Background Diabetic foot ulcers represent one of the most serious complications of diabetes mellitus, affecting approximately 6.3% of individuals globally. They have a profound impact on patients' physical, psychological, social, and economic well-being. These ulcers are associated with pain, mobility restrictions, social isolation, and financial burdens, all of which contribute to a diminished health-related quality of life (HRQoL). Understanding the extent and nature of this impact is essential for optimising care strategies and improving patient outcomes. Objective To systematically review and synthesise existing evidence on the impact of diabetic foot ulcers on HRQoL of adults aged 18 years and above, and to identify the HRQoL measurement tools most frequently utilised in this population. Methods This systematic review followed the PRISMA 2020 guidelines. A comprehensive search of MEDLINE (OVID), EMBASE, CINAHL Plus, and Scopus was conducted using a combination of keywords and MeSH/Emtree terms. Eligible studies, published in English only, of adults aged 18 years and older with an existing DFU, were included. Independent reviewers conducted the screening, data extraction, and quality appraisal using the Evidence-Based Librarianship (EBL) critical appraisal tool. Due to heterogeneity in study designs and outcome measures, data were narratively synthesised. Results A total of 2609 records were identified, of which 47 studies met the inclusion criteria. Most of these studies were cross-sectional and were conducted across Asia/Middle East, Europe, and Africa. Overall, adults with DFUs demonstrated lower HRQoL across all domains with low SF-36 scores (≈36-54) and EQ-5D index values ranging from 0.44 to 0.61. The most significant deficit was reported in physical functioning and mobility. The findings from all the HRQoL instruments used in the reviewed studies were consistent in their assessments of the impact of DFU on HRQoL, including physical, psychological, social, and overall QoL satisfaction. Conclusions DFUs are associated with lower HRQoL across physical, psychological and social domains. The results highlight the need for comprehensive, multidisciplinary care for patients with DFU. Registration PROSPERO registration number: CRD42024501488.
Design Content validation study using a modified Delphi process. Setting Online teleconsultation and remote evaluation context. Participants Nineteen clinical professionals with expertise in musculoskeletal physiotherapy and five patients with non-arthritic hip pain participated. A total of 49 professionals were invited, yielding a 42% response rate. Intervention A preliminary set of items for a new patient-reported outcome measure (PROM), the Teleconsultation Evaluation of Hip Pain (TE-HIP), was generated. Two rounds of semistructured one-on-one interviews with professionals and one round with patients were conducted to assess item relevance, clarity, and completeness. Main measures Consensus regarding the content validity of TE-HIP was sought, focusing on the adequacy of subdomains and individual items to capture functional limitations in non-arthritic hip pain within teleconsultation contexts. Results The iterative process resulted in a PROM comprising seven subdomains addressing functional aspects of non-arthritic hip pain. After three rounds, both patients and professionals agreed on the relevance and comprehensibility of the proposed items. Content validity was established, with TE-HIP judged to adequately reflect the functional impact of hip pain in non-arthritic conditions suitable for remote clinical settings. Conclusions TE-HIP demonstrated good content validity and may serve as a useful tool in clinical and research settings to assess functionality in non-arthritic hip pain during teleconsultations. Nonetheless, further evaluation is required to establish its reliability (internal consistency, test–retest reliability, measurement error), validity (structural, cross-cultural, criterion-related), and responsiveness. Until such evidence is available, TE-HIP should be applied alongside other established instruments.
Objective Oral mucosal injury is commonly accompanied by local inflammation and tissue repair, yet experimental models that enable reproducible investigation of these dynamic processes remain limited. This study aimed to establish and comprehensively characterize a reproducible murine model of chemically induced oral mucosal injury and to evaluate its responsiveness to topical anti-inflammatory treatment. Methods Oral mucosal injury was induced in male C57BL/6 mice by repeated chemical cauterization of the dorsal tongue mucosa. Lesion development and healing were monitored by macroscopic observation. Histopathological examination was performed to assess epithelial injury and inflammatory cell infiltration. Transcriptomic profiling, quantitative PCR, immunohistochemistry, and Western blotting were used to characterize inflammation-related molecular responses. The model's therapeutic responsiveness was assessed with topical dexamethasone. Results Repeated chemical cauterization produced reproducible oral mucosal ulcerative injury with a defined course of lesion formation and spontaneous healing. Histopathological analysis demonstrated epithelial disruption, inflammatory cell infiltration, and subsequent tissue regeneration during healing. Transcriptomic analysis revealed significant enrichment of inflammatory and immune-related pathways, and molecular analyses supported increased activation of the NF-κB, STAT3, and STING signaling pathways. Expression of the pro-inflammatory mediators TNF-α, IL-6, and IL-1β was also increased in the lesion tissues. Topical dexamethasone significantly accelerated macroscopic injury healing and was accompanied by attenuation of NF-κB-, STAT3-, and STING-related inflammatory signaling. Conclusions We established a reproducible murine model of post-traumatic oral mucosal injury that exhibits clinical, histopathological, and molecular features. This model provides a practical platform for investigating local inflammatory responses and tissue repair following oral mucosal injury and for evaluating potential pharmacological and targeted interventions.
A recent study found that there are currently 536.6 million persons worldwide with diabetes and believed to be 783.2 million till 2045. An extensive literature survey was done using Springer, Nature, and PubMed sources to compile the review based on the effectiveness and possible mechanism of action of protein based biological growth factors in diabetic wound healing. The most prevalent type of diabetic wounds is the diabetic foot ulcer (DFU), which has a recurrence incidence of 30%-50%. When it comes to diabetic wounds in particular, Growth Factors (GFs) play a significant part in poor wound healing. They have an impact on a variety of activities including alterations in inflammatory cells, macrophages etc. GFs speed up to enhance wound healing. Conclusively, all the growth factors exhibited an effective wound healing response through various mechanisms of action including fibroblast proliferation, enhancing proliferating, granulation tissue formation, re-epithelization, capillary density, tissue remodelling, detoxification of ROS and tissue formation when incorporated in diverse form of novel drug delivery systems i.e., particulates, hydrogels, scaffolds, and/or other systems. In future, the recombinant growth factors might be utilized in the healing/management of diabetic wounds i.e., acute or chronic wounds. However, more research is need to determine the effectiveness of this combination treatment approach. This is promising research to confirm the efficacy and mechanism of action of recombinant growth factors.
