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  1. Article ; Online: Disparities in preventative diabetic foot examination.

    Fermawi, Sarah Ali / Tolson, Jeffrey P / Knapp, Shannon M / Marrero, David / Zhou, Wei / Armstrong, David G / Tan, Tze-Woei

    Seminars in vascular surgery

    2023  Volume 36, Issue 1, Page(s) 84–89

    Abstract: The objective of this study was to assess the overall differences in the standard of preventive foot care for patients at risk of diabetic foot ulceration and to identify specific demographic factors affecting these health care practices, including race ... ...

    Abstract The objective of this study was to assess the overall differences in the standard of preventive foot care for patients at risk of diabetic foot ulceration and to identify specific demographic factors affecting these health care practices, including race and ethnicity. The National Health and Nutrition Examination Survey data for 2011 to 2018 were analyzed. Participants (20 years and older) with diabetes were categorized as White, Black, Hispanic, Asian, and others (including multiracial participants) based on self-reported race and ethnicity. The primary outcome was foot examination over the past year administered by a medical professional. Logistic regression was performed to examine the effects of race and ethnicity on the annual diabetic foot examination, controlling for age (65 years and older), gender, and health insurance status. Among the 2,836 participants included in the study (weighted percentage: 61.1% were White, 13.9% were Black, 15.1% were Hispanic, 5.4% were Asian, and 4.5% were other), 2,018 (weighted percentage: 71.6%) received annual diabetic foot examination over the past year. Hispanic participants (adjusted odds ratio [aOR] = 0.685; 95% CI, 0.52-0.90) were significantly less likely than White participants to receive an annual foot examination (Black participants: aOR = 1.11; 95% CI, 0.83-1.49; Asian participants: aOR = 0.80; 95% CI, 0.60-1.07; other participants: aOR = 0.66; 95% CI, 0.40-1.10). Factors associated with receipt of foot examination were age 65 years or older (aOR = 1.42; 95% CI, 1.05-1.92) and having health insurance (aOR = 3.02; 95% CI, 2.27-4.03). Our findings suggest that Hispanic adults with diabetes are receiving disproportionately lower rates of preventive foot care compared with their White counterparts. This significant variation in the standard of care for individuals with diabetes reflects the need to further identify factors driving the disparities in preventive foot care services among racial and ethnic minority groups.
    MeSH term(s) Adult ; Humans ; Diabetes Mellitus ; Diabetic Foot/diagnosis ; Diabetic Foot/prevention & control ; Ethnicity ; Healthcare Disparities ; Minority Groups ; Nutrition Surveys ; United States/epidemiology
    Language English
    Publishing date 2023-01-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645131-7
    ISSN 1558-4518 ; 0895-7967
    ISSN (online) 1558-4518
    ISSN 0895-7967
    DOI 10.1053/j.semvascsurg.2023.01.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Outcomes of upper arm axillary artery and brachial artery arteriovenous grafts.

    Fermawi, Sarah Ali / Fadia, Rueshil / Chong, Chyi Chyi / Berman, Scott / Rybin, Denis / Siracuse, Jeffrey J / Zhou, Wei / Tan, Tze-Woei

    The journal of vascular access

    2022  Volume 24, Issue 6, Page(s) 1500–1506

    Abstract: Background: We compared the outcomes of upper arm arteriovenous grafts (AVGs) in a large, prospectively collected data set to determine if there are clinically significant differences in axillary artery-based and brachial artery-based AVGs.: Methods: ...

    Abstract Background: We compared the outcomes of upper arm arteriovenous grafts (AVGs) in a large, prospectively collected data set to determine if there are clinically significant differences in axillary artery-based and brachial artery-based AVGs.
    Methods: Patients who received upper arm AVGs within the Society of Vascular Surgery Vascular Quality Initiative (VQI) dataset were identified. The primary outcome measures were primary and secondary patency loss at 12-month follow-up. Other outcomes included were wound infection, steal syndrome, and arm swelling at 6-month follow-up. The log-rank test was used to evaluate patency loss using Kaplan-Meier analysis, and Cox proportional hazards models were used to examine adjusted association between inflow artery (brachial artery vs axillary artery) and outcomes, adjusting for configuration (straight vs looped).
    Results: Among 3637 upper extremity AVGs in the VQI (2010-2017), there were 510 upper arm brachial artery AVGs and 394 upper arm axillary artery AVGs. Patients with axillary artery AVGs were more likely to be female (72% vs 56%,
    Conclusions: From this observational study analyzing the outcomes of upper extremity hemodialysis access, axillary artery AVGs were associated with significantly lower patency rates and higher risk of steal syndrome than brachial artery AVGs.
    MeSH term(s) Humans ; Female ; Male ; Brachial Artery/diagnostic imaging ; Brachial Artery/surgery ; Arm ; Arteriovenous Shunt, Surgical/adverse effects ; Axillary Artery/diagnostic imaging ; Axillary Artery/surgery ; Graft Occlusion, Vascular/etiology ; Graft Occlusion, Vascular/surgery ; Vascular Patency ; Blood Vessel Prosthesis Implantation/adverse effects ; Risk Factors ; Treatment Outcome ; Upper Extremity/blood supply ; Vascular Diseases/surgery ; Wound Infection/surgery ; Renal Dialysis ; Retrospective Studies
    Language English
    Publishing date 2022-04-23
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 2252820-9
    ISSN 1724-6032 ; 1129-7298
    ISSN (online) 1724-6032
    ISSN 1129-7298
    DOI 10.1177/11297298221091760
    Database MEDical Literature Analysis and Retrieval System OnLINE

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