scholarly journals Utility of Blood Parameters to Detect Complications during Long-Term Follow-Up in Patients with Diabetic Foot Osteomyelitis

2020 ◽  
Vol 9 (11) ◽  
pp. 3768
Author(s):  
Aroa Tardáguila-García ◽  
Yolanda García Álvarez ◽  
Esther García-Morales ◽  
Francisco Javier Álvaro-Afonso ◽  
Irene Sanz-Corbalán ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Characteristic Curve ◽  
Glycosylated Hemoglobin ◽  
Diagnostic Value ◽  
Blood Parameters ◽  
Blood Parameter ◽  
Cross Sectional ◽  
Hemoglobin C ◽  
Diabetic Foot Osteomyelitis

The evidence is still unclear regarding the role of blood parameters in detecting complications in patients who suffer from diabetic foot osteomyelitis (DFO). In this study, the aim was to identify the capacity of different blood parameters in the diagnosis and prediction of the onset of complications. A cross-sectional prospective study was carried out with 116 DFO patients. The following blood parameters were evaluated during 1 year of follow-up: leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, erythrocyte sedimentation rate (ESR), glycemia, glycosylated hemoglobin, C-reactive protein (CRP), alkaline phosphatase, albumin, and creatinine. Complication events were assessed for each participant during the study period. We investigated the association between blood parameter values and the onset of complication events by conducting a receiver operating characteristic curve analysis. Eighty-five (73.3%) patients developed complications. Regarding blood parameters, higher values of lymphocytes and albumin were predictive factors at the 12-month follow-up once the ulcer had healed. Higher values of ESR had predictive and diagnostic value for the onset of complication events, and higher values of CRP and hyperglycemia were diagnostic factors since they were elevated during the occurrence of an event. In conclusion, after suffering from DFO, the elevation of lymphocytes, ESR, CRP, albumin, and glycemia could be useful in detecting and diagnosing patients who are likely to develop a complication. Serial blood tests are a useful tool for early detection by healthcare professionals to prevent complications.

scholarly journals Novel inflammatory markers in the blood of patients with knee synovitis

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110295
Author(s):  
Kun Gao ◽  
Yong Zhang ◽  
Shufen Sun ◽  
Baocheng Lin ◽  
Weidong Liu ◽  
...  
Keyword(s):  
Independent Predictor ◽  
Inflammatory Diseases ◽  
Early Stage ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Cost Effective ◽  
Diagnostic Value ◽  
Blood Parameters ◽  
Joint Disease ◽  
Cross Sectional

Objective Synovitis is a joint disease that seriously affects patient quality of life, but there are currently no diagnostic markers. The albumin to fibrinogen ratio (AFR) and monocyte to lymphocyte ratio (MLR) are non-invasive and cost-effective markers for various systemic inflammatory diseases. However, these markers have not yet been investigated for synovitis. This cross-sectional study evaluated the predictive ability of AFR and MLR in patients with non-specific knee synovitis. Methods One hundred fifty-five patients with knee synovitis and 108 healthy control patients were enrolled. Patient characteristics, blood parameters, AFRs, and MLRs were assessed, and the diagnostic value of these factors was determined. Results Among 125 patients included, patients with synovitis had a lower AFR and higher MLR than control subjects. The diagnostic values of AFR and MLR were 0.86 and 0.84, respectively, and higher compared with other parameters by receiver operating characteristic curve assessments. Additionally, MLR was negatively correlated with AFR. Late-stage patients showed significantly lower AFRs and significantly higher MLRs than early-stage patients. Binary logistic regression analyses indicated that AFR was an independent predictor for synovitis severity. Conclusions The AFR and MLR had high diagnostic value for knee synovitis. The AFR was an independent predictor for synovitis severity.

scholarly journals Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Hiroki Kaneko ◽  
Hironobu Umakoshi ◽  
Yuki Ishihara ◽  
Kazutaka Nanba ◽  
Mika Tsuiki ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Sodium Intake ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Saline Infusion ◽  
Loading Test ◽  
Cross Sectional ◽  
Sodium Loading ◽  
Oral Sodium

Abstract Context Urinary aldosterone levels (Uald) are widely measured in the oral sodium-loading test to confirm primary aldosteronism (PA), but reliable studies on their diagnostic value are limited. This may be due to the difficulty in collecting urine with reliable accuracy, keeping oral sodium intake constant between patients. Therefore, we focused on 24-hour Uald after intravenous saline infusion in a hospitalized setting, which provides a reliable sodium load in consistent amounts. Objective Comparing plasma aldosterone concentrations (PAC) and Uald after saline infusion in the sitting position, to evaluate the accuracy in determining PA subtypes and the correlation of both measurements. Design and Setting This was a retrospective cross-sectional study in a single referral center. Patients Of 53 patients without renal dysfunction who were diagnosed with PA and underwent adrenal venous sampling, 16 and 37 were diagnosed with unilateral and bilateral PA, respectively. Main Outcome Measures Uald collected for 24 hours and PAC after saline infusion. Results The area under the receiver operating characteristic curve for diagnosing unilateral PA was not significantly different between Uald and PAC after saline infusion (0.921 and 0.958, respectively; P = 0.370). The predicted optimal cutoff value of Uald was 16.5 μg/day (sensitivity, 87.5%; specificity, 100%), and that of PAC after saline infusion was 19.3 ng/dL (sensitivity, 87.5%; specificity, 97.3%). In studied patients with PA, Uald was positively correlated with PAC after saline infusion (r = 0.617; P < 0.001). Conclusions We reassessed Uald in PA patients under sufficient sodium loading and demonstrated the correlation between Uald and PAC after saline infusion.

scholarly journals Heat Shock Protein 70 (Hsp70) Level is Lower in Premature Rupture of Membrane

2014 ◽  
pp. 69-75
Author(s):  
Muhammad RA Radam ◽  
Soetrisno Soetrisno ◽  
Supriyadi H Respati
Keyword(s):  
Heat Shock ◽  
Heat Shock Protein ◽  
Heat Shock Protein 70 ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Hsp 70 ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Cross Sectional

AbstractObjective: To prove wheth er the levels of Heat Shock Protein 70 (Hsp70) was lower in women experiencing premature rupture of membranes than in women with normal aterm pregnancy in order to explain occurrence of pregnancy premature rupture of membranes at termin biomolecular (Hsp70). Method: This was an obse rvational resear ch and the study design was a cross-sectional study. The number of all samples was 60 women, divided into 2 groups and each group contained 30 women. Independ ent var iable: Heat Shock Protein 70 level, Depend ent var iable: Premature Rupture of Membrane. Data was analyzed by t test Result: Based on matern al character istic on both groups, the mean levels of Hsp70 in serum of pr egnant women with PROM lower (0.36) compared to normal pregnant group (3.94) and this difference was statistically significant (p<O.OOl). Diagnostic valu e of the power levels of Hsp 70 in th e PROM compared with norm al pregnancies analysis using Receiver Operating Characteristic curve (ROC) in SPSS17.0 for Windows for by 0.833 or 83.3%, it can be concluded that the diagnostic value of the PROM Hsp70 levels were good (>50%). Conclusion: Theme an levels of Hsp 70 in premature rupture of membranes obtained lower levels than in normal full-term pregnancy and this difference was sta tistically significant. Keywords: Heat Shock Protein 70, maternal stress, PROM

scholarly journals Antibiotic Bone Cement Combined With Other Comprehensive Interventions in the Treatment of Diabetic Foot Osteomyelitis

2021 ◽  
Author(s):  
Fanyu Bu ◽  
Xiaofeng Guo ◽  
Peng Xu ◽  
Jin Wang ◽  
Mingyu Xue ◽  
...  
Keyword(s):  
Bone Cement ◽  
Diabetic Foot ◽  
Pathogenic Bacteria ◽  
Healing Time ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Ulcer Recurrence ◽  
Duration Of Hospitalization ◽  
Diabetic Foot Osteomyelitis

Abstract BackgroundDiabetic foot osteomyelitis (DFO) is serious chronic complication that causes disability or death in diabetic patients. Antibiotic-loaded bone cement is an effective sustained-release system for the treatment of chronic osteomyelitis and induces biofilm formation. This study aimed to valuate the outcomes and summarize the experiences of bone cement loaded with vancomycin combined with other comprehensive interventions in the treatment of DFO.MethodsOne hundred and twelve involved feet in 93 patients (43–92 years old) with DFO treated with antibiotic-loaded bone cement combined with other comprehensive interventions were retrospectively analyzed. The durations of oral and intravenous antibiotics and hospitalization, ulcer healing times, recurrence and rehospitalization rates, and the rates of amputation above the ankle were evaluated at the last follow-up. One hundred and forty four pathogenic bacteria were co-cultured from the secretions of deep wounds from foot ulcers. The Maryland criteria were used to evaluate the recoveries of foot functions. ResultsEighty seven patients with 105 involved feet were followed up successfully over an average period of 14 months. All wounds exhibited good union on follow up, and DFO was cured. The average durations of oral and intravenous antibiotic administrations were 12.2 ± 1.5 and 10.8 ± 2.5 days, respectively. The average duration of hospitalization was 14.0 ± 2.7 days and the healing time for the ulcers was 37.8 ± 6.3 days. Rehospitalization presented in 21 (18.8％) foot ulcers among those with ulcer recurrence. No patients required amputation above the ankle. According to the Maryland criteria, 31, 45, 26, and three feet were rated as excellent, good, fair, and failures, respectively. Overall, 72% were rated as excellent-good. ConclusionsThe rate of amputation above the ankle was significantly reduced with the use of comprehensive interventions to retain foot function and improve quality of life. This management strategy in the treatment of DFO is effective and comprehensive comprehensive; therefore, it should be more frequently used in clinical settings.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients on Follow-Up Clinic at Jimma Medical Center, Southwest Ethiopia, 2019: An Institutional-Based Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Daba Abdissa ◽  
Tesfaye Adugna ◽  
Urge Gerema ◽  
Diriba Dereje
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Medical Center ◽  
Previous History ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
History Of

Background. Diabetic foot ulceration is a devastating complication of diabetes mellitus and is a major source of morbidity and mortality. So far, there are few published data on diabetic foot ulcers and its determinants among diabetic patients on follow-up at Jimma Medical Center. Hence, the aim of this study was to assess the prevalence of diabetic foot ulcer and its determinants among patients with diabetes mellitus at Jimma Medical Center. Methods. A hospital-based cross-sectional study was conducted from June 1 to August 30, 2019, and systematic random sampling technique was applied. The total number of study subjects who participated in the study was 277. Data were collected using an interview-administered structured questionnaire. Data were entered into EpiData version 3.1 and exported to SPSS version 20 software for analysis. Analysis was done using descriptive statistics and logistic regression. A variable having a p value of <0.25 in the bivariate model was subjected to multivariate analysis to avoid confounding the variable’s effect. Adjusted odds ratios (AOR) were calculated at 95% confidence interval and considered significant with a p value of ≤0.05. Result. The mean of age of participants was 50.1±14.19 years. More than three-fourths of participants (82.7%) were type 2 DM. The mean duration of diabetic patients was 6.00±5.07 years. The prevalence of diabetic foot ulcer was 11.6% among study participants. According to multivariate logistic regression analysis, previous history of ulceration (AOR=5.77; 95% CI: 2.37, 14.0) and peripheral neuropathy (AOR=11.2; 95% CI: 2.8, 44.4) were independent predictors of diabetic foot ulcer. Conclusion. The prevalence of diabetic foot ulcer was 11.6%. Previous history of ulceration and peripheral neuropathy were associated with diabetic foot ulcer. The health care providers are recommended to thoroughly give emphasis during follow-up of patients who had previous history of ulceration and peripheral neuropathy in order to decrease the occurrence of diabetic foot ulcer.

scholarly journals Elevated plasma trimethylamine-N-oxide levels are associated with diabetic retinopathy

2020 ◽  
Author(s):  
Weiming Liu ◽  
Chunmin Wang ◽  
Yu Xia ◽  
Wei Xia ◽  
Gaoqin Liu ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Plasma Levels ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Diagnostic Model ◽  
Cross Sectional ◽  
The Relationship ◽  
Integrated Discrimination Improvement

Abstract Aims To determine the relationship between plasma levels of trimethylamine-N-oxide (TMAO) and odds of diabetic retinopathy (DR). Methods A cross-sectional study was conducted. Blood samples were obtained from 122 type 2 diabetes mellitus (T2DM) patients with or without DR. Multivariable logistic regression analyses were performed to identify the association between plasma TMAO and DR. The diagnostic value of plasma TMAO was assessed by the area under the receiver operating characteristic curve (AUROC) and integrated discrimination improvement (IDI). Results In the T2DM patients, plasma levels of TMAO were significantly higher in patients with DR compared with those without DR (P = 0.001). As logarithmic (ln) transformation of TMAO increased per standard deviation (SD), there was higher probability to have DR [odds ratio (OR) = 2.31; P = 0.005]. As ln-transformed TMAO increased per SD, the severity of DR was more likely to get worse (OR = 2.05; P = 0.004). In the diagnostic model, the addition of TMAO contributed to the improvement in AUROC from 0.646 to 0.734 (P = 0.043), and the IDI was 10.7% (P < 0.001). Conclusion Elevated levels of plasma TMAO were associated with higher odds and worse severity of DR in T2DM patients, and further investigation is required for the causality of this association.

scholarly journals Long-Term Complications after Surgical or Medical Treatment of Predominantly Forefoot Diabetic Foot Osteomyelitis: 1 Year Follow Up

2021 ◽  
Vol 10 (9) ◽  
pp. 1943
Author(s):  
Aroa Tardáguila-García ◽  
Yolanda García-Álvarez ◽  
Esther García-Morales ◽  
Mateo López-Moral ◽  
Irene Sanz-Corbalán ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Diabetic Foot ◽  
Prospective Observational Study ◽  
Group Versus ◽  
Medical Group ◽  
Long Term Follow Up ◽  
Surgical Group ◽  
Diabetic Foot Osteomyelitis

Aim: To compare long-term complications according to the treatment received for management of diabetic foot osteomyelitis (surgical or medical) at 1 year follow up. Design and Participants: A prospective observational study was conducted involving 116 patients with diabetic foot osteomyelitis. The patients received surgical or medical treatment based on the principles described in the literature. To register the development of a complication, both groups of treatments were followed-up 1 year after the ulcer had healed. Results: Ninety-six (82.8%) patients received surgical treatment and 20 (17.2%) medical treatment. No differences were found in the time to healing between both groups of treatment, 15.7 ± 9.2 weeks in the surgical group versus 16.4 ± 12.1 weeks in the medical group; p = 0.103. During follow up, 85 (73.3%) patients developed complications without differences between both groups, 68 (70.8%) in the surgical group versus 17 (85%) in the medical group (p = 0.193). The most common complication in both groups was re-ulceration. We did not observe significant differences comparing complication-free time survival between both treatments (p = 0.665). Conclusion: The onset of complications after healing in patients who suffered from diabetic foot osteomyelitis was not associated with the treatment received. Surgical and medical approaches to the management of diabetic foot osteomyelitis produced similar results in long-term follow up.

scholarly journals Investigating the Diagnostic Value of Ultrasound in Determining the Opposite Inguinal Hernia in Children with Unilateral Inguinal Hernia Diagnosis

2020 ◽  
pp. 1-6
Author(s):  
Ashjaei Bahar ◽  
Ashjaei Bahar ◽  
Amiri Shakiba ◽  
Najdi Fatemeh ◽  
Movahedi Jadid Merisa
Keyword(s):  
Inguinal Hernia ◽  
Clinical Examination ◽  
Medical Center ◽  
Diagnostic Value ◽  
Bilateral Inguinal Hernia ◽  
Cross Sectional ◽  
Unilateral Inguinal Hernia ◽  
Center Hospital ◽  
Inguinal Hernia In Children

Objective: This study was conducted to evaluate and compare the results of ultrasound and clinical examination in the diagnosis of inguinal hernia in children and also to evaluate the benefits and complications of ultrasound in these children. Study Design: This study, was performed by a cross-sectional method in Children's Medical Center Hospital during 2013-2014 years and follow up was done until July 2020 with the help of a questionnaire from 70 children who had been referred due to unilateral inguinal hernia symptoms. All 70 children underwent Ultrasonographic evaluation and the results of the ultrasound were compared with the initial clinical examination and then with surgery and follow up. Results: In 95.7% of cases, uni or bilateral inguinal hernia was correctly diagnosed by ultrasound. Ultrasound revealed 13.4% of cases were bilateral and 86.6% were unilateral, all of which were confirmed by surgery. In 17.1% of cases, although they were referred with the chief complaint and clinical examination of unilateral inguinal hernia, Bilateral diagnosis was made for them during the ultrasound, and during the surgery, 75% of them were confirmed to have bilateral inguinal hernia. Conclusion: Ultrasound is effective in diagnosing the opposite side of the hernia in cases with unilateral hernia.

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