Publications by authors named "Lavery L"

Our objective was to compare clinical outcomes in diabetic foot ulcers (DFU) treated with AmnioExcel applied weekly (AMX1) or biweekly (AMX2) over a 12-week evaluation period. This randomized clinical trial evaluated 40 people with UT 1A and 1D DFUs >30 days but less than 6 months duration and age >21 years. We excluded patients with untreated osteomyelitis, gangrene, widespread malignancy, or active substance abuse.

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Background: Diabetic nephropathy remains a strong risk factor for chronic kidney disease progression. Hemoglobin A1C (HBA1C) has historically been used as a marker for complications related to diabetes.

Objectives: The purpose of this study is to examine the relationship between HBA1C and clinical complications in a patient population with end stage renal disease.

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Our objective was to assess the incidence, risk factors and clinical outcomes of dehiscence after foot surgery in diabetic patients. We used pooled patient-level data from two randomised clinical trials with 240 diabetic patients who required foot surgery for infections. Most patients (n = 180, 75.

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This meta-analysis aimed to systematically assess and synthesise healing rates within a 12- to 24-week treatment period among patients with diabetic foot ulcers receiving standard-of-care interventions in randomised controlled trials. This meta-analysis included 32 randomised controlled trials conducted between 1996 and 2023, with sample sizes ranging from 9 to 169 patients. A random-effects model was applied to estimate pooled healing and infection rates.

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To compare the incidence of infection, wound closure and time to wound closure in patients treated with cryopreserved (CPUT) and lyopreserved umbilical tissue (LPUT) in complex diabetic surgical wounds. This single-blinded 12-week randomized clinical trial compared cryopreserved and lyopreserved amniotic cord tissue to treat complex diabetic foot wounds. LPUT or CRAT was applied at baseline and again after four weeks.

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To investigate risk factors for re-infection and compare the outcomes in people with diabetic foot infections. A retrospective chart review was conducted, and 294 hospitalised patients with moderate to severe diabetic foot infections (DFIs) were analysed for this study. The diagnosis and classification of the severity of infection was based on the International Working Group on the Diabetic Foot (IWGDF) infection guidelines.

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The aim of this study was to compare the microbial loads of patients with diabetic foot infections treated with negative pressure wound therapy (NPWT) with and without irrigation with polyhexamethylene biguanide (NPWTi-P). This is a post hoc analysis of combined data of two randomized clinical trials. We evaluated people with diabetes treated with moderate and severe diabetic foot infections that required surgery.

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Purpose: The purpose of this study was to review the current literature of intravascular ultrasound (IVUS) use in real world cohorts inclusive of chronic limb threatening ischemia (CLTI) patients and compare the outcomes to patients imaged by angiography alone.

Methods: The systematic review was registered in Research Registry. A literature search was performed across 4 databases: PubMed, Medline/Embase, Cochrane Review, and Web of Science for eligible comparative studies.

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Lower extremity amputation (LEA) is one of the most feared consequences of diabetes mellitus (DM). The purpose of this study was to evaluate the impact of DM on LEA rates in patients at various stages of chronic kidney disease (CKD). A commercially available de-identified database was searched for patients undergoing LEA and for CKD patients, from 2010 to 2023.

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Article Synopsis
  • * Out of 530 patients analyzed, those with ROM showed a significantly higher risk of infection (2.0 times) and amputation (4.3 times) compared to those without ROM.
  • * Patients with ROM also required longer courses of antibiotics, with an average increase of 16.3 days compared to those without ROM.
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  • The study aimed to compare clinical outcomes between patients who underwent complete versus partial surgical resection for diabetic foot osteomyelitis (OM) using data from two clinical trials with 171 patients.
  • Patients with no residual osteomyelitis (NRO) experienced shorter durations of antibiotic therapy during hospitalization and follow-up compared to those with residual osteomyelitis (RO), but the NRO group had more amputations during the initial hospitalization.
  • Over a 12-month period, there were no significant differences in re-infection rates, ulcerations, or time to wound healing between NRO and RO patients, with successful treatment rates being similar for both groups.
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  • - Reports of antimicrobial resistance have led some clinicians to use alternative wound dressings called DACC-coated dressings, claiming antimicrobial activity despite being non-medicated.
  • - A systematic review was conducted to evaluate the effectiveness of these dressings on chronic wound healing and infection control, using the GRADE framework and PICO format to structure the research.
  • - The review analyzed 748 records, ultimately including 10 relevant studies, but found the overall quality of evidence to be very low, highlighting the need for more rigorous randomized controlled trials for better clarity on DACC-coated dressings.
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To identify the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection, reinfection and clinical outcomes. Four hundred forty-six patients that were admitted to the hospital with moderate or severe foot infections were retrospectively reviewed. Tissue and bone cultures were obtained from the index hospital admission.

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Article Synopsis
  • - Diabetes affects 537 million people globally, and 34% are at risk of developing foot ulcers, prompting the need for standard outcomes in treatment studies.
  • - A Core Outcome Set (COS) was created through a structured process involving systematic reviews, patient interviews, and a two-round Delphi survey with input from patients and experts.
  • - The COS includes 8 critical outcomes, such as wound healing and quality of life, which will help improve the consistency of research assessing diabetes-related foot ulcer treatments.
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Although there are no podiatrists in 85% of countries worldwide, how diabetic foot is managed in those countries is still unknown. We sought to identify the health professionals involved in diabetic foot and their tasks in Japan, where no podiatrists exist. This cross-sectional study used the Japanese Nationwide Survey on Foot Ulcer Management dataset, consisting of 249 medical doctors and 680 allied health professionals.

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Article Synopsis
  • Diabetes-related foot infections are prevalent and challenging to treat, with outcomes from a large cohort analyzed from a hospital database from 2018 to 2023.
  • The study included 647 episodes of foot infections in 397 patients, categorizing infections into skin and soft tissue infections (SST-DFI) and osteomyelitis (OM).
  • Infection resolution was achieved in 69% of cases, but OM had a significantly higher failure rate compared to SST-DFI, particularly in patients with peripheral arterial disease (PAD).
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Purpose: The purpose of this review and meta-analysis is to determine the clinical outcome differences between patients with chronic limb-threatening ischemia who underwent direct versus indirect angiosome revascularization using either the surgical or endovascular approach.

Materials And Methods: The data sources used for article selection included PubMed, Embase/Medline, Cochrane reviews, and Web of Science (All studies were in English and included up to September 2023). All articles included were comparative in design, including retrospective, prospective, and randomized controlled trials that compared the clinical outcomes between direct and indirect angiosome-guided revascularization in chronic limb-threatening ischemia.

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Microbubble () contrast agents combined with ultrasound targeted microbubble cavitation () are a promising platform for site-specific therapeutic oligonucleotide delivery. We investigated UTMC-mediated delivery of siRNA directed against epidermal growth factor receptor (), to squamous cell carcinoma () via a novel MB-liposome complex (). were constructed by conjugation of cationic liposomes to the surface of CF gas-filled lipid MBs using biotin/avidin chemistry, then loaded with siRNA via electrostatic interaction.

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The aim of this study was to evaluate the diagnostic characteristics of biomarker for diabetic foot osteomyelitis (DFO). We searched PubMed, Scopus, Embase and Medline for studies who report serological markers and DFO before December 2022. Studies must include at least one of the following diagnostic parameters for biomarkers: area under the curve, sensitivities, specificities, positive predictive value, negative predictive value.

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  • Treatment of calcaneal fractures in patients with diabetes is complex and this study aimed to evaluate post-operative outcomes from open reduction and internal fixation (ORIF) across different diabetes categories.
  • Researchers analyzed data from 2010 to 2021, categorizing patients into three groups: those without diabetes, those with uncomplicated diabetes, and those with complicated diabetes.
  • Results showed that patients with complicated diabetes had significantly higher rates of adverse events like non-union and infection compared to those without diabetes, indicating increased post-operative risks for diabetic patients.
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The objective of this paper was to investigate erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) in diagnosing pedal osteomyelitis (OM) in patients with and without diabetes, and with and without severe renal impairment (SRI). This was a retrospective cohort study of patients with moderate and severe foot infections. We evaluated three groups: Subjects without diabetes (NDM), subjects with diabetes and without severe renal insufficiency (DM-NSRI), and patients with diabetes and SRI (DM-SRI).

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Background: The infodemic accompanying the COVID-19 pandemic has led to an overwhelming amount of information, including questions, concerns and misinformation. Pandemic fatigue has been identified as a concern from early in the pandemic. With new and ongoing health emergencies in 2022, it is important to understand how pandemic fatigue is being discussed and expressed by users on digital channels.

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The aim of this study was to compare outcomes of moderate and severe foot infections in people with and without diabetes mellitus (DM). We retrospectively evaluated 382 patients (77% with DM and 23% non-DM). We collected demographic data, co-morbidities and one-year outcomes including healing, surgical interventions, number of surgeries, length of stay, re-infection and re-hospitalisation.

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The likelihood of developing a diabetic foot ulcer (DFU) during one's lifetime for individuals with diabetes mellitus is around 19% to 34%. Continuous and repetitive loading on soft tissues are the major causative factors for DFU. This paper introduces an air cell array insole designed for cyclically offloading pressure from plantar regions to reduce repetitive stress and loading on foot.

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The aim was to investigate methicillin-resistant Staphylococcus aureus (MRSA) incidence, conversion and outcomes in diabetic foot infections (DFIs). This is a pooled patient-level analysis of combined data sets from two randomised clinical trials including 219 patients admitted to the hospital with moderate or severe DFIs. Intraoperative bone and tissue cultures identified bacterial pathogens.

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