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10.1016/j.diabres.2020.108245

http://scihub22266oqcxt.onion/10.1016/j.diabres.2020.108245
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suck abstract from ncbi


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pmid32497745      Diabetes+Res+Clin+Pract 2020 ; 165 (ä): 108245
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  • Management of diabetic persons with foot ulceration during COVID-19 health care emergency: Effectiveness of a new triage pathway #MMPMID32497745
  • Meloni M; Izzo V; Giurato L; Gandini R; Uccioli L
  • Diabetes Res Clin Pract 2020[Jul]; 165 (ä): 108245 PMID32497745show ga
  • AIM: To define the outcomes of persons with diabetes and foot ulcers (DFUs) managed through a specific triage pathway during the COVID-19 crisis. METHODS: Patients who had an active DFU during the COVID-19 emergency were included. All participants were managed using a specific triage system driven both by ulcer'severity and concomitant co-diseases. Subjects with severely complicated DFUs were urgently referred to hospital regardless of the concomitant comorbidities. Subjects with complicated DFUs received outpatient evaluation (within 48-72 h) and were admitted to hospital if required (revascularization, surgical intervention, intravenous antibiotic therapy); after the first outpatient visit or hospitalization, patients were followed according to the number of comorbidities (in the case of 3 or more comorbidities patients were followed up by telemedicine). Patients with uncomplicated DFUs were managed by telemedicine after outpatient evaluation. Healing, major amputation, death and rate of COVID-19 infection were evaluated. The minimum follow-up was 1 month. RESULTS: The study group included 151 patients. The mean age was 69.9 +/- 14.2 years, 58.9% were male and 91.4% had type 2 diabetes; 58.7% had severely complicated, 21% complicated and 20.3% uncomplicated DFUs. Among those, 78.8% presented with 3 or more comorbidities. One hundred and six patients had regular clinical follow-ups, while 45 were managed through telemedicine. Forty-one (27.1%) patients healed, 3 (1.9%) had major amputations and 3 (1.9%) died. One patient (0.6%) reported COVID-19 positivity due to infection acquired at home. CONCLUSION: The triage pathway adopted during the COVID-19 pandemic showed adequate management of DFUs and no cases of hospital virus exposure.
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Amputation, Surgical[MESH]
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/*epidemiology[MESH]
  • |Diabetes Mellitus, Type 2/complications[MESH]
  • |Diabetic Foot/complications/*therapy[MESH]
  • |Emergency Medical Services[MESH]
  • |Female[MESH]
  • |Follow-Up Studies[MESH]
  • |Hospitalization[MESH]
  • |Humans[MESH]
  • |Italy[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*epidemiology[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |Telemedicine[MESH]
  • |Treatment Outcome[MESH]
  • |Triage/*methods[MESH]


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