Factors Affecting the Quality of Life of Hospitalized Persons with Chronic Foot and Lower Leg Wounds.

OBJECTIVE: To determine the factors affecting the quality of life of patients with chronic wounds. METHODS: This descriptive cross-sectional study was conducted in a university hospital wound care unit in western Turkey with 134 patients. The data were collected via personal information form, Barthel Index for activities of daily living, visual analog scale, and Short Form-12 questionnaire. Descriptive statistics and Spearman correlation were used for data analysis. RESULTS: The mean age of the participants was 60.4 ± 10.7 years; 79.9% of the research group had diabetic foot wounds, and 56.7% had wounds on their right/left big toe. The mean duration of wounds was 9.4 ± 11.4 months, and 68.7% had previously been hospitalized because of wounds. The average visual analog scale pain level was 3.5 ± 2.5, and 45.5% of the patients were PEDIS (perfusion, extent, depth, infection, and sensation) classification grade II. A positive correlation was detected between Short Form-12 physical summary score and activities of daily living score. CONCLUSIONS: Patients with chronic wounds have a poor quality of life. Patient quality of life decreases as pain and PEDIS score increase and increases with their level of independence.

Sialic acid is required for nonspecific adherence of Salmonella enterica ssp. enterica serovar Typhi on Caco-2 cells.

To initiate infection, bacteria must adhere to and colonize host tissues. Specific and nonspecific mechanisms participate in the adherence process. Salmonella enterica ssp. enterica serovar Typhi (S. Typhi) must first adhere to the intestinal epithelium to invade and disseminate throughout the host. In this study, the role of colonic epithelial cell surface sialic acid in the adherence of S. Typhi was defined. Neuraminidase treatment of colonic Caco-2 cells removed 27-58% of surface sialic acid. Thus desialylation diminished the adherence of S. Typhi by 41%. Sialic acid treatment of S. Typhi had no effect on their adherence to neuraminidase-treated or control cells. These results indicate that sialic acid on the surface of colonic cells enhances S. Typhi adherence. These findings may suggest novel therapeutic strategies for S. Typhi infections.

Pathogens isolated from deep soft tissue and bone in patients with diabetic foot infections.

BACKGROUND: We sought to determine the similarity of pathogens isolated from soft tissue and bone in patients with diabetic foot infections. It is widely believed that soft-tissue cultures are adequate in the determination of causative bacteria in patients with diabetic foot osteomyelitis. The culture results of specimens taken concurrently from soft-tissue and bone infections show that the former does not predict the latter with sufficient reliability. We sought to determine the similarity of pathogens isolated from soft tissue and bone in patients with diabetic foot infections. METHODS: Forty-five patients with diabetic foot infections were enrolled in the study. Patients had to have clinically suspected foot lesions of grade 3 or higher on the Wagner classification system. In patients with clinically suspected osteomyelitis, magnetic resonance imaging, scintigraphy, or histopathologic examination were performed. Bone and deep soft tissue specimens were obtained from all patients by open surgical procedures under aseptic conditions during debridement or amputation. The specimens were compared only with the other specimens taken from the same patients. RESULTS: The results of bone and soft-tissue cultures were identical in 49% (n = 22) of cases. In 11% (n = 5) of cases there were no common pathogens. In 29% (n = 13) of cases there were more pathogens in the soft-tissue specimens; these microorganisms included microbes isolated from bone cultures. In four patients (9%) with culture-positive soft-tissue specimens, bone culture specimens remained sterile. In one patient (2%) with culture-positive bone specimen, soft-tissue specimen remained sterile. CONCLUSION: Culture specimens should be obtained from both the bone and the overlying deep soft tissue in patients with suspected osteomyelitis whose clinical conditions are suitable. The decision to administer antibiotic therapy should depend on these results.