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Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fenerbahce University Journal of Health Sciences (FBU-JOSH) / Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi is the property of Fenerbahce University Journal of Health Sciences (FBU-JOSH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diabetic foot ulcers and infections are considered significant health problems worldwide. Turkish Society of Clinical Microbiology and Infectious Diseases Study Group for Diabetic Foot Infections (DAİÇG) prepared a consensus report in 2015 regarding the diagnosis, treatment, and prevention of diabetic foot (DF) ulcers and diabetic foot infections (DFI) in national circumstances. Subsequently, in 2023, representatives assigned through collaboration with relevant national specialty associations reviewed the literature and international guidelines on the pathogenesis, microbiology, assessment and grading, treatment, prevention and control, offloading, post-amputation rehabilitation; identified questions that needed to be addressed, and updated the Consensus Report with answers to these questions. The information in this report is intended to assist healthcare professionals caring for diabetic patients. Some of the answers in the report are listed as follows: 1) Many factors cause DF ulcers, with the main causes being sensorimotor polyneuropathy and the development of peripheral arterial disease (PAD). 2) In a patient with a DF ulcer, the infection should be considered if other causes are ruled out and there are at least two local inflammatory signs, such as purulent discharge or erythema, edema, warmth, pain, tenderness, and induration at the ulcer site. In these cases, the severity of the infection is described as mild, moderate, or severe depending on the depth of the ulcer, its width, and the presence of systemic signs of infection. 3) The causative agents in DFI vary depending on whether the infection is acute or chronic and the severity of the infection. Superficial DFIs that develop in patients with cellulitis and with no previous antibiotic use are mostly caused by aerobic Gram-positive cocci (staphylococci, streptococci). 4) Deep and chronic infections and/ or infections of patients that have received previous antibiotic treatment are generally polymicrobial (Gram-positive cocci + Gram-negative rods). 5) The classification of the Infectious Diseases Society of America (IDSA)/International Working Group on the Diabetic Foot (IWGDF) can be used to assess the severity of DFI. 6) According to this classi- fication, severe and certain special cases of DFI should be hospitalized for treatment. 7) Inflammatory markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin can be useful in differentiating infection from colonization. 8) Before starting antibiotics in suspected DFI, a suitable tissue sample should be taken from the ulcer base by curettage or biopsy for culture. 9) A three-view plain X-ray of the foot should be taken initially as an imaging method for diagnosis. This can help detect infection and bone deformities, fractures, radiopaque foreign bodies, and gas formation in soft tissues. 10) Magnetic resonance imaging (MRI) is a sensitive and specific method for patients who do not respond to treatment or where osteomyelitis or deep soft tissue abscess is suspected. 11) Culture and a positive result in histopathological examination of the bone are accepted as the gold standard in diagnosing osteomyelitis. 12) To promote ulcer healing and salvage of the limb, it is necessary to perform urgent and aggressive debridement to remove dead and infected tissues, provide proper ulcer care, relieve the foot from pressure, administer appropriate antibiotic therapy, achieve metabolic control, diagnose and treat PAD, and restore foot function. 13) In cases of DFI and PAD coexistence, consultation with the relevant surgical specialty is essential for the planning and timing of surgical procedures, and it is also advisable to seek the opinion of a vascular surgeon for revascularization. Surgical management of DF ulcers can be analyzed in five sections: (a) Urgent ulcer intervention; abscess drainage and/or debridement, (b) surgical interventions for vascular pathologies, (c) ulcer closure interventions; reconstruction methods; graft and flap surgery, (d) reconstruction of bone and foot pathologies for ulcer prevention and treatment (Charcot foot deformity, Achilles lengthening, tenotomy, and osteotomies, etc.), (e) minor and major amputations when necessary. 14) Amputation may be a more appropriate choice when infected tissue cannot be completely cleaned with debridement, when the patient is bedridden or has a non-functional extremity, when it is believed that adequate revascularization cannot be achieved by orthopedic and plastic surgical interventions, in cases where reconstruction is nearly impossible, and in dialysis patients. 15) The goal of post-DFI reconstruction is to allow the ankle to reach a neutral position and to make the plantar surface of the foot have a balanced contact with the ground. 16) Selected ulcer care products can be used based on the characteristics of the ulcer to support and accelerate ulcer healing, reduce the risk of complications, ensure patient comfort during treatment, and improve quality of life. 17) DF ulcers often develop due to improper shoe selection during the structural and biomechanical changes, resulting in fluid accumulation and callus formation around bone surfaces. 18) Orthoses, which distribute pressure over the widest possible area, are the most effective means of reducing plantar pressure in the foot. 19) Hyperbaric oxygen therapy is beneficial in addition to revascularization and antibiotic therapy, which are the primary treatments for pathologies causing tissue hypoxia, such as ischemia, infection, and edema. 20) Negative pressure ulcer therapy is an additional adjunct method to conventional techniques, and it can contribute to the healing process with the correct indications. 21) In cases where the infection is under control, active osteomyelitis is absent, topical epidermal growth factor (EGF) can be used for Meggitt-Wagner ulcer classification grade 1-3, and intralesional EGF applications can be used for grade 3-4 in addition to standard treatments. 22) Preventive medical practices in people with diabetes, collaborative efforts of the patients, their families, and the medical team, and regular patient education are necessary to prevent DF ulcer development. In the event of DF ulcer development, interdisciplinary collaboration in moderate/severe infections is essential for early treatment and infection prevention. [ABSTRACT FROM AUTHOR]

Purpose: To compare dry eye findings in diabetes mellitus patients with and without diabetic foot. Methods: Diabetes mellitus patients with and without diabetic foot were included in this controlled cross-sectional study. Tear break-up time (BUT) and Schirmer test results of each participant were noted. Ocular Surface Disease Index (OSDI) questionnaire was administered to each participant. Results: There were 48 diabetic patients in the study; half of them had diabetic foot (n=24). The patients with and without diabetic foot were similar in age and sex distribution. The median levels of BUT (4.0 [3.0 – 6.0] seconds for the right eye, 4.5 [3.0 – 6.5] seconds for the left eye in patients with diabetic foot) (4.0 [3.8 – 6.2] seconds for the right eye, 5.0 [3.8 – 5.2] second for the left eye in patients without diabetic foot) and Schirmer’s test (7.0 [5.0 – 17.0] mm for the right eye, 11.0 [6.8 – 17.0] mm for the left eye in patients with diabetic foot) (11.0 [7.0 – 15.8] mm for the right eye, 14.5 [6.5 – 18.5] mm for the left eye in patients without diabetic foot) were similar in both groups of patients. The scores of OSDI were similar in patients with diabetic foot (22.7 [13.5 – 36.2]) and without diabetic foot (28.4 [13.6 – 41.5]) (p=0.749). Conclusion: The Schirmer test, BUT test, and OSDI score were lower in patients with diabetic foot, but they were not statistically significant. In future studies, peripheral neuropathy examination and corneal confocal microscopy may be beneficial when evaluating dry eye parameters in this group of patients.

Copyright of Sakarya Tıp Dergisi is the property of Sakarya Tip Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Türk Radyoloji Seminerleri is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Ege University Nursing Faculty (JEUNF) is the property of Journal of Ege University Nursing Faculty (JEUNF) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gümüshane Üniversitesi Saglik Bilimleri Dergisi is the property of Gumushane University, Faculty of Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Epidermal growth factor (EGF) plays an important role in wound healing. But, bioavailability of EGF is impaired in chronic diabetic foot ulcer (CDFU) due to increased protease activ- ity. The study's objective was to evaluate the effect of intralesional human-EGF (h-EGF) on wound healing in patients with CDFU. Ma- terial and Methods: Twenty-eight patients with CDFU were included to study. 75 μg intralesional h-EGF thrice a week for 5 weeks were used to accelerate wound healing. Ulcer size was calculated by simple plani- metric measurement. Specimens for culture were taken from all patients. Granulation response were evaluated with healing grade (HG) [HG-0 → no response, HG-I → minimal response, HG-II → partial response, HG-III → complete response] and complete wound closure. Pre- and post-treatment ulcers size were recorded to asses treatment outcome. Results: New granulation tissue over the wound (HG I-III) was present in 26 (92.8%) patients at the end of treatment. Complete wound healing (HG III) was achieved in 10 (35.7%) patients, complete wound closure was seen in 3 (10.7%) patients. Pre and post-treatment mean ulcers size were 23.9±18.5 and 6.5±4.8 cm2 (p=0.001). The most frequent adverse events of h-EGF were tremor (32.1%). Total of 47 causative bacterias (14 different types of bacteria) were isolated from 23 (87.2%) patients, whereas cultures were sterile in 5 (17.8%) of the patients. Primarily, Es- cherichia coli, Proteus mirabilis, Acinetobacter baumannii, Pseu- domonas aeruginosa species were seen in rate of 19.1%, 17%, 12.7%, 10.6% respectively. Conclusion: Intralesional h-EGF is effective in the treatment of CDFU, has no serious side-effect and accelerates wound healing. [ABSTRACT FROM AUTHOR]

Copyright of Karya Journal of Health Science is the property of Karya Journal of Health Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Meandros Medical & Dental Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The aim of this study was to determine the relationship of soft tissue and bone lesions with vascular flow according to different imaging methods in patients with diabetic foot. Materials and Methods: This retrospective, cross-sectional, descriptive study was conducted in the Radiodiagnostic Department of a university hospital. Results: The most commonly seen finding was cellulitis (n:57, 72.2%) and the least seen was subchondral cyst (n:14, 17.7%). According to the CDUS findings, arterial blood flow was absent in 24.1%, and was monophasic in 27.8%. Vascular blood flow on CDUS was accepted as insufficient in 41 (51.9%) patients. On the CTA images, complete obstruction was determined in 21.5% of patients and >70% narrowing in 20.3%. Vascular blood flow was accepted as insufficient in 46 (58.2%) patients according to the CTA findings. In the interpretation of the CDUS findings, insufficient blood flow was determined in 63% of the patients determined with osteomyelitis, in 61% with cellulitis, in 34% with abscess, in 34% with tenosynovitis, in 29% with joint effusion, and in 17%with subchondral cyst. A statistically significant difference was determined in the blood flow determined with CDUS only in the patients determined with cellulitis (p=0.021). Conclusions: In the diagnosis of complications developing secondary to diabetes, and in the decision for amputation, both CDUS and CTA imaging methods are of value. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışma, Diyabetik Ayak ve Yara Bakım servisinde yatan hastaların; diyabetik ayak ülseri özelliklerini paylaşmak, diyabetik ayak tedavi birimlerinin ve bu birimlerde çalışan sağlık profesyonellerinin önemine dikkat çekmek amacıyla tanımlayıcı olarak yapıldı. Gereç ve Yöntem: Araştırma, tanımlayıcı ve retrospektif bir çalışma olup 2016 ve 2018 tarihleri arasında Hitit Üniversite Hastanesi’nin Diyabetik Ayak ve Yara Bakım servisinde yürütüldü. Veriler hasta dosya kayıtları incelenerek elde edildi. İlgili tarihler arasında yatan 382 hasta dosyasının tamamına ulaşıldı. Toplanan veriler; tanımlayıcı istatistikler (ortalama, standart sapma, minimum ve maksimum değer, yüzde, frekans), Kruskall Wallis testi, Mann Whitney U testi, Post Hoc testi ve Spearman Korelasyon analizi kullanılarak değerlendirildi. Bulgular: Çalışmaya katılan hastaların, yaş ortalamasının 64,3±9,5 gün olduğu belirlendi. Hastaların; %69,4’ünü erkeklerin, %30,6’sını kadınların oluşturduğu, %57,5’inin Wagner 3.evre olduğu, %58,9’unun insülin tedavisi aldığı ve %66’sının doku kültüründe üreme olduğu tespit edildi. Hastaların ortalama diyabetik ayak süreleri 300,5±1180,2 gün (2-8760 gün) ve hastaların hastanede kaldığı ortalama sürenin 26,3±23,5 gün olduğu saptandı. Bu yatış süresi içinde hastaların %55’ine, sadece günlük pansuman tedavisi uygulanarak şifa ile taburcu oldukları belirlendi. Yatışta amputasyon düşünülen hastalardan daha az hastaya amputasyon uygulandı (10 hasta). Sonuç: Bu araştırma günümüzde diyabetik ayak ülserinin yaygın olarak görüldüğünü ortaya koymaktadır. Aynı zamanda birden fazla etkenin diyabetik ayak ülserine yol açabileceği tanımlamaktadır. Araştırmadan elde edilen sonuçlar bu hastalara multidisipliner ve alanında uzman kişiler tarafından yapılan tedavilerin, daha kısa sürede etki ettiğini ve ekstremite kayıplarını belirgin şekilde azalttığını göstermektedir.

Objective: Diabetes mellitus is a common health issue with an increasingly rampant incidence all over the world. Diabetic foot ulcers raise morbidity, reduce the quality of life, prolong hospital stay, and cause a high rate of lower extremity amputation. Our aim in this study is to evaluate the patients presented to the hospital with the diabetic foot diagnosis. Methods: 147 diabetic foot patients were evaluated retrospectively in the chronic wound council between 2016--2017 at our hospital. Wagner was used for wound classification, whereas Infectious Diseases Society of America (IDSA) was for infection classification. Results: Evaluating the cases according to the Wagner classification, 1 patient was observed to be on stage 1, 19 were on stage 2, 58 were on stage 3, 58 were on stage 4, 11 were on stage 5. Patients on stage 3 and above accounted for 86.4% of all cases. 66 patients (45%) underwent minor amputation, whereas 18 (21%) were below-knee amputation and 2 (1%) were above-knee amputation. 44 patients recovered with debridement and wound care. Conclusion: Lower extremity ulcers and infections in diabetic patients are one of the most common causes of hospitalization and non-traumatic amputation in diabetic patients. The amputation rate, which was determined as 58.5% in our study, is higher compared to similar studies. We consider that this is due to patients who presented late, who had higher grades of Wagner wound stages, who had osteomyelitis, who had vascular problems and were referred to our center for decision of amputation. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Health Sciences / Türkiye Klinikleri Sağlık Bilimleri Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anxiety-Depression Disorders and Bone Mineral Density in Diabetic Foot Patients Objective: In this study it is aimed to evaluate the depression and anxiety scores as well as biochemical measures in diabetic foot (DF) and none diabetic foot (Non-DF) patients, also to compare the bone mineral densitometry (BMD) measures in order to point out any possible correlation. Material and Method: Diabetic patients who admitted to Firat University Hospital among which 37 had a diagnosis of DF and 40 Non-DF were included in the study according to the Hospital Anxiety and Depression Scale. HbA1c, magnesium (Mg), albumin, urea, creatinine, calcium (Ca), phosphorus (P), parathormone, vitamin D levels and body mass index. (BMI) were recorded for all patients and Wagner classification scores are noted for the cases with DF. In addition, BMD was measured via Dual-energy X-ray absorptiometry from lumbar region and femoral head. Results: The depression and anxiety scores were both significantly higher in female patients DF or Non-DF. It is also reported that the BMD scores were significantly lower in female patients. Results of bone mineral densitometry were not statistically significant in the DF group. There was a positive correlation between BMI and BMD. Also, it has been found that Ca, P, Mg in DF were remarkably lower than in Non-DF. Conclusion: Anxiety, depression and BMI increase while BMD decreases in diabetic foot patients. Diabetic foot complications are not only considered as endocrine and metabolic disorders, so that they should be treated with a multidisciplinary approach including psychiatry. [ABSTRACT FROM AUTHOR]

Copyright of Karya Journal of Health Science is the property of Karya Journal of Health Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diyabette bozulan glikoz metabolizması dokular üzerinde yıkıcı etkilere sahiptir. Uluslararası Diyabet Federasyonu’nun (IDF) verilerine göre 2017 yılında dünya genelindeki 425 milyon diyabetli bireyden yaklaşık 6.7 milyonu Türk toplumunda bulunmaktadır. Diyabetik ayak, yüksek kan glikozunun sinir ve damar hasarı gibi yıkıcı etkileri sonucunda ortaya çıkan alt ekstremitelerde görülen minör bir travmayı takiben gelişen ülser, enfeksiyon ve derin doku hasarıdır. Diyabetik ayak dünya genelinde her 20 saniyede bir ayak kaybına neden olmaktadır. Ayak yaraları diyabetik popülasyonda %80 oranında majör amputasyonla sonuçlanabilen durumlardır. Yara bakımı tüm cerrahi hastalarında olduğu gibi diyabetik amputasyon geçiren bireylerde de enfeksiyon ve yeniden amputasyonları önlemek açısından önemlidir. Diyabete bağlı bozulan yara iyileşmesi amputasyon sonrası süreçte de bireyi etkilemektedir. Steril teknikle yapılacak pansuman, negatif basınçlı yara tedavisi gibi uygulamalar iyileşmeyi destekleyerek yara iyileşme sürecini hızlandırabilecek yöntemlerdir. Bu makale diyabetik amputasyonlarda yara iyileşme süreçleri ve yara bakımı hakkında farkındalık yaratmak amacıyla yazılmıştır.

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mersin Üniversitesi sağlık Bilimleri Dergisi is the property of Mersin University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Giriş: Diyabetik ayak enfeksiyonları önemli morbidite ve mortalite nedenidir. Tanı ve tedavide gecikmeler ve yetersizlikler hastanede yatış sürelerini uzatmakta, iş gücü kaybı, sakatlık ve psikososyal travmaya neden olmakta, tedavi masrafları hastaya ve ülkeye ciddi mali yük getirmektedir. Bu çalışmada, multidisipliner yaklaşımla takip edilen diyabetik ayak tanılı hastaların klinik ve mikrobiyolojik verilerinin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu çalışma, 2011-2018 yıllarında Endokrinoloji Kliniği’mizde diyabetik ayak konseyinde takip edilen 36 diyabetik ayak olgusu verileri retrospektif olarak incelendi. Hastalar medikal tedavi ve cerrahi tedavi olarak iki gruba ayrıldı. Bulgular: Çalışmaya 24 (%66.6) erkek, 12 (%33.3) kadın toplam 36 hasta alındı. Medikal tedavi ve cerrahi tedavi grubu hastalar karşılaştırıldığında, cerrahi tedaviye gidiş ile hipertansiyon, hiperlipidemi, kültürde bakteri üremesi, sigara kullanımı, lökositoz, cinsiyet, oral antidiyabetik ilaç ya da insülin kullanımı gibi parametreler arasında istatistiksel olarak anlamlı fark bulunamadı. Cerrahi tedaviye gidiş ile periferik damar hastalığı, kötü glisemik kontrol, osteomiyelit, sedimantasyon gt;70 mm/s, nöropati, retinopati, nefropati varlığı arasında anlamlı istatistiksel farklılık saptandı. Sonuç: Diyabetik ayak ülserlerinin önlenmesi için eğitim, nöropatinin erken saptanması ve iyi glisemik kontrol ile mümkündür. Diyabetik ayak ülseri gelişen olguları amutasyondan korumak için hastalar multidisipliner bir şekilde değerlendirilmeli, donanımlı bir ekip tarafından tedavi ve takibi yapılmalıdır.

Hyperbaric oxygen (HBO) therapy is a therapy method based on inhalation of 100% pure oxygen through a mask or endotracheal tube or directly from the environment while subjected to a fully closed pressure chamber with >1 atmosphere. It has been successfully used to treat many diseases from different medical specialties. This review, apart from describing the general features of HBO therapy, emphasises on its therapeutic application in different medical specialties. This would promote its usage, alongside other methods, by physicians from different clinical fields. [ABSTRACT FROM AUTHOR]

Introduction: The burden of care-giving is defined as the burden sustained by an individual who is giving care to an elderly, chronically ill or incapacitated person; the levels of perception of the burden are known to be affected by various personal and disease-related characteristics. Studies that compare the burden of internal patients’ caregivers with psychiatric patients’ caregivers, reported higher caregiving burden for caregivers of psychiatric patients. In this study, it was aimed to compare the levels of the caregiving burden of those caring for patients with diabetic foot with care-givers of psychotic patients. Caregivers of those with inguinal hernia were designated as the control group to determine the characteristics that are related to the care-giving burden. Methods: The study was comprised of care-givers of 30 hospital in-patients with diabetic foot, 30 in-patients with inguinal hernia, and care givers of 30 patients with a recorded diagnosis of psychotic disorder at Çorum Community Mental Health Centre. The evaluation was made from voluntary completion of the Zarit Burden Interview Form and the Beck Depression, Beck Anxiety, Hospital Anxiety and Depression (HAD) and Short Form-36 (SF-36) scales. Results: The caregivers of the diabetic foot group were found to be mostly non-working females. No difference was found between the burden levels of psychotic and diabetic patient groups but the burden level of caregivers of psychotic patients was determined to be significantly higher than the control group (p lt;0.001). In comparison with those of the control and psychotic group, the depression and anxiety scales of the diabetic foot group were signficantly high and some points of the quality of life scales were determined to be significantly low. A correlation between the duration of care-giving and the burden was only determined in the diabetic foot group (r=0.421, p=0.020). Conclusion: Care-givers of diabetic foot patients remained more socially isolated. This was probably due to having to live with an elderly person requiring care. For various reasons, care-givers of diabetic foot patients were found to have high levels of anxiety and depression, low quality of life, and burden levels as high as those of the psychotic group. Therefore, in the context of protecting the physical and emotional health of care-givers, careful monitoring and when necessary, supportive treatment would be appropriate.

Giriş: Osteomiyelit (OM) zamanında tanınması enfeksiyonun migrasyonunu önlemek için önemlidir. OM tedavisindeki gecikme tekrarlayan ayak ülserlerine yol açarak, cerrahi girişim gereksinimini artırmakta ve antibiyotik tedavi süresini uzatmaktadır. Bu çalışmada, klinik ve laboratuvar bulguları kullanılarak, diyabetik ayak enfeksiyonunda OM için bağımsız risk faktörlerinin belirlenmesi, böylece erken tanıya olanak sağlaması hedeflenmiştir. Gereç ve Yöntem: 2020-2022 tarihleri arasında hastanemize başvuran, diyabetik ayak enfeksiyonu (DAİ) tanılı hastaların katılımıyla gerçekleştirildi. DAİ evresine eşlik eden kemik enfeksiyonu ayrıca belirtildi. Verilerin analizi için SPSS-22 paket programı kullanıldı. Bulgular: Çalışmaya 247 hasta dahil edildi. Bu hastaların 162'si (%65,5) erkekti. Doksan beş (%38,5) hastada OM saptandı. OM'si olan ile olmayan hastalar arasında yaş, beyaz küre, C-reaktif protein (CRP), prokalsitonin (PCT), nötrofil-lenfosit oranı (N/L), CRP/albümin (CRP/albümin) ve eritrosit sedimentasyon hızı (ESH) açısından istatistiksel açıdan anlamlı fark saptandı (p<0,05). OM için tek yönlü analizde artan yaş, beyaz küre, N/L, CRP, ESH, CRP/albümin prediktif faktörler iken, çok yönlü analizde sadece artmış ESH önemli bir parametre olarak karşımıza çıkmaktadır (Tablo 1). Sonuç: Çalışmamızda OM olan ve olmayan hastalar arasında artmış yaş, beyaz küre, CRP, PCT, N/L, CRP/albümin ve ESH önemli oranda yüksek olmakla beraber çok yönlü analizde sadece yüksek ESH düzeyi, OM'yi ön görmede bağımsız risk faktörü olarak saptandı. [ABSTRACT FROM AUTHOR]

Aim: In this study, we aimed to evaluate the patients, treated in our clinic, with diabetic foot infection retrospectively. Method: Clinical outcome and treatment results of all patients, hospitalized between January 2011 and January 2014 in our clinic, were evaluated retrospectively. Results: Among patients 39(73.6%) were male and 14 (26.4% )were female and mean age was 67.28±12.5(22-89) years. Patients were evaluated according to Pedis classification, and 28 patients were grade 2, 23 patients were grade 3 and 2 patients were grade 4. Conclusion: Diabetic foot infections rate are increasing and sharing regional data is important for diagnosis and treatment in order to determine the etiology and suitable emphrical therapy,

Background: Diabetic foot ulcer (DFU) is a serious health problem affecting 15% of patients with diabetes mellitus. Diabetic foot ulcers cause a decrease in the quality of life of patients like labor loss, long-term of stay in hospital, financial burden and also lower extremity amputation. Many methods have been applied to treat patients with DFU, but amputations have not been prevented. In this study, we aimed to present the effects of our treatment in DFU patients who had been major amputation (transmetatarsal, tarsometatarsal, intertarsal, rare foot, and at the upper level of the ankle amputations) decision Methods: In this study, we presented patients who had been referred to us from various hospitals with a decision for major amputation, but treated by us using intralesional epidermal growth factor therapy (EGF) combined with negative-pressure wound therapy (NPWT) to prevent below-knee amputation. NPWT (three times a week on alternate days up to the complete closing with skin tissue was achieved) combined with EGF (twice times a week for three days up to complete granulation tissue was achieved ) therapy were applied to patients. The efficacy of treatment was assessed according to wound closure and amputation prevention. Results: According to PEDIS classification, 27 (84.3%) out of 32 patients were the grade 3, and 5 (15.6%) were the grade 4 patients. Infection was present in 24 (75%) of the patients. Necrosis was present in 12 (37.5%) of these patients. The average wound size was 18 cm (10-25 cm). Complete skin closure was achieved in 27 patients (84.3%), and closure with 100% granulation was achieved in 5 patients (15.6%). None of the patients underwent major amputation. EGF [average of 10 injections (7-12 injections)] combined with NPWT [average of 11 sessions (8-13 sessions)] treatment were administered for 45 days on average. Infections were developed in three patients during one-year of follow-up approximately, and medical treatment was administered. Conclusion: Our patients were in the high risk group for major amputation, which were referred from various hospitals with the recommendation of major amputation. We think that the regular application of NPWT combined with EGF can prevent major amputations. [ABSTRACT FROM AUTHOR]

Background: Diabetic foot is one of the major and long-term complications of diabetes. As known, wound healing is slow in diabetic individuals and as a result of inclusion of bacterial invasion to this condition, non-healing diabetic foot wounds occur with prolonged inflammation. The aim of this study was to determine the expressions of TNF-α, a proinflammatory cytokine and matrix metalloprotein MMP-2, involved in tissue remodeling via collagen degradation by immunohistochemical methods in diabetic foot wound tissues. Methods: This study included 30 males and 30 females, a total of 60 patients diagnosed with diabetic foot having open wounds. After washing the foot with isotonic solution, the hole wounds were cut and tissues were fixed in 10% formaldehyde solution. After routine histological follow-up, the sections were embedded in paraffin and semi-thin sections were cut and histopathological examinations were performed. For immunohistochemical analysis, tissue samples were stained with MMP- 2 and TNF-α primary antibodies and examined under a microscope. Results: In our study, leukocytes, lymphocytes and monocytes were observed in the diabetic foot wound tissue. Degeneration of collagen fibers and dilatation of blood vessels, congestion and edema were observed. TNF-α expression was increased in inflammatory cells and necrosis areas. MMP-2 expression was found to be positive in degenerated collagen fibers, fibroblasts and extracellular matrix among the intense inflammation around the vein. Conclusion: Regarding the MMP expression in diabetic foot wound treatment, we think that an approach to the healing of non-healing foot wounds may be developed in the diabetic population. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to investigate the infecting agents and their resistance rates and to determine the risk factors with regard to growth of multidrug resistant (MDR) organisms in patients with diabetic foot infections. Methods: Follow-up forms of 114 diabetic foot patients who had completed their treatments at the care unit for chronic wounds, and their infections between September 2016 and August 2017 were evaluated retrospectively. According to the antimicrobial susceptibility testing, Gram-negative organisms resistant to at least two antimicrobial category, enterococci resistant to penicillin group, or staphylococci resistant to methicillin were accepted as MDR. One MDR isolate was assumed sufficient for evaluation in case more than two organisms were isolated in the same culture. Results: Of 114 patients who were included in this study, 73 (64%) were male. Ninety one (79.8%) of the patients had stage 3 and 4 foot infections according to the PEDIS classification. Microorganisms were isolated in 85 (74.6%) cultures taken from wound sites, and 11 (12.9%) of them were dual growth. A total of 96 organisms, 35 (36.4%) Gram-positives and 61 (63.6%) Gram-negatives, were isolated. The most frequent isolates were 24 (25%) coagulase-negative staphylococci, 19 (19.8%) Pseudomonas aeruginosa and 12 (12.5%) Escherichia coli. Among all isolates, 46 (47.9%) were MDR in the initial wound site cultures. MDR rates of the most frequently-isolated bacteria were 66.7% for coagulase-negative staphylococci, 89.5% for P. aeruginosa and 41.7% for E. coli. Growth of an MDR pathogen was significantly associated with peripheral arterial disease (p≤0.001), hypertension (p≤0.001), polymicrobial growth (p=0.023) and history değişof hospitalization (p=0.026). However, its association with osteomyelitis was not found to reach a significant level statistically (p=0.052). Conclusions: Out of every four patients, three yielded an organism in their initial deep tissue cultures. Of the most frequently-isolated infections, MDR rates were among the highest rates in similar studies. Resistance to antibiotics is a major problem that threatens human life throughout the world, and as we have seen in our study, this threat is also apparent for diabetic foot infections. [ABSTRACT FROM AUTHOR]

Background: Diabetic foot ulcer (DFU) is developing in 15%> of diabetic patients and 3%> of them have lower extremity amputation. Negative pressure wound treatment (NPWT) is a modern, noninvasive adjunctive therapy system. The aim of this study is to share our experience with the use of NPWT in our patients with DFU and to emphasize its impact on healing. Methods: Patients who were admitted to the clinic due to DFU and who used NPWT during their treatment were retrospectively reviewed. The status of the injury before and after NPWT was evaluated by looking at the photographs taken before. The recovery status of the wounds was classified as "complete improvement", "large improvement", "partial improvement", "no improvement" and "worsening" based on the observation of two different specialists. Results: We enrolled 13 patients to our study, whom of 8 were female and 5 were male. All our patients were treated six NBYT sessions. The mean age of the patients was 61.2 ± 5.3 years and the Wagner class was 2 in five patients, 3 in seven patients and 4 in one patient. Fifty four % of the patients had partial improvement, 39%> had a significant improvement, and 8%> had no improvement. With NBYT, C-reactive protein (±%: - 88,9 ± 70,3) (p <0.007), sedimentation rate (±%: - 40,7 ± 13,4) (p <0.005) and white blood cells (hücr%: - 40.6 ± 35.3) (p <0.007) levels was significantly reduced. Conclusions: According to our clinical experience we believe that effective use of NPWT will increase blood flow in DFU ulcers and may improve recovery rates by reducing proinflammatory markers and exudates and reduce amputation rates in selected patients. [ABSTRACT FROM AUTHOR]

Amaç: Diyabetli (DM) hastaların diyabetik ayak (DA) ve ayak bakımı ile ilgili bilgi, tutum ve davranışlarını ve ilişkili faktörleri değerlendirmek.Materyal ve Metot: Kesitsel tipteki çalışmaya Mayıs-Ağustos 2014 tarihleri arasında, DM tanısıyla takip ve tedavi için Keçiören Eğitim ve Araştırma Hastanesi Aile Hekimliği Poliklinikleri’ne başvuran hastalar dahil edildi. Çalışma verileri, araştırmacı tarafından hazırlanan ve hastaların sosyo-demografik özellikleri, DA’la ilgili bilgi, tutum ve davranış düzeyini sorgulayan 56 sorudan oluşan anket formu ile toplandı. Sorulara verilen doğru cevaplar ‘1’, yanlış cevaplar ‘0’ puan olarak değerlendirildi. Ham puanlar hesaplandıktan sonra elde edilen puanlar yüzlük standart puana çevrildi. Tüm hastalara boy, vücut ağırlığı, kan basıncı ölçümleri ve ayak muayenesi yapıldı, üre, kreatinin, açlık tokluk kan glukozu düzeyleri değerlendirildi. Elde edilen verilerin değerlendirilmesinde frekans ve yüzdesel dağılımların yanında, değişkenler arasındaki ilişki korelasyon analizi ve Ki-Kare analizi, gruplar arasında değerlerin karşılaştırılmasında Mann-Whitney U ve Kruskall-Wallis H testi kullanıldı.Bulgular: Çalışmaya dahil edilen 176 hastanın %78,98’i (n=139) kadın %21,02’i (n=37) erkekti. Yaş ortalaması 57,96±10,60 yıldı. Hastaların %54,55’inde (n:96) hipertansiyon mevcuttu. Yüzde %9,70’inde (n:17) ayak yarası, %3,40’ında (n:6) ayak yarası nedeniyle hastanede yatış, %2,80’inde (n:5) operasyon öyküsü vardı. Yüzde 45,50’si (n:80) düzenli ayak bakımı yaptığını, %79,00’u (n:139) ayak tabanlarını düzenli kontrol ettiğini, %25,60’ı (n:45) giyinmeden önce ayakkabısının içini kontrol ettiğini belirtirken %54,00’ü (n:95) evde ya da dışarıda yalınayak yürüdüğünü belirtti. Muayene bulgularına göre %50,00 (n:88) hastanın DA için yüksek risk grubunda yer aldığı saptandı. Katılımcıların % 64,80’i (n:114) DM ilişkin, %90,90’ı (n:160) da DA ve ayak bakımıyla ilgili herhangi bir eğitim almamıştı. Düzenli ayak bakımı yapanların %93,80’i, yapmayanların %82,30’u DM’li hastaların düzenli ayak bakımı yapması gerektiğini belirtti. Hastaların ortalama bilgi düzeyi puanı 100 üzerinden 70,58±21,12; tutum ve davranış puanı 48,13±13,28 idi. Bilgi düzeyi ile tutum ve davranış puanı arasında pozitif korelasyon saptandı (p=0,02). Cinsiyet, eğitim, DM ilişkin eğitim alma durumu ve tedavi şeklinin bilgi, tutum ve davranış üzerine etkisi saptanmadı. DM tanı süresi, kontrol sıklığı ve DA için risk durumunun bilgi düzeyine etkisi yokken tutum ve davranış puanlarının 10-20 yıldır takip edilenlerde, düzenli kontrole gidenlerde ve DA için yüksek risk taşıyanlarda daha yüksek olduğu saptandı (sırasıyla p=0,007, p=0,04 ve p=0,02). Ailesinde başka DM’li hasta olanların bilgi, tutum ve davranış puanları olmayanlara göre daha yüksekti (sırasıyla p=0,003 ve p=0,004). Sonuç: Diyabetik hastaların DA ve ayak bakımı ile ilgili eğitim almadıkları, bilgileri yeterli olsa dahi bildiklerini uygulamadıkları görülmektedir. Standardize edilmiş DM ve diyabetik ayak eğitimi tüm hastalara düzenli aralıklarla verilmeli ve eğitimde vurgulanan noktaların uygulanma durumu yakından takip edilmelidir.

ABSTRACTIntroduction: Diabetic foot wounds are one of the most important causes of long duration hospitalizations regarding diabetic patients. Lower extremity amputation risk is 15 to 40 times higher in diabetics compared to normal population. Methods for preventing diabetic foot wounds are providing good blood glucose regulation, appropriate shoe wearing, foot care, toe-nail care, regular foot examinations and patient education. We aimed to investigate the effects of education level of the patients and the caregivers on the diabetic foot wound.Methods: 67 patients having diabetic foot wound applying to General Surgery, Internal Medicine and Diabetes outpatient clinics of Izmir Tepecik Education and Research Hospital in 2009 and 57 caregiver caring for these patients were analyzed prospectively with a face to face questionnaire for a correlation between education levels of patients and caregivers and Wagner staging of patients’ diabetic foot wounds and foot examination findings.Results: It was found that education levels of patients and caregivers did not affect Wagner staging of the wounds (p=0.167), but patients with regular follow-up and previously educated for diabetic foot wounds had a lower stage of wound (p=0.021).Conclusion: Education level of patients and caregivers was not found to be effective on the stage of the wound, but regular clinical follow-up and patient education had an decreasing effect on the stage of wound. Whatever the patients’ education levels are, educations on diabetic foot care and providing regular follow up of patients at risk for diabetic foot will decrease the rates of extremity amputations.

Objective: Diabetic foot ulcers that are one of the factors determined the duration and quality of life of diabetic patients are one of the most frequent causes of hospitalization and surgery. In this study, it was aimed to investigate the levels of interleukin (IL) 12 P70, 17, 18, HbA1c, and some parameters in subjects with type 2 diabetic mellitus, diabetic foot syndromes. Methods: The study was performed on three groups. They were patients with diabetic foot, patients with diabetes mellitus type 2 and healthy individuals (control). IL-12 P70, IL-17, and IL-18, HbA1c levels and other biochemical tests were compared for the three groups. Results: We found higher IL-17, IL-18, WBC, glucose and HbA1c in the diabetic and diabetic foot groups than control group. IL-12 P70 levels in diabetic foot group were significantly higher compared to control group. The performances in diagnosing of IL-12 P70, 17 and 18 as a biomarker for diabetic foot were statistically significant. IL-12 P70, 17 and 18 levels in diabetic patients were not statically significant compared with diabetic foot patients. Conclusion: In this study, it is thought that IL-12 P70, IL-17 and IL-18 for diabetic foot can be used as biomarkers. Further studies are needed to show the role of IL-12 P70, IL-17 and IL-18 levels in chronic inflammatory diseases as a biomarker. [ABSTRACT FROM AUTHOR]

Ulcer development in a diabetic patient's foot can cause serious morbidity and even mortality in patients. In these patients, a small infection can rapidly increase sepsis during the day due to the effects of both vascular pathologies and the disorder of blood sugar regulation, especially the mechanical problems leading to impaired load distribution. The physiological working process of the liver is becoming more difficult with using of painkillers and antibiotics and septic process. This case was initially hospitalized for evaluation and treatment plan for infected diabetic foot ulcer. However, additional investigations were necessary because of the icterus that is required to be detected in terms of the primary liver problem. Clinically detectable icterus of the amputated patient due to diabetic foot infection and impaired liver function tests have dramatically improved with the elimination of source of infection after amputation. [ABSTRACT FROM AUTHOR]

Background: The purpose of consultation is to obtain the necessary information for the follow-up and treatment of the patient from the physicians in the relevant specialty. The list of hyperbaric medicine indications is quite extensive and it is collaboration with many departments. Material and Methods: 75 diabetic foot consultations of 53 patients were included in the retrospective study from the consultations sent to the Hyperbaric Medical Service between May 26, 2017 and May 26, 2018. Patients' personal information, diagnosis, duration of consultation request and answer, changes in laboratory parameters after the applications, consultations to be made to other departments recommended by hyperbaric medicine specialist were evaluated. Results: 49% of the patients were female, 51% were male and the mean age was 60.28 ± 10.8. 15.67% of the patients were Wagner 1, 30.34% were Wagner 2, 30.34% were Wagner 3, and 23.67% were Wagner 4 diabetic foot patients. 80% of these applications constitute of abscess drainage, debridement and dressing. There was a statistically significant decrease in CRP, WBC and sedimentation values of patients after consultation (p <0.05). Consultations made independently have improved the laboratory values, regardless of the duration of the response to the consultation and whether it is urgent(p> 0.05). Conclusions: Whatever the stage of the diabetic foot, while the patients who are diagnosed with diabetic foot diagnosis are being evaluated, it is absolutely to be consulted to the Hyperbaric Medical Clinic. It is thought that the hyperbaric medicine specialists treatment have contributed positively to the management of the wound. [ABSTRACT FROM AUTHOR]

Objective: The most common cause of amputations in diabetes patients is the foot ulcer. The most prevalent factors leading to ulcer include neuropathy, deformity and traumas. Defining the foot risk factors for all diabetes patients and giving related education constitute the most important way of preventing foot ulcer. The purpose of the present study was to examined the influence of education given with the method of Conversation Map (Diabetes conversations) on Type-2 diabetes individuals' diabetic foot behaviors and on the diabetic foot risk factors. Material and Methods: The study was carried out using the descriptive method with the records of diabetes individuals who were all registered to a diabetes education center of a university hospital and who took education with the method of conversation maps. Within the scope of the study, four training sessions based on conversation maps were held with diabetes patients. In the study, the 12th-month foot care behaviors of individuals before and after the education process and the diabetic foot risk factors were compared. Results: The results revealed a significant change over time-before and after the education process-between the 12th-month foot care behaviors of diabetes individuals who took group education with the conversation map method with respect to foot care efficiency, foot care frequency, and with respect to the diabetic foot risk factors of temperature and humidity. Conclusion: The results of the study demonstrated that the map-based program had positive influence on the patients' diabetic foot behaviors. For the purpose of evaluating the effectiveness of the education given based on the conversation map, future studies could be carried out with larger research samples using the randomized controlled design. [ABSTRACT FROM AUTHOR]

Biofilm is a well known issue with increasing importance, especially in the field of medicine. The biofilm formation is usually observed in foreign body infections as well as chronic wound infections. The diabetic foot ulcer is suitable for biofilm formation due to its rich wound exudate and debris content and impaired host immune response. The diabetic foot infection has emerged as one of the most important causes of mortality and morbidity in diabetes mellitus which needs special efforts to eradicate infection due to high rate of biofilm formation. In this review, we discuss the characteristic features of biofilms and the importance of the biofilm formation in diabetic foot infections. We also highlight the diagnosis and management of the biofilm formation. [ABSTRACT FROM AUTHOR]