EVALUATAION OF THE DIABETIC FOOT – WHY, WHEN AND HOW?
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Notice bibliographique
Résumé
The diabetic foot syndrome consists of a heterogenous group of pathological conditions caused bydiabetes such as: somatic and autonomous neuropathy, diabetic micro and macroangiopathy, structural injuriesof the bones and their lesions, wounds (ulcers) and skin lesions of the foot, as well as various combinations ofall of the aforementioned symptoms. Treatment of the ulcers of the diabetic foot is the leading cause for hospitaladmittance in these patients. Amputations in diabetes ill patients are 25 times more often compared to others,and 85% of them begin with foot ulcers. The peripheral neuropathy and arterial disease are the most commonreasons for diabetic foot occurrence. Early detection in these patients through programmed clinicalexaminations, control of vascular status with doppler and duplex sonography, detection of reduced and lostprotective sensibility with 10 gram Semmes – Weinstein 5,07 monofilament, assessment of the vibratorysensitivity with biothesiometer or vibrating tuning fork, enabling categorization, and risk stratification fordiabetic foot. Patients that step inadequately, had previous amputations or there is suspicion of congenitaldeformities of the feet should undergo tests such as podoscopy, podometry, which will detect parts of the footthat are under the biggest pressure, and are potential areas for future ulcers. These techniques are useful indetermining which insoles should be used to compensate the appropriate malformation. All these paremetersenable categorization and diagnosing patients with low, medium, high or very high risk for foot ulcers. Based onthis stratification, with protocol is conducted adequate prevention and therapy. There are brochures that informpatients about the type of the disease, the harm of the disease, possible complications and ways to prevent them.Experiences in Canada and Australia have confirmed that routine examinations and risk stratification reduce thenumber of amputations in the period of 10 years for about 50%. Considering that this preventive program inMacedonia is not routinely conducted , there are actions that need to be implemented in order to manage thisprogram and improve the status of the patients with diabetic foot who till now have lost precious time from oneto other clinic before appropriate diagnostic and therapy is made. Program that covers the forming of a centerfor diabetic foot, creating a database of patients with diabetic foot, compulsory preventive examinations, riskcategorization for foot ulcers, education of patients and printing leaflets and brochures for informing, with thegoal to reduce the forming of ulcers and amputations in the diabetic foot, which would contribute this categoryof patients to live a long life with no complications and handicap.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle