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  1. Article ; Online: Offloading systems for the treatment of neuropathic foot ulcers in patients with diabetes mellitus: a meta-analysis of randomized controlled trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

    Gauna, Carlotta / Romeo, Francesco / Scatena, Alessia / Miranda, Cesare / Uccioli, Luigi / Vermigli, Cristiana / Volpe, Antonio / Bordieri, Corrado / Tramonta, Rodolfo / Ragghianti, Benedetta / Bandini, Giulia / Monami, Matteo / Monge, Luca

    Acta diabetologica

    2024  

    Abstract: Aim: To compare the effectiveness of commonly used offloading devices for the treatment of neuropathic foot ulcers in patients with diabetes mellitus. This meta-analysis (MA) has been performed for giving an answer to clinical questions on this topic of ...

    Abstract Aim: To compare the effectiveness of commonly used offloading devices for the treatment of neuropathic foot ulcers in patients with diabetes mellitus. This meta-analysis (MA) has been performed for giving an answer to clinical questions on this topic of the Italian guideline on diabetic foot syndrome.
    Methods: The present MA includes randomized controlled studies (duration > 12 weeks) comparing, in patients with diabetes mellitus and non-infected neuropathic foot ulcer: any offloading device vs either no offloading device or conventional footwear; removable versus non-removable offloading devices; surgical procedure vs other offloading approaches. The primary endpoint was ulcer healing.
    Results: A total of 184 studies were identified, and 18 were considered eligible for the analysis. We found that: any plantar off-loading, when compared to the absence of plantar offloading device, is associated with a higher ulcer healing (MH-OR: 3.13 [1.08, 9.11], p = 0.04, I
    Conclusions: Any plantar offloading, compared to the absence of plantar offloading device, is associated with a higher ulcer healing rate. Total contact cast or nonremovable knee-high walker, compared to other offloading devices, is preferable. Surgical offloading for active ulcers, in combination with post-surgery offloading devices, achieves a higher ulcer healing rate when compared to other offloading devices alone. Further studies with a larger cohort of patients with diabetic neuropathic foot ulcers and extended follow-up periods are necessary.
    Language English
    Publishing date 2024-03-15
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 1097676-0
    ISSN 1432-5233 ; 0940-5429
    ISSN (online) 1432-5233
    ISSN 0940-5429
    DOI 10.1007/s00592-024-02262-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 611: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Correction to: Development of the Italian clinical practice guidelines for the treatment of diabetic foot syndrome: design and methodological aspects.

    Monami, Matteo / Scatena, Alessia / Miranda, Cesare / Monge, Luca / De Cassai, Alessandro / Volpe, Antonio / Tramonta, Rodolfo / Medea, Gerardo / Bordieri, Corrado / Falcone, Marco / Stefanon, Laura / Bernetti, Andrea / Cappella, Cristina / Gargiulo, Mauro / Lorenzoni, Valentina / Scevola, Germano / Stabile, Eugenio / Ragghianti, Benedetta / Silverii, Giovanni Antonio /
    da Ros, Roberto / Meloni, Marco / Giurato, Laura / Murdolo, Giuseppe / Bianchini, Eleonora / Gaggia, Francesco / Gauna, Carlotta / Romeo, Francesco / Apicella, Matteo / Mantuano, Michele / Uccioli, Luigi / Vermigli, Cristiana

    Acta diabetologica

    2024  

    Language English
    Publishing date 2024-04-02
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 1097676-0
    ISSN 1432-5233 ; 0940-5429
    ISSN (online) 1432-5233
    ISSN 0940-5429
    DOI 10.1007/s00592-024-02263-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 611: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  3. Article ; Online: Effect of a multidisciplinary team approach in patients with diabetic foot ulcers on major adverse limb events (MALEs): systematic review and meta-analysis for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

    Meloni, Marco / Giurato, Laura / Monge, Luca / Miranda, Cesare / Scatena, Alessia / Ragghianti, Benedetta / Silverii, Giovanni Antonio / Vermigli, Cristiana / De Cassai, Alessandro / Volpe, Antonio / Tramonta, Rodolfo / Medea, Gerardo / Bordieri, Corrado / Falcone, Marco / Stefanon, Laura / Bernetti, Andrea / Cappella, Cristina / Gargiulo, Mauro / Lorenzoni, Valentina /
    Scevola, Germano / Stabile, Eugenio / Da Ros, Roberto / Murdolo, Giuseppe / Bianchini, Eleonora / Gaggia, Francesco / Gauna, Carlotta / Romeo, Francesco / Apicella, Matteo / Mantuano, Michele / Monami, Matteo / Uccioli, Luigi

    Acta diabetologica

    2024  Volume 61, Issue 5, Page(s) 543–553

    Abstract: The treatment of patients with diabetic foot ulcers (DFUs) is extremely complex, requiring a comprehensive approach that involves a variety of different healthcare professionals. Several studies have shown that a multidisciplinary team (MDT) approach is ... ...

    Abstract The treatment of patients with diabetic foot ulcers (DFUs) is extremely complex, requiring a comprehensive approach that involves a variety of different healthcare professionals. Several studies have shown that a multidisciplinary team (MDT) approach is useful to achieve good clinical outcomes, reducing major and minor amputation and increasing the chance of healing. Despite this, the multidisciplinary approach is not always a recognized treatment strategy. The aim of this meta-analysis was to assess the effects of an MDT approach on major adverse limb events, healing, time-to-heal, all-cause mortality, and other clinical outcomes in patients with active DFUs. The present meta-analysis was performed for the purpose of developing Italian guidelines for the treatment of diabetic foot with the support of the Italian Society of Diabetology (Società Italiana di Diabetologia, SID) and the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD). The study was performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. All randomized clinical trials and observational studies, with a duration of at least 26 weeks, which compared the MDT approach with any other organizational strategy in the management of patients with DFUs were considered. Animal studies were excluded. A search of Medline and Embase databases was performed up until the May 1st, 2023. Patients managed by an MDT were reported to have better outcomes in terms of healing, minor and major amputation, and survival in comparison with those managed using other approaches. No data were found on quality of life, returning-to-walking, and emergency admission. Authors concluded that the MDT may be effective in improving outcomes in patients with DFUs.
    MeSH term(s) Diabetic Foot/therapy ; Humans ; Patient Care Team ; Italy ; Amputation, Surgical/statistics & numerical data ; Practice Guidelines as Topic ; Wound Healing ; Treatment Outcome
    Language English
    Publishing date 2024-03-10
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis ; Systematic Review ; Review
    ZDB-ID 1097676-0
    ISSN 1432-5233 ; 0940-5429
    ISSN (online) 1432-5233
    ISSN 0940-5429
    DOI 10.1007/s00592-024-02246-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 611: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Development of the Italian clinical practice guidelines for the treatment of diabetic foot syndrome: design and methodological aspects.

    Monami, Matteo / Scatena, Alessia / Miranda, Cesare / Monge, Luca / De Cassai, Alessandro / Volpe, Antonio / Tramonta, Rodolfo / Medea, Gerardo / Bordieri, Corrado / Falcone, Marco / Stefanon, Laura / Bernetti, Andrea / Cappella, Cristina / Gargiulo, Mauro / Lorenzoni, Valentina / Scevola, Germano / Stabile, Eugenio / Ragghianti, Benedetta / Silverii, Giovanni Antonio /
    da Ros, Roberto / Meloni, Marco / Giurato, Laura / Murdolo, Giuseppe / Bianchini, Eleonora / Gaggia, Francesco / Gauna, Carlotta / Romeo, Francesco / Apicella, Matteo / Mantuano, Michele / Uccioli, Luigi / Vermigli, Cristiana

    Acta diabetologica

    2023  Volume 60, Issue 11, Page(s) 1449–1469

    Abstract: Aims: Diabetic foot syndrome (DFS) and its complications are a growing public health concern. The Italian Society of Diabetology (SID) and the Italian Association of Clinical Diabetologists (AMD), in collaboration with other scientific societies, will ... ...

    Abstract Aims: Diabetic foot syndrome (DFS) and its complications are a growing public health concern. The Italian Society of Diabetology (SID) and the Italian Association of Clinical Diabetologists (AMD), in collaboration with other scientific societies, will develop the first Italian guidelines for the treatment of DFS.
    Methods: The creation of SID/AMD Guidelines is based on an extended work made by 19 panelists and 12 members of the Evidence Review Team. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide aims, reference population, and target health professionals. Clinical questions have been created using PICO (Patient, Intervention, Comparison, Outcome) conceptual framework. The definition of questions has been performed using a two-step web-based Delphi methodology, a structured technique aimed at obtaining by repeated rounds of questionnaires a consensus opinion from a panel of experts in areas wherein evidence is scarce or conflicting, and opinion is important.
    Results: The mean age of panelists (26.3% women) was 53.7 ± 10.6 years. The panel proposed 34 questions. A consensus was immediately reached for all the proposed questions, 32 were approved and 2 were rejected.
    Conclusions: The areas covered by clinical questions included diagnosis of ischemia and infection, treatment of ischemic, neuropathic, and infected ulcers, prevention of foot ulceration, organization and education issues, and surgical management. The PICO presented in this paper are designed to provide indications for healthcare professionals in charge of diabetic foot treatment and prevention, primarily based on clinical needs of people with diabetic foot syndrome and considering the existing organization of health care.
    MeSH term(s) Adult ; Female ; Humans ; Male ; Middle Aged ; Consensus ; Diabetes Mellitus ; Diabetic Foot/etiology ; Diabetic Foot/therapy ; Diabetic Foot/diagnosis ; Italy/epidemiology ; Surveys and Questionnaires ; Practice Guidelines as Topic
    Language English
    Publishing date 2023-07-25
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1097676-0
    ISSN 1432-5233 ; 0940-5429
    ISSN (online) 1432-5233
    ISSN 0940-5429
    DOI 10.1007/s00592-023-02150-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 611: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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