The International Working Group on the Diabetic Foot (IWGDF) has published evidence-based guidelines on the prevention and management of diabetic foot disease since 1999. This is the first guideline on the diagnosis and treatment of active Charcot neuro-osteoarthropathy in persons with diabetes published by the IWGDF. We followed the GRADE Methodology to devise clinical questions in the PACO (Population, Assessment, Comparison, Outcome) and PICO (Population, Intervention, Comparison, Outcome) format, conducted a systematic review of the medical literature, and developed recommendations with the rationale. The recommendations are based on the evidence from our systematic review, expert opinion when evidence was not available, and also taking into account weighing of the benefits and harms, patient preferences, feasibility and applicability, and costs related to an intervention. We here present the 2023 Guidelines on the diagnosis and treatment of active Charcot neuro-osteoarthropathy in persons with diabetes mellitus and also suggest key future topics of research.
Multiple disciplines are involved in the management of diabetes-related foot disease and a common vocabulary is essential for clear communication. Based on the systematic reviews of the literature that form the basis of the International Working Group on the Diabetic Foot (IWGDF) Guidelines, the IWGDF has developed a set of definitions and criteria for diabetes-related foot disease. This document describes the 2023 update of these definitions and criteria. We suggest these definitions be used consistently in both clinical practice and research, to facilitate clear communication with people with diabetes-related foot disease and between professionals around the world.
Literature Database, regardless of publication time or language.Main outcome(s): outcome measurements comprise of sensitivity, specificity, precision, accuracy, false positive rate, true positive rate, false negative rate, and diagnostic adds ratio.
目的:探讨三维可视化(3DV)技术辅助单孔胸腔镜肺癌根治术对R0切除率、炎性反应及术后疼痛的影响.方法:Ⅰ、Ⅱ期肺癌并拟行肺癌根治术患者47例,随机分为观察组(24例)和对照组(23例).观察组行3DV技术辅助单孔胸腔镜肺癌根治术,对照组行单孔胸腔镜肺癌根治术.比较两组患者手术情况,恢复情况,R0切除率,术前1 d和术后3、7 d的C反应蛋白(CRP)和白细胞介素-6(IL-6)水平,以及术后24、36 h时静息、活动时疼痛情况.结果:与对照组比较,观察组手术时间、住院时间短,术中出血量少,淋巴结清扫数量多(P<0.05).观察组R0切除率(21例,87.5％)明显高于对照组(14例,60.87％;P<0.05).两组炎性指标CRP和IL-6术后3 d均有所上升,术后7 d均回落,观察组术后1 d和术后3 d均小于对照组(P<0.05).两组术后48 h观察组轻微活动时疼痛评分明显低于对照组(P<0.05),其余观察时间点疼痛评分以及两组拔管时间差异无统计学意义(P>0.05).结论:3DV辅助单孔胸腔镜肺癌根治术可提高手术R0切除率,改善术后炎性反应与疼痛情况.
目的:报告 1 例高毒力肺炎克雷伯菌(hvKP)致脓毒性休克及血源播散性肺脓肿的临床特征和诊疗过程,为临床诊疗提供依据.方法:回顾性分析 1 例原发感染部位不明,病程迁延反复的糖尿病合并肺炎克雷伯菌感染致脓毒性休克及血源性肺脓肿患者的临床资料,分析其临床诊断、诊疗过程及转归.结果:经积极的痰液引流、强效抗感染、控制血糖、高营养支持、康复治疗等综合治疗,患者转归良好.结论:hvKP侵袭性强,积极寻找感染灶并加强引流联合强效的抗感染、高营养支持、严格血糖控制、早期康复治疗等综合措施有助于改善患者预后.
