Evaluation Of A Person With An Acute Diabetic Foot Problem

HISTORY AND PHYSICAL EXAMINATION_______________________ Patient Name: Chapman Robert Kinsey Patient ID: 110589 Room No.: 322-B Date of Admission: 23 February ---Admitting Physician: Martha C. Eaton, MD, Geriatrics Chief Complaint: Admitted from Dr. Max Hirsch’s office due to deep ulcer on left toe. Admitting Diagnoses 1. Severe peripheral vascular disease, status post deep ulcer on left toe. Rule out thrombolysis. The patient was admitted to a regular floor. Condition is serious. 2. ALLERGY TO PENICILLIN, which puts patient into anaphylactic shock. 3. Continue with home medications. DETAILS OF PRESENT ILLNESS: Mr. Kinsey is an 87-year-old white gentleman with history of (1) Chronic atrial fibrillation, on Coumadin. (2) Chronic deafness,

The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies.

John is in his early forties and has had Type 2 Diabetes for 8 years. When he was first diagnosed, he was offered a diet sheet and advice from his doctor to introduce physical exercise into his life. John is a manual worker and feels he doesn’t need to exercise as he keeps active most of the day. He gave up smoking and drinking alcohol, but after 3 months his blood glucose level was still above normal and was prescribed medication. Eight years later, he now uses insulin to control his blood glucose levels and is a non-smoker. He was admitted to hospital following a road traffic accident which resulted in an operation on his foot which had sustained multiple injuries. The wound was very slow healing and intravenous antibiotics were prescribed.

In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of

Today, I followed Dr. Koch in podiatry. For the first patient we saw, the patient already had cotton balls on their feet, which I thought Dr. Koch’s assistants had probably already looked at the patient. Anyway, the patient had an appointment with Dr. Koch about 2 months ago and was told to wear diabetic shoes when walking. As she and Dr. Koch talked, Dr. Koch removed one of the cotton balls and there was a big sore on the patient's foot. Dr. Koch then asked the patient if they had diabetic shoes, and if so, how often did they wear them. The patient answered by saying she does but only wore the shoes for about fifty percent of the time. Dr. Koch told the patient she need to have the shoes on the entire time, otherwise she’ll keep getting sores

Both clinicians who are enquiring clinical questions and researchers who are conducting in-depth searches for systematic reviews come across a few

Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)

In the 2015 study conducted by Popov, a 61 year old male was diagnosed after arterial surgery. The patient came in complaining of pain. This is common along with inflammation and a red, hot feeling in the area. The person may also experience a fever. In other cases, some people have been infected after surgery. It is more likely to occur in an individual that has a compromised immune system. In one instance of the infection, the person contracted on the forearm around the area of what was constant drug use. The source would have been a dirty needle. Another individual contracted the bacterium on the upper leg. This was suspected to be the site of an insulin injection for a woman with diabetes.

Foot injuries are very common in athletics as well as in everyday life. It’s very debilitating to have a foot injury since we use our feet in all of our daily activities. Research published in "Medicine and Science in Sports and Exercise” indicates that the average adult takes between 5,000 to 7,000 steps a day. Some sports require the most dedicated athletes spend multiple hours a day pounding their feet on the turf or pavement. Most injuries that occur in the foot require a person to try and stay off of it or completely immobilize it. Since this is very difficult for a person to do, a large percentage of foot injuries often have a very high chance of reoccurring. The severity of some injuries that can be deceiving as well. Often times a nagging pain is ignored and eventually becomes a much bigger problem.

This patient has athlete’s foot that has transmitted to his hand. This is a fungal infection caused by tineas, a cutaneous mycoses (22).

Osteomyelitis is a broad and debilitating disease typically triggered by a variety of conditions. Osteomyelitis starts off as inflammation seen within bone and bone marrow that can quickly progress into a large, subclassified infection. The length of time the infection has been present in the body and whether or not there is a pus formation or increased density among the infected bone is commonly used to classify severity. Pyrogenic bacteria or mycobacteria systematically attack the route and anatomic location of the infection evolving acute conditions into chronic ones. “Staphylococcus Aureus is a gram-positive, round shaped, non-mobile cocci typically found in clusters inside these wounds. Staphylococcus Aureus is one of the most common causes of infections after injury or surgery and affects nearly 500,000 patients in hospitals each year. Staphylococcus Aureus belongs to the family Staphylcoccaceae and survives by affecting all known mammalian species including humans” (www.news-medical.net). Osteomyelitis can start in one area of the body while spreading through the blood stream into other bone regions. Typical treatment options for Osteomyelitis includes antibiotics, removal of

With chronic osteomyelitis, the first aid is let your doctor knows about your medical history so that your condition can be under control. On condition that you have diabetes, have a close concentration on your feet and the first sign of infection is an important thing you should contact your doctor immediately.

A 53-year-old man had just had prosthetic joints cemented into place without added antibiotics to fight infection. For 3 months after the surgery he was doing fine until he found he had a dental infection and didn’t seem to think anything of it, so he did not go to the dentist to fix it. Soon aftter he suffered from chills without fever, swelling, pain, an unusual warming sensation, and irritation over the left knee and had a hard time

This is a 66-year-old female who has indicated that she has been falling because she is “is tripping over her own feet”. Initially there was some question as to whether the patient may be displaying some Parkinson type symptoms. Patient is a type 2 diabetic with mild peripheral neuropathy of the lower extremities. In concern was that the patient’s falls may be related to low blood sugar or a result of the neuropathy. The patient reports that her blood sugars have been stable and, when checked after fall, they are not low. In fact, at times, they have been as high as 225. Patient reports that when she falls she is not able to get back up and must wait for help to arrive. Patient denies dizzy spells. Patient’s son is present for the consultation

In this case the level of prevention used, when implementing the diabetic foot care teaching, is tertiary prevention. “This intervention begins once the disease if obvious: the aim is to interrupt the course of the disease,