Microbiome of limb-threatening diabetic foot ulcers indicates the association of fastidious Stenotrophomonas and major amputation.

Background: Proper identification of the polymicrobial microorganisms in patients with limb-threatening diabetic foot ulcers (LTDFUs) using conventional culture is insufficient. This prospective study evaluates the potential value of adjuvant molecular testing assisting in identify fastidious micro-organisms in LTDFUs compared to standard treatment alone.

Methods: Ninety patients with LTDFUs received interdisciplinary and standard antibiotic treatment in a referral diabetic foot center.

Diabetic foot disease in subjects with End-stage renal Disease: A nationwide study over 14 years highlighting an emerging threat.

Aims: To disclose prevalence, demographic, foot characteristics as well as management and lower-extremity amputations (LEAs) of subjects with end-stage renal disease (ESRD) on diabetic foot diseases (DFDs).

Methods: Data were derived from the Taiwan National Health Insurance Research Database between 2004 and 2017. DFDs were defined as ulcers, infections, or severe peripheral arterial diseases (PADs) in patients with type 2 diabetes.

Survival of Patients Following First Diagnosis of Diabetic Foot Complications: A Nationwide 15-Year Longitudinal Analysis.

Background And Aims: The long-term survival in people with type 2 diabetes following first diagnosis of diabetic foot complications (FDDFC) is unclear. The object is to evaluate the mortality rate in subjects with type 2 diabetes following FDDFC and the impacts of the major cardiovascular comorbidities.

Methods: Nationwide data were analyzed for subjects with T2D and DFC between 2003 and 2017 according to ICD-9 coding.

A comprehensive investigation of nutritional status and psoas muscle mass in predicting five-year survival in patients with liver transplant.

Background/purpose: Although nutrition and sarcopenia have impacts on the surgery outcome of patients who have received living donor liver transplant (LDLT), the use of the prognostic nutritional index (PNI) or psoas muscle mass index (PMI) as an indicator for five-year survival in those patients is still unclear.

Methods: A total of 138 patients receiving LDLT were followed at a medical center in Taiwan. As well as analysis of clinical factors using Cox regression, time-varying PNI and PMI values as before surgery (0) and at 3-, 6-, and 12- months after LDLT were analyzed by time-dependent Cox analysis.

Impact of wound microbiology on limb preservation in patients with diabetic foot infection.

Aims/introduction: To investigate the association between specific bacterial pathogens and treatment outcome in patients with limb-threatening diabetic foot infection (LT-DFI).

Materials And Methods: Consecutive patients treated for LT-DFI in a major diabetic foot center in Taiwan were analyzed between the years 2014 and 2017. Patients with positive wound culture results at first aid were enrolled.

Nationwide trends in the epidemiology of diabetic foot complications and lower-extremity amputation over an 8-year period.

Objective: To study the prevalence and trends of lower extremity complications of diabetes over an 8-year period in a single nation.

Research Design And Methods: Nationwide data for people with type 2 diabetes (T2D) and diabetic foot complications (DFCs) were analyzed over an 8-year period (2007-2014) from National Health Insurance Research Database using the International Classification of Diseases, Ninth Revision disease coding. The DFCs were defined as ulcers, infections, gangrene, and hospitalization for peripheral arterial disease (PAD).

Diabetic Foot Infection Presenting Systemic Inflammatory Response Syndrome: A Unique Disorder of Systemic Reaction from Infection of the Most Distal Body.

Diabetic foot infection (DFI) is a major complication of diabetic foot that lead to nontraumatic lower-extremity amputation (LEA). Such distal infection of the body having systemic inflammatory response syndrome (SIRS) is rarely reported. Consecutive patients treated for limb-threatening DFI in a major diabetic foot center in Taiwan were analyzed between the years 2014 to 2017.

The efficacy and safety of concentrated herbal extract granules, YH1, as an add-on medication in poorly controlled type 2 diabetes: A randomized, double-blind, placebo-controlled pilot trial.

Background: In Asian countries, many patients with type 2 diabetes fail to achieve controlled glycated hemoglobin (HbA1c) levels while taking several classes of oral hypoglycemic agents (OHAs). Traditional Chinese medicine could be an alternative therapeutic option for poorly controlled type 2 diabetes. YH1 is a concentrated Chinese herbal extract formula that combines Rhizoma Coptidis and Shen-Ling-Bai-Zhu-San.

Amino acids and wound healing in people with limb-threatening diabetic foot ulcers.

Background: Amino acids are associated with wound healing in traumatic wounds and burns, although their effects on healing in patients with diabetic foot ulcers (DFUs) are limited. This study aimed to evaluate and identify specific amino acids associated with healing outcomes of patients with DFUs.

Methods: Sixty-two out of 85 patients who completed the in-hospital treatment for limb-threatening DFUs were enrolled.

A short-term follow-up of glycemic and body weight changes in diabetic patients who replaced dipeptidyl peptidase-4 inhibitors with the sodium-glucose cotransporter 2.

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2is, gliflozins) are associated with lower all-cause mortality than other anti-diabetic agents in patients with type 2 diabetes. In patients who may benefit from SGLT2is, but cannot add them to a dipeptidyl peptidase-4 inhibitor (DPP4i, gliptin) treatment for various reasons, replacement of the DPP4i with a SGLT2i may be considered.

Objectives: Evaluate changes in metabolic parameters in patients with diabetes after replacing a DPP4i with the SGLT2i empagliflozin.

Antimicrobial resistance and outcomes of community-onset bacterial bloodstream infections in patients with type 2 diabetes.

Objectives: Antimicrobial resistance of bacterial pathogens in the diabetic population with infection is seldom investigated. This study evaluated the antimicrobial resistance and outcomes of community-onset bloodstream infections (CO-BSIs) in patients with diabetes.

Methods: From 2007-2014, 1271 monomicrobial CO-BSIs and 178 polymicrobial CO-BSIs were identified in patients with type 2 diabetes from three teaching hospitals in Taiwan.

Effect of limb preservation status and body mass index on the survival of patients with limb-threatening diabetic foot ulcers.

Aims: To evaluate the effect of limb preservation status and body mass index (BMI) on the survival of patients with diabetic foot ulcers (DFUs).

Methods: A total of 1346 patients treated for limb-threatening DFUs at a major diabetic foot center in Taiwan from 2002 to 2009 were tracked until December 2012. The patients were classified into three groups: limb-preserved (n=858), minor lower-extremity amputation (LEA) (n=249), and major LEA (n=239).

Pitavastatin improves glycated hemoglobin in patients with poorly controlled type 2 diabetes.

Aims/introduction: To investigate the effect of pitavastatin on glucose control in patients with type 2 diabetes.

Materials And Methods: Medical records of 340 patients with type 2 diabetes treated with pitavastatin or atorvastatin between 1 August 2013 and 31 May 2014 were reviewed. A total of 96 patients who had not received statins were treated with pitavastatin (N to P group).

Clinical Characteristics and Risk Factor Analysis for Lower-Extremity Amputations in Diabetic Patients With Foot Ulcer Complicated by Necrotizing Fasciitis.

Patients with diabetes are at a higher risk of having diabetic foot ulcers (DFUs) or necrotizing fasciitis (NF). The present study aims to examine the clinical characteristics and associated risk factors for lower-extremity amputation (LEA) in patients with DFU complicated by NF.We retrospectively reviewed patients treated at a major diabetic foot center in Taiwan between 2009 and 2014.

The impact of nutritional status on treatment outcomes of patients with limb-threatening diabetic foot ulcers.

Aim: This study aimed to investigate the nutritional status of patients with limb-threatening diabetic foot ulcers (DFUs) and its impact on treatment outcomes.

Methods: A total of 478 consecutive patients (mean age, 65.4years) treated for limb-threatening DFUs were enrolled.

Risk factors for in-hospital mortality in patients with type 2 diabetes complicated by community-acquired Klebsiella pneumoniae bacteremia.

Background/purpose: Patients with diabetes are at a high risk of infection-related morbidity and mortality. Klebsiella pneumoniae bacilli are prevalent among diabetic patients, especially in Asian populations. The present study aimed to identify risk factors for in-hospital mortality among diabetic patients complicated by community-acquired K.

High-fat diet aggravates islet beta-cell toxicity in mice treated with clozapine.

Background: Clozapine, an atypical antipsychotic drug, induces derangements in glucose homeostasis in certain patients. This study investigated the mechanisms of clozapine-induced beta-cell toxicity.

Methods: Fifty-two healthy C57BL/6 male mice were randomized into 4 groups to study the effects of clozapine (group C, D) and a high-fat diet (group B, D).

Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer.

Background: Papillary and follicular thyroid cancer is a common malignancy in young patients, and the incidence of this cancer has been increasing. The aims of this study are to assess the clinical characteristics of papillary and follicular thyroid cancer in young patients and evaluate the long-term therapeutic outcomes and prognostic factors for cancer mortality and recurrence.

Methods: We performed a retrospective analysis of 116 patients aged ≤20 years who underwent thyroidectomy and a mean follow-up of 11.

Risk factors for lower extremity amputation in diabetic foot disease categorized by Wagner classification.

Aims: To elucidate the risk factors for lower extremity amputation (LEA) in patients of diabetic foot disease with different Wagner gradings.

Methods: This study was conducted in a multidisciplinary diabetic foot care center. Demographic characteristics, laboratory data, disease history, ankle brachial pressure index (ABI) and Wagner classification were considered as independent variables to predict the therapeutic outcome (major LEA, minor LEA, and non-amputation).

Pyogenic liver abscess caused by Pseudomonas aeruginosa: clinical analysis of 20 cases.

Background: There are few reports of Pseudomonas aeruginosa liver abscess (PALA) in the literature, and clinical information regarding its risk factors, route of transmission, and clinical course remains limited.

Methods: The medical records of 1076 patients with pyogenic liver abscess treated at Chang Gung Memorial Hospital were reviewed.

Results: Twenty of the patients whose records were analyzed had PALA.

Effects of a novel short-term continuous subcutaneous insulin infusion program evaluated by continuous glucose monitoring on young adult type 1 diabetic patients in Taiwan.

The aim of this study is to evaluate the effectiveness of blood sugar control by a short-course reinforcement program, consisting of using continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) for young adult type 1 diabetic patients. Twenty-six pump-naïve type 1 diabetic patients were successively enrolled in two years. The mean disease duration was 13 years and the mean HbA1c was 8.

Antithyroid drug-induced agranulocytosis: report of 13 cases.

Background: Antithyroid drug (ATD)-induced agranulocytosis is rare but may cause fatal complications in patients with thyrotoxicosis during treatment with thionamide-derived drugs. From our previous experience, we note that 2 of 11 such patients died in a 10-year retrospective study.

Methods: We reviewed thirteen patients who developed agranulocytosis from 7,466 patients with hyperthyroidism while they were being treated with ATD from July 1989 to November 2003.