex differences were confirmed in combined models. Step counts and A1C did not demonstrate clinically important associations. CONCLUSIONS/SIGNIFICANCE: A 1,000 steps/day increment is associated with important blood pressure decrements among women with type 2 diabetes but the data were inconclusive among men. Targeted "dose increments" of 1,000 steps/day in women may lead to measurable blood pressure reductions. This information may be of potential use in the titration or "dosing" of daily steps. No associations were found between step count increments and A1C.

ANEMIA IN HEMODIALYSIS PATIENTS: DIABETIC VS NON DIABETIC PATIENTS

Directory of Open Access Journals (Sweden)

SH SHAHIDI

2002-12-01

Full Text Available Introduction. One of the characteristic signs of uremic syndrome is anemia. One of major factors that affects on severity of anemia in ESRD is underlying diseas. The porpuse of this study is to compaire anemia between diabetic and non diabetic ESRD patients. Methods. In a case control study we compared the mean valuse of Hb, Het, MCV, MCH, MCHC, BUN, Cr and duration of dialysis between diabetic and nondiabetic patients on chronic hemodialyis. some variables (such as age, sex, use of erythropoietin, nonderolone decaonats, folic acid, ferrous sulfate, transfusion and blood loss in recent three months and acquired kidney cysts were matched between cases and controls. Results. Means of Hb were 9±1.3 and 8 ± 1.7 in diabetic and non diabetic patients (P<0.05. Mean corposcular volume in diabetic patients (91±3.1 fl was more higher than non diabetic ones (87.1 ± 8.9 (P < 0.05. Other indices had no differences between two groups (P > 0.05. Discussion. Severity of anemia in patients with diabetic nephropathy is milder that other patients with ESRD. So, Anemia as an indicator of chronocity of renal disease in diabetics is missleading.