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Content available remote The major clinical outcomes of diabetic foot infections: One center experience
Diabetes mellitus with its limb and life-threatening complications such as diabetic foot infection and amputation are increasing at epidemic rates all over the world. The objective of this study was to determine the rate of lower extremity amputation, the risk factors and the bacteriologic profile for diabetic foot lesions. The records of all 84 patients with diabetic foot infections of a large general hospital over a 4-year period were retrospectively included. The most commonly isolated pathogens were Staphylococcus aureus (39%), Pseudomonas aeruginosa (14%), Proteus mirabilis (14%), Escherichia coli (14%), Group B streptococci (12%), and Klebsiella pneumonia (8%). The variables, independently associated with higher foot infections, were inadequate diabetic regulation (93%), peripheral neuropathy (88.1%), peripheral vascular disease (73.8%), smoking (56%), past history of ulcer (28.5%), penetrating injury (20.3%), inadequate foot wear (15%) and Charcot osteoartropathy (10.7%). The general amputation rate was 38.1%. Diabetic foot ulcers and its complication rates including infection, gangrene and lower extremity amputation in Turkey are still high. Preventive care of the foot in patients with diabetes mellitus is extremly important. Therefore early diagnosing of risk factors for diabetic foot infections in the primary care setting and their adequate therapy under multidisciplinary approach should not be neglected.
Study aim: The aim of this study was to assess proportion and symmetry between torque in muscles that affect the hip joint in the non-amputated and the amputated limb in persons both engaged in and not engaged in sports. Material and methods: Study participants comprised 12 persons with above-knee leg amputation. The group of participants was divided into two subgroups: persons engaged in sports and physically inactive persons. The strength and the speed capacity of hip joint flexors and hip joint extensors were measured using a Biodex System 4 dynamometer. The measurement was conducted at two angular velocities (60°/s and 120°/s) and during isometric activity of the non-amputated and the amputated limb. Results: Maximal torque of hip joint flexors in the amputated limb of physically active persons constituted 65.3% of the corresponding value in persons without amputation and was higher than in physically inactive persons (55.9%). Similar values were obtained for extensors. The time to reach maximal muscle torque in the amputated limb during the extension of the hip joint at 60°/s equalled 400 ms in physically active persons and 900 ms in physically inactive persons and during flexion, equalled 400 ms and 600 ms, respectively. Conclusions: Physically active persons showed greater dynamics in generating maximal muscle torque, especially during the extension of the hip joint. Physical activity benefits the strength and speed capacity of muscles that affect the hip joint in persons with above-knee amputation, thus decreasing asymmetry and disproportion between limbs.
Content available remote A case of Nicolau syndrome treated with hyperbaric oxygen
A 3-year-old boy with a Nicolau Syndrome (NS) on the left side of the body and the limbs after benzathine penicilline injection is reported. To the authors’ best knowledge, this is the first report of hyperbaric oxygen used in the late treatment of NS preventing the progress of the necrosis and therefore limiting the amputation level.
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