Offloading treatment in people with diabetic foot disease: A systematic scoping review on adherence to foot offloading.

BACKGROUND AND AIMS: To identify measurement methods, proportions of adherent participants, factors affecting adherence, and concordance promoting interventions. METHODS: A systematic scoping review was conducted by searching Medline, CINAHL, PubMed, EMBASE, and EMCARE databases. RESULTS: Twenty-four trials were identified from 1001 citations. Only 25% of the included studies used objective methods to quantify adherence. The proportion of adherent participants (≥80% of daily steps/time) ranged from 28% to 60%. Psychosocial factors are the most common influencers of adherence. However, interventions for improving compliance are lacking. CONCLUSION: There is a need to accurately quantify and optimize adherence to foot offloading in people with diabetes.

Caecal volvulus: untwisting the mystery.

Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop obstruction, small bowel ischaemia and perforation. Early recognition and prompt treatment is key; however, due to the rarity of this pathology, it is seldom listed as a differential diagnosis. Here, we present a single-centre case series of two patients presenting with caecal volvulus to an Emergency Surgery Unit at a University Hospital.