bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost of treating diabetic foot ulcers in five different countries
Authors: Cavanagh Peter , Attinger Christopher , Abbas Zulfiqarali , Bal Arun , Rojas Nina , Xu Zhang‐Rong 
Published: January 2012

AbstractMost estimates in the literature for the economic cost of treating a diabetic foot ulcer (DFU) are from industrialized countries. There is also marked heterogeneity between the complexity of cases considered in the different studies. The goal of the present article was to estimate treatment costs and costs to patients in five different countries (Chile, China, India, Tanzania, and the United States) for two hypothetical, but well‐defined, DFUs at the extreme ends of the complexity spectrum. A co‐author, who is a treating physician in the relevant country, was asked to choose treatment plans that represented the typical application of local resources to the DFU. The outcomes were pre‐defined as complete healing in case 1 and trans‐tibial amputation in case 2, but the time course of treatment was determined by each investigator in a manner that would be typical for their clinic. The costs, in local currencies, for each course of treatment were estimated with the assistance of local hospital administrators. Typical reimbursement scenarios in each country were used to estimate the cost burden to the patient, which was then expressed as a percentage of the annual per capita purchasing power parity‐adjusted gross domestic product. There were marked differences in the treatment plans between countries based on the availability of resources and the realities of local conditions. The costs of treatment for case 1 ranged from Int$102 to Int$3959 in Tanzania and in the United States, respectively. The cost for case 2 ranged from Int$3060 to Int$188 645 in Tanzania and in the United States, respectively. The cost burden to the patient varied from the equivalent of 6 days of average income in the United States for case 1 to 5.7 years of average annual income for case 2 in India. Although these findings do not take cost‐effectiveness into account, they highlight the dramatic economic burden of a DFU for patients in some countries. Copyright © 2012 John Wiley & Sons, Ltd.
A systematic review of interventions to enhance the healing of chronic ulcers of the foot in diabetes
Authors: Game F. L. , Hinchliffe R. J. , Apelqvist J. , Armstrong D. G. , Bakker K. , Hartemann A. , Löndahl M. , Price P. E. , Jeffcoate W. J. 
Published: January 2012

SUMMARYThe outcome of management of diabetic foot ulcers is poor, and there is continuing uncertainty concerning optimal approaches to management. It was for these reasons that in 2006 the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing undertook a systematic review of the evidence to inform protocols for routine care and to highlight areas which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between December 2006 and June 2010. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network criteria. Selected studies fell into the following ten categories: sharp debridement and wound bed preparation with larvae and hydrotherapy; wound bed preparation using antiseptics, applications and dressing products; resection of the chronic wound; hyperbaric oxygen therapy (HBOT); compression or negative pressure therapy; products designed to correct aspects of wound biochemistry and cell biology associated with impaired wound healing; application of cells, including platelets and stem cells; bioengineered skin and skin grafts; electrical, electromagnetic, lasers, shockwaves and ultrasound; other systemic therapies which did not fit in the above categories. Heterogeneity of studies prevented pooled analysis of results.Of the 1322 papers identified, 43 were selected for grading following full text review. The present report is an update of the earlier IWGDF systematic review, but the conclusion is similar: that with the exception of HBOT and, possibly, negative pressure wound therapy, there is little published evidence to justify the use of newer therapies. This echoes the conclusion of a recent Cochrane review and the systematic review undertaken by the National Institute for Health and Clinical Excellence Guidelines Committee in the UK. Analysis of evidence presents considerable difficulties in this field particularly as controlled studies are few and the majority are of poor methodological quality. Copyright © 2012 John Wiley & Sons, Ltd.
A systematic review of the effectiveness of interventions in the management of infection in the diabetic foot
Authors: Peters E. J. G. , Lipsky B. A. , Berendt A. R. , Embil J. M. , Lavery L. A. , Senneville E. , Urbančič‐Rovan V. , Bakker K. , Jeffcoate W. J. 
Published: January 2012

SummaryThe International Working Group on the Diabetic Foot expert panel on infection conducted a systematic review of the published evidence relating to treatment of foot infection in diabetes. Our search of the literature published prior to August 2010 identified 7517 articles, 29 of which fulfilled predefined criteria for detailed data extraction. Four additional eligible papers were identified from other sources. Of the total of 33 studies, 29 were randomized controlled trials, and four were cohort studies.Among 12 studies comparing different antibiotic regimens in the management of skin and soft‐tissue infection, none reported a better response with any particular regimen. Of seven studies that compared antibiotic regimens in patients with infection involving both soft tissue and bone, one reported a better clinical outcome in those treated with cefoxitin compared with ampicillin/sulbactam, but the others reported no differences between treatment regimens. In two health economic analyses, there was a small saving using one regimen versus another. No published data support the superiority of any particular route of delivery of systemic antibiotics or clarify the optimal duration of antibiotic therapy in either soft‐tissue infection or osteomyelitis. In one non‐randomized cohort study, the outcome of treatment of osteomyelitis was better when the antibiotic choice was based on culture of bone specimens as opposed to wound swabs, but this study was not randomized, and the results may have been affected by confounding factors.Results from two studies suggested that early surgical intervention was associated with a significant reduction in major amputation, but the methodological quality of both was low. In two studies, the use of superoxidized water was associated with a better outcome than soap or povidone iodine, but both had a high risk of bias. Studies using granulocyte‐colony stimulating factor reported mixed results. There was no improvement in infection outcomes associated with hyperbaric oxygen therapy. No benefit has been reported with any other intervention, and, overall, there are currently no trial data to justify the adoption of any particular therapeutic approach in diabetic patients with infection of either soft tissue or bone of the foot. Copyright © 2012 John Wiley & Sons, Ltd.
A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease
Authors: Hinchliffe R. J. , Andros G. , Apelqvist J. , Bakker K. , Fiedrichs S. , Lammer J. , Lepantalo M. , Mills J. L. , Reekers J. , Shearman C. P. , Valk G. , Zierler R. E. , Schaper N. C. 
Published: January 2012

SummaryIn several large recent observational studies, peripheral arterial disease (PAD) was present in up to 50% of the patients with a diabetic foot ulcer and was an independent risk factor for amputation. The International Working Group on the Diabetic Foot therefore established a multidisciplinary working group to evaluate the effectiveness of revascularization of the ulcerated foot in patients with diabetes and PAD. A systematic search was performed for therapies to revascularize the ulcerated foot in patients with diabetes and PAD from 1980–June 2010. Only clinically relevant outcomes were assessed. The research conformed to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, and the Scottish Intercollegiate Guidelines Network methodological scores were assigned. A total of 49 papers were eligible for full text review. There were no randomized controlled trials, but there were three nonrandomized studies with a control group. The major outcomes following endovascular or open bypass surgery were broadly similar among the studies. Following open surgery, the 1‐year limb salvage rates were a median of 85% (interquartile range of 80–90%), and following endovascular revascularization, these rates were 78% (70.5–85.5%). At 1‐year follow‐up, 60% or more of ulcers had healed following revascularization with either open bypass surgery or endovascular revascularization. Studies appeared to demonstrate improved rates of limb salvage associated with revascularization compared with the results of medically treated patients in the literature. There were insufficient data to recommend one method of revascularization over another. There is a real need for standardized reporting of baseline demographic data, severity of disease and outcome reporting in this group of patients. Copyright © 2012 John Wiley & Sons, Ltd.
The development of global consensus guidelines on the management and prevention of the diabetic foot 2011
Authors: Bakker K. , Schaper N. C. ,   on behalf of the International Working Group on the Diabetic Foot Editorial Board
Published: January 2012

SummaryDiabetic foot ulcers are the source of major suffering and very large costs for both the patient and the health‐care system, and every 30 s, a leg is lost somewhere in the world. Investing in a diabetic foot care guideline can therefore be one of the most cost‐effective forms of health‐care expenditure, provided the guideline is goal focused and properly implemented. The objective of the International Working Group on the Diabetic Foot (IWGDF) is to develop guidelines that will reduce the effect of diabetic foot disease through cost‐effective and quality health care, based on the principles of evidence‐based medicine. These guidelines are produced by working groups of experts in the field and are endorsed by the more than 100 country representatives of the IWGDF. In 2009, the IWGDF invited again three working groups to write consensus guidelines on peripheral arterial disease, infection, and wound healing. New texts were produced according to a systematic review of the literature in order to inform protocols for routine care and to highlight areas that should be considered for further study. During a meeting of the members of the IWGDF in May 2011, the new set of guidelines was approved and is published in this journal. Copyright © 2012 John Wiley & Sons, Ltd.
Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot
Authors: Schaper N. C. , Andros G. , Apelqvist J. , Bakker K. , Lammer J. , Lepantalo M. , Mills J. L. , Reekers J. , Shearman C. P. , Zierler R. E. , Hinchliffe R. J. 
Published: January 2012

SummaryThe International Working Group on the Diabetic Foot (IWDGF) has produced in 2011 a guideline on the diagnosis and treatment of peripheral arterial disease in patients with diabetes and a foot ulcer. This document, together with a systematic review that provided the background information on management, was produced by a multidisciplinary working group of experts in the field and was endorsed by the IWDGF. This progress report is based on these two documents and earlier consensus texts of the IWDGF on the diagnosis and management of diabetic foot ulcers. Its aim is to give the clinician clear guidance on when and how to diagnose peripheral arterial disease in patients with diabetes and a foot ulcer and when and which treatment modalities should be considered, taking both risks and benefits into account. Copyright © 2012 John Wiley & Sons, Ltd.
Hyperbaric oxygen therapy as treatment of diabetic foot ulcers
Authors: Löndahl Magnus 
Published: January 2012

SummaryHyperbaric oxygen therapy (HBO) could be described as a short‐term, high‐dose oxygen inhalation and diffusion therapy, delivered systemically through airways and blood, achieved by having the patient breathing concentrated oxygen at a pressure higher than 1 absolute atmosphere. In clinical practice, monoplace or multiplace hyperbaric chambers are used to achieve this. Treatment is usually given as daily 90‐ to 120‐min‐long HBO sessions at pressures between 2.0 and 2.5 absolute atmosphere, aiming for 30–40 treatment sessions.The use of HBO as treatment of diabetic foot ulcers has been founded on weak scientific ground, although the outcomes from previous studies are in concert with the conclusions from preclinical studies and supports the theoretical framework of HBO reversing hypoxia‐induced pathology. Two well‐designed randomized double‐blind trials have put HBO on firmer ground and may justify adjunctive HBO treatment to a selected group of patients with nonhealing diabetic foot ulcers.Some health economic studies suggest potential cost effectiveness, but these studies are limited by deficient primary clinical data and should be interpreted with caution.Several issues remain to be addressed, such as developing robust criteria to improve treatment protocols, determining which patients are likely to benefit, and when to start and stop treatment. Copyright © 2012 John Wiley & Sons, Ltd.
The ulcerated leg: when to revascularize
Authors: Apelqvist J. A. P. , Lepäntalo M. J. A. 
Published: January 2012

SummaryThe role of peripheral arterial disease in ulcerated diabetic feet has long been underestimated. Progressive claudication, rest pain and the extent of irreversible tissue loss have frequently been indications for revascularization for neuroischaemic ulcers in diabetic patients. These typical ischaemic symptoms are warning signs that are less frequent in diabetic individuals with ischaemia than those without diabetes. Consequently, 30–50% of individuals with diabetes and foot ulcers already have gangrene at admission and are therefore often considered unsuitable for revascularization. Furthermore, the healing of a neuroischaemic ulcer is worsened by microvascular dysfunction, causing arteriovenous shunting, capillary ischaemia, leakage and venous pooling. Therefore, the threshold of revascularizing neuroischaemic ulcers should be lower than that of purely ischaemic ulcers. Comorbidity, ulcer characteristics and infection affect the decision as to when to intervene, as do the severity and extent of occlusive arterial lesions. The window of opportunity for vascular intervention in the neuroischaemic diabetic foot should not be missed, and the need for early vascular intervention as an integrated part of a strategy to achieve healing should be emphasized. Noninvasive vascular testing should be performed on all individuals with an ulcerated diabetic foot. The arterial tree should be imaged if noninvasive tests indicate ischaemia or when mild or questionable ischaemia is diagnosed and conservative treatment does not promote ulcer healing in 6 weeks. Revascularization should be performed whenever feasible to repair distal perfusion to achieve ulcer healing. Copyright © 2012 John Wiley & Sons, Ltd.
Lessons from Eurodiale
Authors: Schaper N. C. 
Published: January 2012

AbstractThe European Study Group on Diabetes and the Lower Extremity is a collaborative, multi‐disciplinary network of 14 centres from ten countries. In 2003–2004, all patients treated in the participating centres because of a new diabetic foot ulcer (n = 1232) were included in a prospective observational study. Subjects attended follow‐up visits on a monthly basis until final outcome: healing of the foot, lower‐leg amputation, death or non‐healing after 1 year. During all visits, data were recorded on standardized case record forms by investigators who were trained during several plenary meetings and on‐site visits. Unique aspects of the study were its size, the pan‐European scope and the integrated/holistic approach for a multi‐organ disease. In this review, the main findings of the study and its implications for diabetic foot care are discussed. Copyright © 2012 John Wiley & Sons, Ltd.
Neogenin regulates sonic hedgehog pathway activity during digit patterning
Authors: Hong Mingi , Schachter Karen A. , Jiang Guoying , Krauss Robert S. 
Published: January 2012

AbstractBackground: Digit patterning integrates signaling by the Sonic Hedgehog (SHH), fibroblast growth factor (FGF), and bone morphogenetic protein (BMP) pathways. GLI3, a component of the SHH pathway, is a major regulator of digit number and identity. Neogenin (encoded by Neo1) is a cell surface protein that serves to transduce signals from several ligands, including BMPs, in various developmental contexts. Although neogenin is implicated in BMP signaling, it has not been linked to SHH signaling and its role in digit patterning is unknown. Results: We report that Neo1 mutant mice have preaxial polydactyly with low penetrance. Expression of SHH target genes, but not BMP target genes, is altered in Neo1 mutant limb buds. Analysis of mice carrying mutations in both Neo1 and Gli3 reveals that, although neogenin plays a role in constraint of digit numbers, suppressing polydactyly, it is also required for the severe polydactyly caused by loss of GLI3. Furthermore, embryo fibroblasts from Neo1 mutant mice are sensitized to SHH pathway activation in vitro. Conclusions: Our findings indicate that neogenin regulates SHH signaling in the limb bud to achieve proper digit patterning. Developmental Dynamics 241:627–637, 2012. © 2012 Wiley Periodicals Inc.
Accuracy of self‐reported energy intake in weight‐restored patients with anorexia nervosa compared with obese and normal weight individuals
Authors: Schebendach Janet E. , Porter Kathleen J. , Wolper Carla , Walsh B. Timothy , Mayer Laurel E.S. 
Published: January 2012

AbstractObjective:To compare self‐reported and measured energy intake in weight‐restored patients with anorexia nervosa (AN), weight‐stable obese individuals (OB), and normal weight controls (NC).Method:Forty participants (18 AN, 10 OB, and 12 NC) in a laboratory meal study simultaneously completed a prospective food record.Results:AN patients significantly (p = .018) over‐reported energy intake (16%, 50 kcal) and Bland‐Altman (B‐A) analysis indicated bias toward over‐reporting at increasing levels of intake. OB participants significantly (p = .016) under‐reported intake (19%, 160 kcal) and B‐A analysis indicated bias toward under‐reporting at increasing levels of intake. In NC participants, NS (p = .752) difference between reported and measured intake was found and B‐A analysis indicated good agreement between methods at all intake levels.Discussion:Self‐reported intake should be cautiously interpreted in AN and OB. Future studies are warranted to determine if over‐reporting is related to poor outcome and relapse in AN, or under‐reporting interferes with weight loss efforts in OB. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)
Association between the serotonin transporter triallelic genotype and eating problems is moderated by the experience of childhood trauma in women
Authors: Stoltenberg Scott F. , Anderson Cynthia , Nag Parthasarathi , Anagnopoulos Cheryl 
Published: January 2012

AbstractObjective:This study investigated a potential interaction between the triallelic polymorphism of the serotonin transporter gene (SLC6A4) promoter and the experience of childhood trauma on the number of problem eating behaviors.Method:The study sample was comprised of 439 (64.7% female) Caucasian college students (mean age = 22.49, SD = 6.12). Participants completed questionnaires that assessed eating problems and experience of trauma in childhood (ages 0–12) and donated cheek cells for 5‐HTTLPR and rs25531 genotyping.Results:Women carrying a lower expressing allele (i.e., LG or S) who were exposed to higher levels of childhood trauma reported significantly higher mean numbers of eating problems (gender × genotype × trauma interaction, p = .006).Discussion:These results are consistent with findings that the lower expressing alleles of the SLC6A4 promoter are associated with increased sensitivity to the negative impact of childhood stressors on adult behavioral outcomes. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)
Minimizing and treating chronicity in the eating disorders: A clinical overview
Authors: Wonderlich Stephen , Mitchell James E. , Crosby Ross D. , Myers Tricia Cook , Kadlec Kelly , LaHaise Kim , Swan‐Kremeier Lorraine , Dokken Julie , Lange Marnie , Dinkel Janna , Jorgensen Michelle , Schander Linda 
Published: January 2012

AbstractObjective:The purpose of this article is to review the available literature regarding treatment and management of eating disorder patients who fail to change over protracted periods of time.Method:Literature was reviewed pertaining to approaches to promoting change in treatment‐resistant cases and the treatment of chronic eating disordered individuals.Results:Although there are a number of clinical perspectives on the treatment of chronic eating disorder patients, fundamental studies defining the concept of “chronicity” and standardized treatment approaches do not exist. Empirical studies of chronic cases are needed, given the absence of investigation of maintenance factors in chronic eating disorders and evidence‐based approaches for treatment. An integrative and practical clinical protocol is provided.Discussion:The results of this review suggest that a significant number of eating disorder patients display a chronic course, which is poorly understood. Treatments for these individuals are not based on evidence‐based findings. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)
Color feature extraction of regions by means of GA for scenery image retrieval
Authors: Mitsukura Yasue , Sakamoto Koji , Fukai Hironobu , Yoshimori Seiki , Ito Seiji , Fukumi Minoru 
Published: January 2012

AbstractKeyword image retrieval is now widely studied. By using such technologies, we can obtain images with the corresponding keywords easily. In the case of conventional image search systems, we basically search according to file names. However, the file names given are frequently incorrect. To resolve this problem, we propose an automatic keyword addition method for scenery images. In this paper, there are two important points. One is the image segmentation method using the maximum distance algorithm (MDA). The other is automatic keyword addition using the color features of regions. In the image segmentation method, we propose an automatic decision method for the parameters of the MDA. For this purpose, we investigate the relation between the optimal parameters and the features of regions. For the color feature extraction of regions, we propose a genetic algorithm (GA). Moreover, in order to show the effectiveness of the proposed method, we provide simulation examples. The results of simulations demonstrate the effectiveness of keyword addition for scenery images. © 2012 Wiley Periodicals, Inc. Electron Comm Jpn, 95(2): 39–49, 2012; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/ecj.10364