Guía clínica basada en evidencia para el manejo del pie diabético.
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| Title: | Guía clínica basada en evidencia para el manejo del pie diabético. |
|---|---|
| Authors: | Castro, Guadalupe1, Liceaga, Gabriela2, Arrioja, Araceli3, Calleja, Juan Manuel4, Espejel, Alejandro5, Flores, José6, García, Teresa7, Hernández, Sergio8, Gavito, Eduardo López9, de Jesús, Fermín Martínez10, Nettel, Francisco Jacobo11, Raúl Romero Cabello12, Rosas, Juan13, Wacher, Niels H.14, Cote, Lilia15, Guzmán, Rosa María16, Bladinieres, Eduardo17, Márquez, Gustavo10, Alvarez, Edgar R.10 |
| Source: | Medicina Interna de México. nov/dic2009, Vol. 25 Issue 6, p481-526. 46p. 18 Diagrams, 15 Charts. |
| Subjects: | FOOT ulcers, DIABETIC neuropathies, PEOPLE with diabetes, FOOT amputation |
| Geographic Terms: | MEXICO |
| Abstract (English): | Background:infections and ulcers in the foot of diabetic patients are commonplace, complex and costly. Furthermore, they are the primary cause of non-traumatic lower extremity amputation. The management of this complication must be multidisciplinary, timely and effective in order to reduce the potential morbidity related to infection, the need for extended hospital stays, and amputations. Unfortunately, the care given to these patients is most often inadequate, possibly secondary to an incorrect understanding of the diagnostic and therapeutic approaches. Because of this there is a need to unify criteria and to develop a clinical guide which will be useful for the reduction of the medical morbidity, psychological exhaustion and financial costs associated with ulcers and infections of the diabetic foot. Method: in total, 19 expert physicians from different institutions, specializations and States of the Mexican Republic were invited to participate in the development of the guide. The participants were chosen based on criteria such as their experience in the subject and their knowledge in the methodology for the development of the guide. Recommendations were based on levels of clinical evidence for their application within the population, and reasonable conclusions were reached. Results: the experts held discussions on the topic in order to implement the logistics of the elaboration of the recommendation guide. The experts defined the scope of the guide, the topics to be covered and the relevant questions to be answered. Conclusions: Treatment of the diabetic foot must focus primarily on the triggering pathogenic mechanisms and on a coordinated multidisciplinary effort in order to produce a favorable prognosis. It is possible to speak of a general framework in the therapeutic approach to the diabetic foot: first, control of the metabolic state, followed by specific treatment, depending on the severity of clinical involvement. As a general measure and for preventive treatment, patients must be taught how to care for their feet and inspect them continuously. In reference to sugar-level values, there is evidence of a powerful association between hyperglycemia and the development and severity of the diabetic neuropathy which accompanies the diabetic foot, and which is one of the risk factors for the development of foot ulcers. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Antecedentes: las infecciones y úlceras del pie en los pacientes con diabetes son comunes, complejas y de alto costo. Son la principal causa de amputación no traumática de las extremidades inferiores. El tratamiento de esta complicación debe ser multidisciplinario, oportuno y eficaz, con el fin de reducir potencialmente la morbilidad relacionada con las infecciones, la necesidad de estancias hospitalarias prolongadas y las amputaciones. Por desgracia, la mayor parte de las veces la atención de estos pacientes es inadecuada, quizá debido a mal entendimiento de los enfoques diagnóstico y terapéutico; de ahí la necesidad de unificar criterios y la formación de una guía clínica que ayude a disminuir la morbilidad, el agotamiento psicológico y los costos financieros vinculados con las úlceras y las infecciones del pie diabético. Método: se invitó a participar en la elaboración de la guía a 19 médicos especialistas procedentes de diversas instituciones, especialidades y estados de la República Mexicana. Los invitados se seleccionaron con base en criterios de experiencia en el tema y conocimiento de la metodología para el desarrollo de esta guía. Las recomendaciones se basaron en niveles de evidencia clínica, para que las mismas se apliquen en la población, llegando a conclusiones razonables. Resultados: se realizaron las discusiones con los expertos en el tema para implantar la logística de la formación de la guía de recomendaciones. Los expertos definieron el alcance de la guía, los temas a evaluar y las preguntas relevantes a las que se debía dar respuesta. Conclusiones: el tratamiento del pie diabético debe enfocarse, principalmente, a los mecanismos patogénicos desencadenantes y a la atención multidisciplinaria con pronóstico favorable. El esquema general de la terapéutica del pie diabético consiste en: control del estado metabólico y luego del tratamiento específico, dependiendo del grado de afectación clínica. Como medidas generales y de tratamiento preventivo debe enseñarse a los pacientes cómo cuidar los pies e inspeccionarlos continuamente. En relación con el control de los valores de glucosa sanguínea, se demuestra que existe una correlación estrecha entre la hiperglucemia y la aparición y gravedad de la neuropatía diabética acompañante del pie diabético, que forma parte de los factores de riesgo para úlceras en el pie. [ABSTRACT FROM AUTHOR] |
| Copyright of Medicina Interna de México is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: lth DbLabel: MedicLatina An: 52159103 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Guía clínica basada en evidencia para el manejo del pie diabético. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Castro%2C+Guadalupe%22">Castro, Guadalupe</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Liceaga%2C+Gabriela%22">Liceaga, Gabriela</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Arrioja%2C+Araceli%22">Arrioja, Araceli</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Calleja%2C+Juan+Manuel%22">Calleja, Juan Manuel</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Espejel%2C+Alejandro%22">Espejel, Alejandro</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Flores%2C+José%22">Flores, José</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22García%2C+Teresa%22">García, Teresa</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Hernández%2C+Sergio%22">Hernández, Sergio</searchLink><relatesTo>8</relatesTo><br /><searchLink fieldCode="AR" term="%22Gavito%2C+Eduardo+López%22">Gavito, Eduardo López</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22de+Jesús%2C+Fermín+Martínez%22">de Jesús, Fermín Martínez</searchLink><relatesTo>10</relatesTo><br /><searchLink fieldCode="AR" term="%22Nettel%2C+Francisco+Jacobo%22">Nettel, Francisco Jacobo</searchLink><relatesTo>11</relatesTo><br /><searchLink fieldCode="AR" term="%22Raúl+Romero+Cabello%22">Raúl Romero Cabello</searchLink><relatesTo>12</relatesTo><br /><searchLink fieldCode="AR" term="%22Rosas%2C+Juan%22">Rosas, Juan</searchLink><relatesTo>13</relatesTo><br /><searchLink fieldCode="AR" term="%22Wacher%2C+Niels+H%2E%22">Wacher, Niels H.</searchLink><relatesTo>14</relatesTo><br /><searchLink fieldCode="AR" term="%22Cote%2C+Lilia%22">Cote, Lilia</searchLink><relatesTo>15</relatesTo><br /><searchLink fieldCode="AR" term="%22Guzmán%2C+Rosa+María%22">Guzmán, Rosa María</searchLink><relatesTo>16</relatesTo><br /><searchLink fieldCode="AR" term="%22Bladinieres%2C+Eduardo%22">Bladinieres, Eduardo</searchLink><relatesTo>17</relatesTo><br /><searchLink fieldCode="AR" term="%22Márquez%2C+Gustavo%22">Márquez, Gustavo</searchLink><relatesTo>10</relatesTo><br /><searchLink fieldCode="AR" term="%22Alvarez%2C+Edgar+R%2E%22">Alvarez, Edgar R.</searchLink><relatesTo>10</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Medicina+Interna+de+México%22">Medicina Interna de México</searchLink>. nov/dic2009, Vol. 25 Issue 6, p481-526. 46p. 18 Diagrams, 15 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22FOOT+ulcers%22">FOOT ulcers</searchLink><br /><searchLink fieldCode="DE" term="%22DIABETIC+neuropathies%22">DIABETIC neuropathies</searchLink><br /><searchLink fieldCode="DE" term="%22PEOPLE+with+diabetes%22">PEOPLE with diabetes</searchLink><br /><searchLink fieldCode="DE" term="%22FOOT+amputation%22">FOOT amputation</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22MEXICO%22">MEXICO</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: Background:infections and ulcers in the foot of diabetic patients are commonplace, complex and costly. Furthermore, they are the primary cause of non-traumatic lower extremity amputation. The management of this complication must be multidisciplinary, timely and effective in order to reduce the potential morbidity related to infection, the need for extended hospital stays, and amputations. Unfortunately, the care given to these patients is most often inadequate, possibly secondary to an incorrect understanding of the diagnostic and therapeutic approaches. Because of this there is a need to unify criteria and to develop a clinical guide which will be useful for the reduction of the medical morbidity, psychological exhaustion and financial costs associated with ulcers and infections of the diabetic foot. Method: in total, 19 expert physicians from different institutions, specializations and States of the Mexican Republic were invited to participate in the development of the guide. The participants were chosen based on criteria such as their experience in the subject and their knowledge in the methodology for the development of the guide. Recommendations were based on levels of clinical evidence for their application within the population, and reasonable conclusions were reached. Results: the experts held discussions on the topic in order to implement the logistics of the elaboration of the recommendation guide. The experts defined the scope of the guide, the topics to be covered and the relevant questions to be answered. Conclusions: Treatment of the diabetic foot must focus primarily on the triggering pathogenic mechanisms and on a coordinated multidisciplinary effort in order to produce a favorable prognosis. It is possible to speak of a general framework in the therapeutic approach to the diabetic foot: first, control of the metabolic state, followed by specific treatment, depending on the severity of clinical involvement. As a general measure and for preventive treatment, patients must be taught how to care for their feet and inspect them continuously. In reference to sugar-level values, there is evidence of a powerful association between hyperglycemia and the development and severity of the diabetic neuropathy which accompanies the diabetic foot, and which is one of the risk factors for the development of foot ulcers. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Spanish) Group: Ab Data: Antecedentes: las infecciones y úlceras del pie en los pacientes con diabetes son comunes, complejas y de alto costo. Son la principal causa de amputación no traumática de las extremidades inferiores. El tratamiento de esta complicación debe ser multidisciplinario, oportuno y eficaz, con el fin de reducir potencialmente la morbilidad relacionada con las infecciones, la necesidad de estancias hospitalarias prolongadas y las amputaciones. Por desgracia, la mayor parte de las veces la atención de estos pacientes es inadecuada, quizá debido a mal entendimiento de los enfoques diagnóstico y terapéutico; de ahí la necesidad de unificar criterios y la formación de una guía clínica que ayude a disminuir la morbilidad, el agotamiento psicológico y los costos financieros vinculados con las úlceras y las infecciones del pie diabético. Método: se invitó a participar en la elaboración de la guía a 19 médicos especialistas procedentes de diversas instituciones, especialidades y estados de la República Mexicana. Los invitados se seleccionaron con base en criterios de experiencia en el tema y conocimiento de la metodología para el desarrollo de esta guía. Las recomendaciones se basaron en niveles de evidencia clínica, para que las mismas se apliquen en la población, llegando a conclusiones razonables. Resultados: se realizaron las discusiones con los expertos en el tema para implantar la logística de la formación de la guía de recomendaciones. Los expertos definieron el alcance de la guía, los temas a evaluar y las preguntas relevantes a las que se debía dar respuesta. Conclusiones: el tratamiento del pie diabético debe enfocarse, principalmente, a los mecanismos patogénicos desencadenantes y a la atención multidisciplinaria con pronóstico favorable. El esquema general de la terapéutica del pie diabético consiste en: control del estado metabólico y luego del tratamiento específico, dependiendo del grado de afectación clínica. Como medidas generales y de tratamiento preventivo debe enseñarse a los pacientes cómo cuidar los pies e inspeccionarlos continuamente. En relación con el control de los valores de glucosa sanguínea, se demuestra que existe una correlación estrecha entre la hiperglucemia y la aparición y gravedad de la neuropatía diabética acompañante del pie diabético, que forma parte de los factores de riesgo para úlceras en el pie. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Medicina Interna de México is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Languages: – Code: spa Text: Spanish PhysicalDescription: Pagination: PageCount: 46 StartPage: 481 Subjects: – SubjectFull: FOOT ulcers Type: general – SubjectFull: DIABETIC neuropathies Type: general – SubjectFull: PEOPLE with diabetes Type: general – SubjectFull: FOOT amputation Type: general – SubjectFull: MEXICO Type: general Titles: – TitleFull: Guía clínica basada en evidencia para el manejo del pie diabético. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Castro, Guadalupe – PersonEntity: Name: NameFull: Liceaga, Gabriela – PersonEntity: Name: NameFull: Arrioja, Araceli – PersonEntity: Name: NameFull: Calleja, Juan Manuel – PersonEntity: Name: NameFull: Espejel, Alejandro – PersonEntity: Name: NameFull: Flores, José – PersonEntity: Name: NameFull: García, Teresa – PersonEntity: Name: NameFull: Hernández, Sergio – PersonEntity: Name: NameFull: Gavito, Eduardo López – PersonEntity: Name: NameFull: de Jesús, Fermín Martínez – PersonEntity: Name: NameFull: Nettel, Francisco Jacobo – PersonEntity: Name: NameFull: Raúl Romero Cabello – PersonEntity: Name: NameFull: Rosas, Juan – PersonEntity: Name: NameFull: Wacher, Niels H. – PersonEntity: Name: NameFull: Cote, Lilia – PersonEntity: Name: NameFull: Guzmán, Rosa María – PersonEntity: Name: NameFull: Bladinieres, Eduardo – PersonEntity: Name: NameFull: Márquez, Gustavo – PersonEntity: Name: NameFull: Alvarez, Edgar R. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 11 Text: nov/dic2009 Type: published Y: 2009 Identifiers: – Type: issn-print Value: 01864866 Numbering: – Type: volume Value: 25 – Type: issue Value: 6 Titles: – TitleFull: Medicina Interna de México Type: main |
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