Natural DNA Transformation Is Functional in Lactococcus lactis subsp. cremoris KW2.

is one of the most commonly used lactic acid bacteria in the dairy industry. Activation of competence for natural DNA transformation in this species would greatly improve the selection of novel strains with desired genetic traits. Here, we investigated the activation of natural transformation in subsp.

The use of telemedicine in the management of diabetes-related foot ulceration: a pilot study.

Objective: To determine if the management of forefoot ulcerations through telemedicine is medically equivalent to ulcer care at a diabetes foot program.

Design: Nonrandomized comparison of forefoot ulcer healing rates.

Setting: The Louisiana State University Health Sciences Center Diabetes Foot Program, Baton Rouge, LA, and Lallie Kemp Medical Center, Independence, LA.

A staged management diabetes foot program versus standard care: a 1-year cost and utilization comparison in a state public hospital system.

Objective: To determine whether staged management of foot ulcers reduces health care costs and utilization.

Design: Nonrandomized retrospective study using data from 1998-1999 in the Louisiana public hospital system.

Setting: Louisiana public hospital system.

The impact of a staged management approach to diabetes foot care in the Louisiana public hospital system.

By the beginning of 1999, a Disease Management Initiative (DMI), consisting of targeted goals for the medical management of diabetes, had been established at all Louisiana State public hospitals. Concurrently, a regional Diabetes Foot Program (DFP) utilizing a staged management approach to foot problems was established in Baton Rouge. This study compares annual rates of hospitalization for diabetes-related foot problems and diabetes-related lower extremity amputations in diabetes patients treated for foot ulceration at the Louisiana public hospitals before and after implementation of DMI and the DFP.

Comparison of forefoot ulcer healing using alternative off-loading methods in patients with diabetes mellitus.

Objective: To compare the healing rate of forefoot ulcers in patients with diabetes treated using a total contact cast with those treated using alternative off-loading methods. DESIGN Retrospective analysis of healing rates of forefoot ulcers.

Setting: Louisiana State University Health Sciences Center Diabetes Foot Program, Baton Rouge, LA.

A decision pathway for the staged management of foot problems in diabetes mellitus.

This review describes a decision pathway for the conservative management of foot problems in persons with diabetes mellitus. The decision pathway was developed by the Louisiana State University Health Sciences Center Diabetes Foot Program as part of the Statewide Diabetes Disease Management Initiative to standardize foot care in a medically underserved population. The pathway describes the prevention and/or management of foot problems through 5 clinical subpathways: injury prevention, warm swollen foot, ulcer, osteomyelitis, and remodeling.

Effectiveness of a comprehensive diabetes lower-extremity amputation prevention program in a predominantly low-income African-American population.

Objective: To compare patient outcomes 1 year before and 1 year after enrollment in a comprehensive diabetes lower-extremity amputation prevention program.

Research Design And Methods: Outcome data were obtained on 197 patients enrolled in the Louisiana State University Health Sciences Center Diabetes Foot Program, which provides foot care to a predominantly low-income African-American population in Louisiana. Data were obtained using a structured interview administered by a registered nurse.

Factors associated with ulceration and amputation in the neuropathic foot.

The purpose of this paper is to review selected literature on the relationship of neuropathy and other related factors in foot ulceration and lower extremity amputation. There is strong evidence that sensory loss and mechanical stress are the primary cause of foot ulceration and common factors in the pathway to lower extremity amputation. Foot stress results from extrinsic factors such as footwear and intrinsic factors such as deformity and limited joint mobility.

Public health applications of Hansen's disease research and treatment.

Because of the similarities in causative agents of Hansen's disease and tuberculosis, Hansen's disease research is now being used in the identification, treatment, and prevention of tuberculosis. Numerous studies are under way to screen and develop new drugs to combat the threat of multiple drug-resistant tuberculosis. Additional studies focus on factors to reduce the transmission of tuberculosis and on the development of techniques for early diagnosis and identification of drug resistance.

Healing rates of plantar ulcers in leprosy and diabetes.

Comparison was made of wound healing time in a consecutive series of leprosy and diabetic patients with plantar ulceration. In the leprosy group, 66 of 70 (94%) ulcers healed in a mean time of 42.7 (+/- 36.

Management of the insensitive foot in diabetes: lessons learned from Hansen's disease.

Diabetes mellitus is the number one cause of lower extremity amputation (LEA) in the United States, accounting for about 60,000 cases per year. While the combination of reduced blood supply and the loss of sensation to the foot in a diabetic are responsible for the high incidence of LEAs, in most cases it is the loss of sensation that is primarily responsible for the initial foot wound and its failure to heal. The authors review the four mechanical causes for foot ulceration and eventual amputation.