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Diabetic Foot Ulcer: A Review
Mohammad Zubair,
Abida Malik,
Jamal Ahmad
Issue:
Volume 3, Issue 2, March 2015
Pages:
28-49
Received:
18 December 2014
Accepted:
30 December 2014
Published:
26 February 2015
Abstract: Diabetic foot problems are common throughout the world, resulting in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable. People at greatest risk of ulceration can easily be identified by careful clinical examination of the feet: education and frequent follow-up. Infection when complicates a foot ulcer, combination can be limb or life-threatening, and infection is defined clinically, but wound cultures assist in identifying the causative pathogens. Tissue specimens are strongly preferred to wound swabs for wound cultures. Antimicrobial therapy should be guided by culture results, and although such therapy may cure the infection, it does not heal the wound. Alleviation of the mechanical load on ulcers (offloading) should always be a part of treatment. Plantar neuropathic ulcers typically heal in 6 weeks with irremovable casting, because pressure at the ulcer site is mitigated and compliance is enforced. The success of other approaches to offloading similarly depends on the patients’ adherence to the effectiveness of pressure relief.
Abstract: Diabetic foot problems are common throughout the world, resulting in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable. People at greatest risk of ulceration can easily be identified by careful clinical examinati...
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Traumatic Brain Injuries in Internal Medicine Wards: An Emerging Challenge Needing for a Call to Action
Luca Masotti,
Gianni Lorenzini,
Irene Chiti,
Laura Policardo,
Paolo Francesconi,
Grazia Panigada,
Giancarlo Landini
Issue:
Volume 3, Issue 2, March 2015
Pages:
50-54
Received:
27 January 2015
Accepted:
9 February 2015
Published:
2 March 2015
Abstract: Background: Traumatic brain injuries (TBIs) represent fearing occurrences in clinical practice, due to high mortality and morbidity. Whether the burden of TBIs is increased in Internal Medicine wards remains unclear, therefore the aim of our study was to provide information about it. Materials and Methods: International Classification of Diseases, 9th revision, Clinical Modification (ICD-9th CM) database referred to patients discharged from Tuscan Hospitals in the 2003, 2008 and 2012 years was analyzed. We searched for codes from 850 to 853.19 and from 854.00 to 854.19 as traumatic intracranial bleedings (TIBs) and codes from 800.00 to 804.99 as traumatic brain injuries without bleedings (TBIWBs) in the first six diagnoses of hospital discharge schedules referred to Internal Medicine wards. Results: Overall, hospital discharges for TBIs reduced over the years. However, hospital discharges for TBIs were 47,2% increased in Internal Medicine wards from 2003 to 2012. TBIs increased in 3,4% of patients under 75 years and 93,7% in patients over 75 years. Internal Medicine ward was the hospital setting in 11,20% and 16,70%of TIBs and TIBWBs in 2003 and 24,10% and 37.50%in 2012, respectively. In-hospital mortality in TBIs patients was unchanged over the years and was seven-tenfold greater in patients over 75 years compared to patients under 75 years. Conclusion: Admissions for TBIs are dramatically increased over the last 10 years in Internal Medicine wards, especially in patients over 75 years, making these conditions as a real emerging challenge for the Internists.
Abstract: Background: Traumatic brain injuries (TBIs) represent fearing occurrences in clinical practice, due to high mortality and morbidity. Whether the burden of TBIs is increased in Internal Medicine wards remains unclear, therefore the aim of our study was to provide information about it. Materials and Methods: International Classification of Diseases, ...
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Gender Differences in Heart Failure: Findings from Italian Internal Medicine Wards
Paolo Biagi,
Valerio Verdiani,
Niccolo’ Napoli,
Cristiana Seravalle,
Luca Masotti,
Irene Chiti,
Grazia Panigada
Issue:
Volume 3, Issue 2, March 2015
Pages:
55-66
Received:
19 February 2015
Accepted:
5 March 2015
Published:
18 March 2015
Abstract: Background and aim: Literature evidence shows that about one half of patients with heart failure (HF) are females. However, they are poorly represented in clinical trials. Therefore, this syndrome remains still understood and its burden underestimated in female sex. The aim of our study was to compare demography, etiology, clinical patterns, outcome, co-morbidity, disability and cognitive performance between females and males in a cohort of patients with HF. Materials and methods: We analyzed data of the Confine Study, a recently real world survey performed in Italian Internal Medicine wards. We compared clinical and instrumental characteristics between males and females. Results: Females with HF were significantly older than men. Hypertensive and valvular etiologies were significantly more prevalent in females whereas ischemic and dilatative were in males. Neither clinical aspects, with the exception of atrial fibrillation, nor echocardiographic aspects were more frequent in females. According to international guidelines on topic, both sexes received under-treatment, but this one was more evident in females. Females presented more frequently cognitive impairment and functional disability than males. Conclusion: Female sex is under-represented in clinical trials on HF. Our study may provide a contribute on this topic.
Abstract: Background and aim: Literature evidence shows that about one half of patients with heart failure (HF) are females. However, they are poorly represented in clinical trials. Therefore, this syndrome remains still understood and its burden underestimated in female sex. The aim of our study was to compare demography, etiology, clinical patterns, outcom...
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Association of N-Terminal Pro–Brain Natriuretic Peptide, Matrix –Metalloprotinase-9, and 8-Oxo-2 Deoxy Guanosine with the Incidence of Essential Hypertension
Julian Yonan Ismaeil,
Shatha Rouf Moustafa
Issue:
Volume 3, Issue 2, March 2015
Pages:
67-77
Received:
8 March 2015
Accepted:
19 March 2015
Published:
23 March 2015
Abstract: Background and Objectives: Oxidative stress and inflammation are cooperative events involved in essential hypertension diseases. This study was as a step for elucidating the contribution of N-terminal pro-brain natriuretic peptide, matrix-metalloprotinase-9 and 8-oxo2-deoxyguanosine with the essential hypertension incidence, development, and progression. Aims: The objective was to determine the serum studied parameters levels in essential hypertensive and normotensive subjects, and to assess the association between these biomarkers with the essential hypertension, and to investigate the effect of other confounding factors like stages, age, and gender and finally find the correlation between all studied parameters. Methods: This study was designed to examine the associations between the focused parameters with the essential hypertension on 50 patients of both genders, as well as an equal numbers of matched age–gender healthy adults were also enrolled in this study as a control group. The hypothesis suggesting that oxidative stress and inflammatory processes influence the risk of adverse clinical outcomes are worth investigating. These parameters were analyzed using enzyme linked immunosorbent assay. Statistical analyses were performed with SPSS version 18. Results: Patients with essential hypertension exhibited significantly higher serum focused parameters levels as compared with the control group. The mean serum N-terminal pro–brain natriuretic peptide levels in patients and control groups were 304.33 ± 204.19, 76.52±20.98 pg/ml respectively. The mean serum matrix–metalloprotinase-9 level in patients and control groups were 2.36±1.1, 1.4±0.8 respectively. The mean serum 8-oxo-2-deoxy guanosine level in patients and control groups were 170.40±41.95, 84.11±34.07 (mg/ml) respectively. Conclusions: Data suggested an association between these circulating biomarkers with the incidence, development, and progression of essential hypertension. No effect of age and gender present on serum levels of focused biomarkers in both groups. These focused parameters seem to be a simple, non-invasive tools and independent parameters for early detection, assessing disease severity, and involved in the etiology of disease. Data indicated an alteration in the oxidative status and inflammatory processes in patients with essential hypertension. Accordingly, this work was undertaken to assess contribution of the oxidative stress and inflammatory process as a risk factors. In addition, these parameters are regarded as markers with prognostic significance and as potential therapeutic targets. These biomarkers are tools that might aid the physicians in diagnosis and subsequent risk stratification, guiding selection of therapy, secondary prevention, and serving as a target for therapy.
Abstract: Background and Objectives: Oxidative stress and inflammation are cooperative events involved in essential hypertension diseases. This study was as a step for elucidating the contribution of N-terminal pro-brain natriuretic peptide, matrix-metalloprotinase-9 and 8-oxo2-deoxyguanosine with the essential hypertension incidence, development, and progre...
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