Saving the diabetic foot with special reference to the patient with chronic renal failure.

The chronic renal failure patient with diabetes has a lower limb amputation rate 10 times greater than the diabetic population at large. In studies of causal pathways leading to non-traumatic related lower extremity amputation, foot ulcers preceded approximately 84% of the amputations. Even though foot ulcers are more likely to develop in patients with diabetic nephropathy, they are no less likely to heal than are those in diabetic patients with normal renal function.

A comparison of diabetic foot ulcer patients managed in VHA and non-VHA settings.

Objective: To compare patients with diabetes and new onset foot ulcers treated in Veterans Health Administration (VHA) and non-VHA settings.

Methods: The treatment of patients with new onset diabetic foot ulcers was prospectively monitored in three VHA and three non-VHA hospitals and outpatient settings until ulcer healing, amputation, or death.

Results: Of the 302 individuals enrolled in this study, 47% were veterans receiving VHA care.

Risk factors for colonization with yeast species in a Veterans Affairs long-term care facility.

Objectives: To assess colonization and serious infection with yeasts and the risk factors that are associated with colonization by these organisms.

Design: Monthly surveillance for colonization and infection over a period of 2 years.

Setting: A long-term-care facility (LTCF) attached to an acute-care Veterans Affairs Medical Center.

Validity of contour-clamped homogeneous electric field electrophoresis as a typing system for Candida albicans.

Instigated by an increase in serious human Candida infections and aided by advances in technology, there has been renewed interest in the study of the epidemiology of fungal infections. Among the newer techniques available, contour-clamped homogeneous electric field (CHEF) electrophoresis has shown great promise as a tool for typing strains of Candida albicans. However, few studies have addressed the reproducibility of the preparatory and electrophoretic methods.

Epidemiology of oral candidiasis in HIV-infected patients: colonization, infection, treatment, and emergence of fluconazole resistance.

Purpose: To study the epidemiology of oral candidiasis and the effect of treatment of thrush in human immunodeficiency virus (HIV)-infected patients.

Patients And Methods: We conducted a prospective observational study of 92 patients over 1 year, including a nonblinded, randomized treatment trial of thrush with clotrimazole troches or oral fluconazole. Oral sites were cultured monthly and when thrush occurred.