ABSTRACT
The treatment of diabetic foot osteomyelitis [DFO] is a controversial issue, with disagreement regarding whether the best treatment is surgical or conservative. The purpose of this study was to compare the outcome of patients with DFO who were treated with antibiotherapy alone and those who underwent concurrent minor amputation. Hospital records of patients who were diagnosed as having DFO within a 2-year study period were retrospectively reviewed. Patients were divided into two groups: those who received antibiotherapy alone and those who underwent concurrent minor amputation. Groups were compared in terms of duration in hospitalization, antibiotherapy, and wound healing. Thirty seven patients were included in the study. These comprised patients who received antibiotherapy alone [ABG, n=15] and patients who underwent concurrent minor amputation [AB-MAG, n=22]. Hospitalization duration was 37.2 [+/- 16.2] days in ABG and 52.8 [+/- 40.2] days in AB-MAG [p = 0.166]. Mean duration of antibiotherapy was 45.0 [+/- 21.7] days in ABG and 47.7 [+/- 19] days in AB-MAG [p = 0.689]. Wound healing duration was 265.2 [+/- 132.7] days in ABG and 222.6 [+/- 85.9] days in AB-MAG [p = 0.243]. None of the outcome measures were significantly different between ABG and AB-MAG. Our results have shown similar outcomes for both patient groups who received antibiotherapy alone and who underwent concurrent minor amputations. Considering the small sample sizes in this study, it is important to confirm these results on a larger scale
ABSTRACT
We present a patient who developed visual loss after carbon monoxide [CO] poisoning and was treated with hyperbaric oxygen. Clinical Presentation and Intervention: A 21-year-old woman poisoned with CO [with coma lasting 4 h and carboxyhemoglobin level 46%] developed seizures and cortical blindness 3 days after poisoning. Four years later, her visual acuity was 0.2 in both eyes. An 18F-fluorodeoxyglucose positron emission tomography [PET] scan showed reduced metabolism in the bilateral posterior temporal and occipital lobes. The patient received a total of 50 hyperbaric oxygen sessions over 3 months for visual loss and the visual acuity improved to 0.5 in both eyes. In addition, increased metabolism was detected in the brain in post-treatment PET scans. PET documented brain hypoperfusion 4 years after CO poisoning and hyperbaric oxygen therapy improved visual acuity. However, we cannot endorse routine use of hyperbaric oxygen for such patients, until results of further clinical trials demonstrate efficacy of hyperbaric oxygen in CO-induced chronic brain injury