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At least 19 recordsLinked to original sources
PubMed2002

Diabetic foot disease and foot care in a Caribbean community.

We estimated the prevalence of foot symptoms and disease and evaluated foot care practices in a primary care based sample including 2106 people with diabetes in Trinidad. Symptoms of neuropathy were reported by 1030 (49%), previous foot ulceration by 257 (12%), and amputation by 92 (4%). Previous foot ulceration was associated with longer duration of diabetes (odds ratio 1.05, (95% CI 1.04-1.06) per year) and greater severity of neuropathy symptoms (1.17 (1.10-1.24) per unit increase in score). A history of foot ulceration gave relative odds of amputation of 16.3 (8.1-32.9). In those with previous foot ulceration, 120 (47%) went barefoot in the home, and 44 (17%) went barefoot outside the house. Overall, 1491 (71%) subjects reported they cut their toenails themselves, help was provided by a friend or relative to 584 (28%) and by a nurse or chiropodist to 13 ( < 1%). Most patients (1320, 63%) reported that they would treat a cut or blister on the foot themselves, while only 650 (31%) would attend for health care. Diabetic foot disease is common but care practices predispose to foot injury. Implementation of a strategy to improve care of the feet is needed.

Amputation, Surgical↗
PubMed1993

Preventing diabetic foot disease.

Diabetic foot disease results from two common pathologies: peripheral vascular disease and diabetic neuropathy. If these pathologies are not identified, ulceration may occur in the foot. Ulcers can lead to infection and finally amputation. This article discusses the components of the physical exam, current treatment for both pathologies, and client education. Because the two pathologies are similar in presentation, it is important for clinicians to distinguish between the two pathologies. Careful attention to the feet during the physical exam and assessment for symptoms can help distinguish the two pathologies. There are new treatments available for peripheral vascular disease to improve the client's circulation. Treatment of peripheral neuropathy is usually palliative, but can improve the client's quality of life. Through early identification and treatment of peripheral vascular disease and diabetic neuropathy, clients with diabetes can avoid ulceration. Client education is central to the treatment plan.

Diabetic Angiopathies↗
PubMed1996

Foot pathology and risk factors for diabetic foot disease in elderly men.

We examined 3 groups of elderly men; men with diabetes and previous or present foot ulcers, men with diabetes, and men without diabetes. In the foot diseased group, diabetes duration was longer (18 +/- 11 vs 8 +/- 7 years), insulin treatment was more common (86% vs 7%), fasting blood glucose and HbA1c were significantly higher (10.5 +/- 4.0 mmol/1, 8.4% +/- 1.6%) than in the diabetic control group (8.3 +/- 3.4 mmol/l, 7.4 +/- 1.7%). Men in the foot diseased group were taller than men in the diabetic group and non-diabetic men (1.79 vs 1.74 m) but not more obese (BMI 26-27 kg/m2 in all three groups). Current or previous alcoholic problems were more common in the foot diseased group (32%) compared to the control diabetic group (9%) and the non-diabetic group (10%). Diabetic patients with known foot disease had more often callosities, absent hair growth, dry skin and redness, compared to the other groups. Psychosocial problems (alcohol and divorce), long standing diabetes duration and poor metabolic control seem to be of importance for the development of diabetic foot ulcers.

Aged↗
PubMed1986

A critical review of epidemiologic studies on black-foot disease.

An endemic disease in Taiwan named "Black-foot Disease", which has been researched since 1958 and about which many papers have been published, was considered caused by arsenic poisoning from artesian well water. In the beginning some information related to the disease before 1958 is introduced and then, reviews of the six papers titled "Epidemiologic Studies" on "Black-foot Disease" are made without referring to any findings from other papers. The data related to the incidence and severity of the disease from the papers are reevaluated, paying special attention to the fact that the incidence of the disease increased after the installation of pipe system water-supply to replace the artesian wells. With the above-mentioned result the theory which considers arsenic poisoning as the cause of the disease, is disproved.

Arsenic Poisoning↗
PubMed2002

A prospective epidemiologic survey on the prevalence of foot disease in Hong Kong.

A prospective epidemiologic survey on the prevalence of foot disease in Hong Kong found foot disease in 64% of patients screened. All of the patients were ethnically Chinese. Of the conditions specified in the questionnaire, fungal foot infection, tinea pedis, and toenail onychomycosis were the most frequently encountered conditions, followed by metatarsal corns, eczema, psoriasis, and pes planus. Vascular disease, osteoarticular pathology, diabetes mellitus, obesity, atopy, and participation in sports were the main factors coexisting with the foot conditions. Of the study population, 17% and 21% reported that their quality of life was affected by pain and discomfort, respectively. These percentages are much lower than those obtained in other studies; it may therefore be inferred that foot complaints are being neglected by the ethnic Chinese population in Hong Kong.

Adolescent↗
PubMedDate not supplied

An overview of foot disease in patients with diabetes.

Effective management of diabetic foot disease requires a multidisciplinary approach and good communication between all healthcare professionals involved. This article provides an overview of the main factors that need to be considered when assessing patients with diabetic foot disease.

Aged↗
PubMed1998

Hospital discharges for diabetic foot disease in New Zealand: 1980-1993.

The aim of this study was to determine the prevalence of hospital discharges for diabetic foot disease from 1980 to 1993 in New Zealand and identify regional variations. Data from the International Classification of Disease (ICD) discharge codes for diabetes and its complications from 1980 to 1993 were reviewed for diabetic foot disease. The total number of discharges/100,000 total population has increased from 13.56 in 1980 to 25.79 in 1993. The age and sex-standardised total bed/days per 1000 total population increased from 5.02 in 1980 to 5.85 in 1993. The total inpatient cost for the management of diabetic foot disease in New Zealand (population 3.3 million) for 1993 is estimated to be in the region of NZ$10-11 million (USD$7-7.7 million), indicating the need to put strategies in place to manage this problem. Strategies that reduce the individual and inpatient burden of this advanced stage complication of diabetes mellitus can be implemented easily for a relatively modest cost.

Adult↗
PubMed1993

The incidence of bladder cancer in the black foot disease endemic area in Taiwan.

A high incidence of bladder cancer (23.53/100,000 population per annum from 1981-1985) was found in an endemic area of peripheral vascular disease known as black foot disease (BFD) on the southwest coast of Taiwan. The average incidence of bladder cancer in the whole of the Taiwan area was 2.29/100,000 during the same period. The incidence of female bladder cancer (21.10/100,000) in this area was also high. The ratio of male to female bladder cancer in the BFD endemic area and the neighbouring area was 1.24 and 1.09, lower than that in the whole Taiwan area (2.75) and elsewhere around the world. The high content of arsenic and the high concentration of a "fluorescent substance" in artesian well water in this area are the only 2 related factors identified so far. Determination of the actual carcinogen requires further investigation.

Female↗
PubMed2001

Evaluation of arterial obstructive leg and foot disease by three-phase bone scintigraphy.

BACKGROUND: The level selected for amputation should generally be the lowest compatible with tissue viability, with a reasonable expectation of wound healing in patients with arterial obstructive leg and foot disease, but determining the amputation level of an ischemic lower limb remains controversial. The general consensus is that a decisive and final decision about the amputation level should be made intraoperatively based on the extent of hemorrhage from the incised skin and soft tissue, and the degree of viability of the stump. OBJECTIVE: To estimate the extent of such hemorrhage, and thus suggest the level of amputation preoperatively, the author applied three-phase bone scintigraphy (TPBS) to assess the blood flow in the small arteries and capillary vessels. METHOD: TPBS was performed in patients scheduled to undergo lower limb amputation in an attempt to determine the appropriate amputation level preoperatively, objectively, and visually. Imaging results of this examination were compared with the clinical findings in three cases of arterial obstructive foot disease. RESULTS: The "capillary phase" depicted the perfusion of blood from the small arteries to the capillary vessels. Decreased accumulation in the capillary phase appeared as two distinctive states: one of clinically remarkable necrosis and the other of decreased blood flow in the small arteries and capillary vessels. The latter inevitably causes necrosis and infection postoperatively. CONCLUSION: The results of this study suggest that TPBS is an extremely useful tool in the evaluation of physiological dysfunction and the likely amputation level in patients with arterial obstructive leg and foot disease.

Amputation, Surgical↗
PubMed1993

The effect of intravenous infusion of prostaglandin E1 on cutaneous microcirculation in black foot disease.

In order to evaluate the effect of an intravenous infusion of prostaglandin E1 (PGE1), 80 micrograms/day for two weeks, on microcirculatory vasculature in seven patients (M:F = 3:4, age 60-78) with black foot disease (a peripheral vascular disease of undefined etiology), we applied laser Doppler velocimetry to measure the maximal cutaneous microcirculatory flow (LDF) at a proximal site near gangrenous ulcers of the foot. Maximal flow was induced by local warming to 42 degrees C with a modified laser Doppler heating probe. Three phasic measurements were recorded, i.e., during pretreatment, treatment and follow-up with the separation interval being two weeks. The net maximal LDF (LDF at 42 degrees C minus LDF at room temperature) increased from 8.8 +/- 4.0 to 11.9 +/- 4.0 volt, p < 0.05. Cutaneous vascular conductance (CVC) was calculated as LDF/mean BP. Mean BP showed no significant change before or after treatment. Net CVC was changed from 7.5 +/- 3.1 to 11.9 +/- 4.0 volt/100 mmHg, p < 0.05. The LDF dropped significantly during the two-week period between treatment and follow-up in five subjects (10.8 +/- 3.4 vs 4.6 +/- 1.8, p < 0.05), while the follow-up LDF was close to the control data (4.6 +/- 1.8 vs 6.3 +/- 2.2, p = NS). Hence, we conclude that PGE1 may beneficially enhance microcirculatory blood flow in black foot disease through direct vasodilatory effects.

Aged↗
PubMed1994

Mutational spectrum in the p53 gene in bladder tumors from the endemic area of black foot disease in Taiwan.

An elevated risk of bladder cancer has been reported in the endemic region of 'black foot disease' on the southwest coast of Taiwan and may be related to high arsenic levels in artesian well water. Thirteen urothelial tumors from this endemic region were examined for mutations in exons 5-8 of the p53 gene to identify the effects of possible exogenous factors at the DNA level. DNA was extracted from archival tissue after microdissection of tumors and analyzed by PCR-SSCP (polymerase chain reaction-based single strand conformation polymorphism), followed by direct sequencing. Eight cases (62%) showed mutations and 9 of the 10 point mutations observed were transitions. The type and position of the mutations were not significantly different when compared with the spectra of p53 mutations previously reported for transitional cell carcinomas (TCCs). However, two of the mutations were CGC-->CAC base changes at codon 175, a mutational hotspot for many tumor types but previously unreported in TCCs except in cases associated with inflammatory agents. Three of the tumors examined were found to contain double mutations, a relatively rare mutagenic event in human cancers. Our results suggest that the agents responsible for the high risk of bladder cancer in the black foot disease region may operate through an inflammation-based mechanism which increases the amount of DNA damage per mutagenic event.

Adult↗
PubMed1988

Combined bone scintigraphy and indium-111 leukocyte scans in neuropathic foot disease.

It is difficult to diagnose osteomyelitis in the presence of neurotrophic osteoarthropathy. We performed combined [99mTc]MDP bone scans and indium-111 (111In) leukocyte studies on 35 patients who had radiographic evidence of neuropathic foot disease and clinically suspected osteomyelitis. The [111In]leukocyte study determined if there was an infection and the bone scan provided the anatomic landmarks so that the infection could be localized to the bone or the adjacent soft tissue. Seventeen patients had osteomyelitis and all showed increased [111In]leukocyte activity localized to the bone, giving a sensitivity of 100%. Among the 18 patients without osteomyelitis, eight had no accumulation of [111In]leukocytes, seven had the [111In]leukocyte activity correctly localized to the soft tissue, two had [111In]leukocyte activity mistakenly attributed to the bone, and one had [111In]leukocyte accumulation in a proven neuroma which was mistakenly attributed to bone. These three false-positive results for osteomyelitis reduced the specificity to 83%. Considering only the 27 patients with a positive [111In]leukocyte study, the combined bone scan and [111In]leukocyte study correctly localized the infection to the soft tissues or bone in 89%. Uninfected neurotrophic osteoarthropathy does not accumulate [111In]leukocytes. We found the combined bone scan and [111In] leukocyte study useful for the detection and localization of infection to soft tissue or bone in patients with neuropathic foot disease.

Adult↗
PubMed1986

Effects of formalin footbathing on foot disease and claw quality in dairy cows.

Two experiments on the effect of routine footbathing in 5 per cent formalin in preventing foot diseases and improving claw horn quality of dairy cows are described. Treatment four times a week significantly (P less than 0.05) reduced the incidence of interdigital lesions but had no significant effect on the incidence of the individual interdigital lesions or on the incidence of individual or overall diseases of the claw horn. A two year study using a divided footbath demonstrated significant improvements in some aspects of claw quality in digits footbathed in formalin. Formalin treated digits had a lower incidence and severity of erosio ungulae (P less than 0.001) a lower moisture content (P less than 0.001) and a reduced severity of haemorrhage of the sole at some sites in the claw compared with untreated digits. Formalin treatment, however, had no significant effect on the incidence of either clinical or subclinical lesions of the claw horn. The improvement in the horn quality of claws treated with formalin for six months did not increase with a further year of treatment.

Animals↗
PubMed2000

Diabetic Foot Disease.

The authors review the impact, areas of influence, and treatment protocols for diabetic foot disease.

Journal Article↗
PubMed1991

[Efforts to prevent static foot diseases in Hungary during the last 40 years].

The necessity of fighting against the harms causing static foot diseases has arisen before about 40 years. On the basis of large-scale foot measurements shoes, correctly constructed from the viewpoint of health, for children and workers were produced. We have switched over to metric system of direct character. The modern development of the industrial technology and commercial network is necessary.

Foot Deformities, Acquired↗