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      Orthopedic infectious diseases: a survey on the composition and perceived value of an emerging subspecialty clinical service

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          Abstract

          We surveyed US orthopedic infectious disease (Ortho ID) specialists and surgeons ( n = 54 clinicians from at least 17 institutions). Three-quarters had a dedicated clinic or inpatient service; orthopedic device-related infections were most commonly seen. All respondents highly valued Ortho ID teams for improving multidisciplinary communication, trust, access to care, and outcomes.

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          Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis †.

          Pengzi Zhang, Jing Lu, Yali Jing … (2017)
          Diabetic foot is a severe public health issue, yet rare studies investigated its global epidemiology. Here we performed a systematic review and meta-analysis through searching PubMed, EMBASE, ISI Web of science, and Cochrane database. We found that that global diabetic foot ulcer prevalence was 6.3% (95%CI: 5.4-7.3%), which was higher in males (4.5%, 95%CI: 3.7-5.2%) than in females (3.5%, 95%CI: 2.8-4.2%), and higher in type 2 diabetic patients (6.4%, 95%CI: 4.6-8.1%) than in type 1 diabetics (5.5%, 95%CI: 3.2-7.7%). North America had the highest prevalence (13.0%, 95%CI: 10.0-15.9%), Oceania had the lowest (3.0%, 95% CI: 0.9-5.0%), and the prevalence in Asia, Europe, and Africa were 5.5% (95%CI: 4.6-6.4%), 5.1% (95%CI: 4.1-6.0%), and 7.2% (95%CI: 5.1-9.3%), respectively. Australia has the lowest (1.5%, 95%CI: 0.7-2.4%) and Belgium has the highest prevalence (16.6%, 95%CI: 10.7-22.4%), followed by Canada (14.8%, 95%CI: 9.4-20.1%) and USA (13.0%, 95%CI: 8.3-17.7%). The patients with diabetic foot ulcer were older, had a lower body mass index, longer diabetic duration, and had more hypertension, diabetic retinopathy, and smoking history than patients without diabetic foot ulceration. Our results provide suggestions for policy makers in deciding preventing strategy of diabetic foot ulceration in the future. Key messages Global prevalence of diabetic foot is 6.3% (95%CI: 5.4-7.3%), and the prevalence in North America, Asia, Europe, Africa and Oceania was 13.0% (95%CI: 10.0-15.9%), 5.5% (95%CI: 4.6-6.4%), 5.1% (95%CI: 4.1-6.0%), 7.2% (95%CI: 5.1-9.3%), and 3.0% (95% CI: 0.9-5.0%). Diabetic foot was more prevalent in males than in females, and more prevalent in type 2 diabetic foot patients than in type 1 diabetic foot patients. The patients with diabetic foot were older, had a lower body mass index, longer diabetic duration, and had more hypertension, diabetic retinopathy, and smoking history than patients without diabetic foot.
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            Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer

            David Armstrong, Mark Swerdlow, Alexandria A. Armstrong … (2020)
            Background In 2007, we reported a summary of data comparing diabetic foot complications to cancer. The purpose of this brief report was to refresh this with the best available data as they currently exist. Since that time, more reports have emerged both on cancer mortality and mortality associated with diabetic foot ulcer (DFU), Charcot arthropathy, and diabetes-associated lower extremity amputation. Methods We collected data reporting 5-year mortality from studies published following 2007 and calculated a pooled mean. We evaluated data from DFU, Charcot arthropathy and lower extremity amputation. We dichotomized high and low amputation as proximal and distal to the ankle, respectively. This was compared with cancer mortality as reported by the American Cancer Society and the National Cancer Institute. Results Five year mortality for Charcot, DFU, minor and major amputations were 29.0, 30.5, 46.2 and 56.6%, respectively. This is compared to 9.0% for breast cancer and 80.0% for lung cancer. 5 year pooled mortality for all reported cancer was 31.0%. Direct costs of care for diabetes in general was $237 billion in 2017. This is compared to $80 billion for cancer in 2015. As up to one-third of the direct costs of care for diabetes may be attributed to the lower extremity, these are also readily comparable. Conclusion Diabetic lower extremity complications remain enormously burdensome. Most notably, DFU and LEA appear to be more than just a marker of poor health. They are independent risk factors associated with premature death. While advances continue to improve outcomes of care for people with DFU and amputation, efforts should be directed at primary prevention as well as those for patients in diabetic foot ulcer remission to maximize ulcer-free, hospital-free and activity-rich days.
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              Debridement, antibiotics and implant retention for periprosthetic joint infections: A systematic review and meta-analysis of treatment outcomes

              Setor Kunutsor, Andrew Beswick, Michael Whitehouse … (2018)
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                Author and article information

                Contributors
                Nicolás Cortés-Penfield
                Journal
                Journal ID (nlm-ta): J Bone Jt Infect
                Journal ID (iso-abbrev): J Bone Jt Infect
                Journal ID (publisher-id): JBJI
                Title: Journal of Bone and Joint Infection
                Publisher: Copernicus GmbH
                ISSN (Electronic): 2206-3552
                Publication date (Electronic): 12 June 2024
                Publication date Collection: 2024
                Volume: 9
                Issue: 3
                Pages: 161-165
                Affiliations
                [1 ] Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
                [2 ] Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA
                Author notes
                [*] Correspondence: Nicolás Cortés-Penfield ( n.cortespenfield@ 123456unmc.edu )
                Article
                Publisher ID: 01021829
                DOI: 10.5194/jbji-9-161-2024
                PMC ID: 11187702
                PubMed ID: 38903858
                SO-VID: d151e172-f8c6-4b67-b1ab-3ec189559374
                Copyright © Copyright: © 2024 Nicolás Cortés-Penfield et al.
                License:

                This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

                History
                Date received : 21 February 2024
                Date accepted : 24 April 2024
                Categories
                Subject: Brief Report

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