Indonesia is one of the top ten diabetes mellittus (DM) countries. However as the main complication of DM, there was lack of studies related to diabetic foot ulcer (DFU). Thus, the aim of this study was to survey the ...Indonesia is one of the top ten diabetes mellittus (DM) countries. However as the main complication of DM, there was lack of studies related to diabetic foot ulcer (DFU). Thus, the aim of this study was to survey the prevalence of DFU risk factors and DFU among type 2 diabetes mellitus (T2DM) patients. An epidemiological study was conducted at an outpatient endocrine clinic in a regional hospital, eastern Indonesia. All T2DM participants attending research setting that were ≥ 18 years were included. Demographic and foot care behavior were assessed using minimum data sheet (MDS). Meanwhile, presence of risk factors was evaluated by using 5.07/10 g Semmes-Weinsten Monofilament (SWM) for neuropathy and presence of angiopathy was evaluated with Ankle Brachial Index (ABI) by using a hand held Doppler (Bidop ES-100V3, Hadeco-Kawasaki, Japan) both dorsal and posterior tibialis foot. At the end of study, 249 T2DM participants were enrolled. The prevalence of DFU risk factors was 55.4% (95% CI: 53.7% - 57.0%), and prevalence of DFU was 12% (95% CI: 10.3% - 13.6%). Based on a logistic regression, predictors for DFU risk factors included age (OR: 1.04;95% CI: 1.005 - 1.074) and daily foot inspection (OR: 0.36;95% CI: 0.186 - 0.703). Meanwhile, the predictors for presence of DFU were insulin (OR: 9.37;95% CI: 2.240 - 39.182), shoes (OR: 0.05;95% CI: 0.007 - 0.294), spiritual belief that DM was a disease (OR: 0.04;95% CI: 0.004 - 0.326) and belief that DM was a temptation from God (OR: 0.13;95% CI: 0.027 - 0.598). In conclusion, we recommend to educate high risk patients to understand positive foot care behavior as essentially preventive strategies to prevent presence risk and DFU.展开更多
目的分析糖尿病足溃疡(DFU)患者伤口愈合后复发的主要危险因素,为临床预防DFU的复发提供依据。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方数据库、维普中文科技期刊全文数据库、中国生物医学文...目的分析糖尿病足溃疡(DFU)患者伤口愈合后复发的主要危险因素,为临床预防DFU的复发提供依据。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方数据库、维普中文科技期刊全文数据库、中国生物医学文献数据库,搜集建库至2021年7月10日关于DFU患者复发危险因素的文献,采用RevMan 5.3软件进行Meta分析。结果最终纳入12篇文献,共计患者2585例,其中累计复发组982例,未复发组1603例。Meta分析结果显示,Wagner分级(Ⅲ、Ⅳ级)(OR=4.40,95%CI:2.21~8.78,P<0.01)、伴有周围神经病变(OR=5.69,95%CI:4.53~7.14,P<0.01)、伴有周围血管病变(OR=3.54,95%CI:3.05~4.11,P<0.01)、多重耐药菌感染(OR=3.61,95%CI:3.13~4.17,P<0.01)、截肢史(OR=19.18,95%CI:10.69~34.42,P<0.01)、既往DFU的持续时间≥60 d(OR=1.02,95%CI:1.00~1.03,P<0.01)、血糖控制差(OR=3.39,95%CI:2.67~4.31,P<0.01)、潜在骨髓炎(OR=2.86,95%CI:2.29~3.58,P<0.01)、初发溃疡在足底(OR=2.80,95%CI:2.10~3.73,P<0.01)、吸烟(OR=2.30,95%CI:1.18~4.48,P=0.01)是DFU复发的危险因素。结论基于现有证据,Wagner分级(Ⅲ、Ⅳ级)、伴有周围神经病变、伴有周围血管病变、多重耐药菌感染、截肢史、既往DFU的持续时间≥60 d、血糖控制差、潜在骨髓炎、初发溃疡在足底、吸烟是DFU复发的危险因素。医务人员应重视这些影响因素,采取相应措施进行针对性预防,从而提高糖尿病足护理服务质量。展开更多
Despite the widespread use of traditional Chinese medicine （TCM） in clinical settings, proving its effectiveness via scientific trials is still a challenge. TCM views the human body as a complex dynamical system, an...Despite the widespread use of traditional Chinese medicine （TCM） in clinical settings, proving its effectiveness via scientific trials is still a challenge. TCM views the human body as a complex dynamical system, and focuses on the balance of the human body, both internally and with its external environment. Such fundamental concepts require investigations using system-level quantification approaches, which are beyond conventional reductionism. Only methods that quantify dynamical complexity can bring new insights into the evaluation of TCM. In a previous article, we briefly introduced the potential value of Multiscale Entropy （MSE） analysis in TCM. This article aims to explain the existing challenges in TCM quantification, to introduce the consistency of dynamical complexity theories and TCM theories, and to inspire future system-level research on health and disease.展开更多
文摘Indonesia is one of the top ten diabetes mellittus (DM) countries. However as the main complication of DM, there was lack of studies related to diabetic foot ulcer (DFU). Thus, the aim of this study was to survey the prevalence of DFU risk factors and DFU among type 2 diabetes mellitus (T2DM) patients. An epidemiological study was conducted at an outpatient endocrine clinic in a regional hospital, eastern Indonesia. All T2DM participants attending research setting that were ≥ 18 years were included. Demographic and foot care behavior were assessed using minimum data sheet (MDS). Meanwhile, presence of risk factors was evaluated by using 5.07/10 g Semmes-Weinsten Monofilament (SWM) for neuropathy and presence of angiopathy was evaluated with Ankle Brachial Index (ABI) by using a hand held Doppler (Bidop ES-100V3, Hadeco-Kawasaki, Japan) both dorsal and posterior tibialis foot. At the end of study, 249 T2DM participants were enrolled. The prevalence of DFU risk factors was 55.4% (95% CI: 53.7% - 57.0%), and prevalence of DFU was 12% (95% CI: 10.3% - 13.6%). Based on a logistic regression, predictors for DFU risk factors included age (OR: 1.04;95% CI: 1.005 - 1.074) and daily foot inspection (OR: 0.36;95% CI: 0.186 - 0.703). Meanwhile, the predictors for presence of DFU were insulin (OR: 9.37;95% CI: 2.240 - 39.182), shoes (OR: 0.05;95% CI: 0.007 - 0.294), spiritual belief that DM was a disease (OR: 0.04;95% CI: 0.004 - 0.326) and belief that DM was a temptation from God (OR: 0.13;95% CI: 0.027 - 0.598). In conclusion, we recommend to educate high risk patients to understand positive foot care behavior as essentially preventive strategies to prevent presence risk and DFU.
文摘Despite the widespread use of traditional Chinese medicine （TCM） in clinical settings, proving its effectiveness via scientific trials is still a challenge. TCM views the human body as a complex dynamical system, and focuses on the balance of the human body, both internally and with its external environment. Such fundamental concepts require investigations using system-level quantification approaches, which are beyond conventional reductionism. Only methods that quantify dynamical complexity can bring new insights into the evaluation of TCM. In a previous article, we briefly introduced the potential value of Multiscale Entropy （MSE） analysis in TCM. This article aims to explain the existing challenges in TCM quantification, to introduce the consistency of dynamical complexity theories and TCM theories, and to inspire future system-level research on health and disease.
