scholarly journals Long-term Results Following Operation for Diabetic Foot Problems: Arterial Disease Confers a Poor Prognosis

2000 ◽  
Vol 19 (2) ◽  
pp. 174-177 ◽  
Author(s):  
W.B Campbell ◽  
D Ponette ◽  
M Sugiono
Keyword(s):  
Diabetic Foot ◽  
Poor Prognosis ◽  
Arterial Disease ◽  
Long Term Results ◽  
Foot Problems

scholarly journals Adherence Over Time: The Course of Adherence to Customized Diabetic Insoles as Objectively Assessed by a Temperature Sensor

2017 ◽  
Vol 12 (3) ◽  
pp. 695-700 ◽  
Author(s):  
Dominic Ehrmann ◽  
Monika Spengler ◽  
Michael Jahn ◽  
Dea Niebuhr ◽  
Thomas Haak ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Temperature Sensor ◽  
Small Sample Size ◽  
Temperature Sensors ◽  
Small Sample ◽  
Gender Effects ◽  
Kaplan Meier ◽  
Foot Problems ◽  
Mean Time

Background: Temperature sensors are an objective way to assess adherence to diabetic footwear. Good adherence is essential for the prevention of diabetic foot problems. Little is known about the long-term course of adherence in patients at risk for diabetic foot problems. Method: A temperature sensor was incorporated into the specialized footwear of patients with type 2 diabetes after their first plantar ulceration. Kaplan-Meier curve was used to analyze when patients started to become nonadherent (not wearing the footwear for two straight weeks). Gender effects on adherence were also analyzed. Results: 26 patients with a mean observation time of 133.5 days could be analyzed. Mean wearing time of diabetic footwear was 4.2 ± 3.6 h/day (Mdn = 3.4 h/day; interquartile range = 0.5-7.0 h/day) and on 51% of the days patients did not wear their footwear at all. Kaplan-Meier curve revealed that the mean time of adherence was 27.5 weeks. Men achieved a mean time of adherence of 30.5 weeks, while women only achieved 14 weeks. However, due to the small sample size, this difference was not statistically significant. Conclusions: Temperature sensors revealed a low long-term adherence to diabetic footwear. Women seemed to be at a higher risk for earlier nonadherent behavior. Adherence to diabetic footwear should be closely monitored and tailored intervention strategies should be developed.

scholarly journals Paclitaxel Exposure and Dosage of Drug-coated Devices for the Treatment of Femoropopliteal Peripheral Artery Disease

2021 ◽  
Vol 4 ◽  
Author(s):  
Ceazón T Edwards ◽  
Peter A Schneider ◽  
Cindy Huynh
Keyword(s):  
Dose Response ◽  
Meta Analysis ◽  
Arterial Disease ◽  
Long Term Results ◽  
Real Patient ◽  
All Cause Mortality ◽  
Artery Disease ◽  
Peripheral Arterial

The role of paclitaxel in the treatment of femoropopliteal peripheral arterial disease is currently ambiguous. A summary-level meta-analysis of randomised trials published in 2018 demonstrated that paclitaxel-coated devices were associated with an increased all-cause mortality in those who underwent treatment at 2 years and 5 years. Further evaluation has been undertaken to establish whether there is a specific dose response, mechanism or reproducible signal. At this time, there has been no confirmation of dose response, as was initially asserted by the summary-level meta-analysis. No mechanism of harm has been identified. Although an association with increased mortality has been confirmed by patient-level meta-analysis, the strength of the signal has been inconsistent. The information suggests there is only an association between paclitaxel-coated devices and increased all-cause mortality, not causation. The authors encourage additional studies designed to follow long-term results after treatment with paclitaxel-coated devices, using real patient data, before a conclusion can be made.

Long-Term Results of First-Line Sequential High-Dose Etoposide, Ifosfamide, and Cisplatin Chemotherapy Plus Autologous Stem Cell Support for Patients With Advanced Metastatic Germ Cell Cancer: An Extended Phase I/II Study of the German Testicular Cancer Study Group

2003 ◽  
Vol 21 (22) ◽  
pp. 4083-4091 ◽  
Author(s):  
H.-J. Schmoll ◽  
C. Kollmannsberger ◽  
B. Metzner ◽  
J.T. Hartmann ◽  
N. Schleucher ◽  
...  
Keyword(s):  
Stem Cell ◽  
Germ Cell ◽  
Poor Prognosis ◽  
Cell Cancer ◽  
Germ Cell Cancer ◽  
Long Term Results ◽  
High Dose ◽  
Stem Cell Support ◽  
Cell Support

Purpose: Patients with disseminated germ cell cancer and poor prognosis (International Germ Cell Cancer Collaborative Group [IGCCCG] classification) achieve only a 45% to 50% long-term survival by standard chemotherapy. First-line high-dose chemotherapy might be able to improve the result. This analysis reports toxicity and long-term results of a large phase I/II study of sequential high-dose etoposide, ifosfamide, and cisplatin (VIP) in patients with advanced germ cell tumors. Patients and Methods: Between July 1993 and November 1999, 221 patients with either Indiana “advanced disease” (n = 39) or IGCCCG “poor prognosis” criteria (n = 182) received one cycle of VIP followed by three to four sequential cycles of high-dose VIP chemotherapy plus stem cell support, every 3 weeks, at six consecutive dose levels. Results: Dose limiting toxicity occurred at level 8 (100 mg/m2 cisplatinum, 1750 mg/m2 etoposide, 12 g/m2 ifosfamide) with grade 4 mucositis (three of eight patients), grade 3 CNS toxicity (one of eight patients), grade 4 renal toxicity (one of eight patients), and prolonged granulocytopenia (one of eight patients). After 4-year median follow-up, progression-free survival and disease-specific survival rates in the poor prognosis subgroup were 69% and 79% at 2 years and 68% and 73% at 5 years, with 76% for gonadal/retroperitoneal versus 67% for mediastinal primaries. Severe toxicity included treatment related death (4%), treatment-related acute myeloid leukemia (1%), long-term impared renal function (3%), chronic renal failure (1%), and persistant grade 2–3 neuropathy (5%). Conclusion: Repetitive cycles of high-dose VIP with peripheral stem cell support can be successfully applied in a multicenter setting. Dose level 6 with cisplatin 100 mg/m2, etoposide 1500 mg/m2, and ifosfamide 10 g/m2 is recommended for further investigation in randomized trials. An ongoing randomized trial within the European Organization for Research and Treatment of Cancer evaluates this protocol against four cycles of standard cisplatin, etoposide, and bleomycin.

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