RESUMEN
BACKGROUND: We considered whether it is more practical to amputate the toe of a diabetic patient with osteomyelitis and good circulation or to treat the patient with antibiotics for a prolonged period. METHODS: We undertook a retrospective study of 141 diabetic patients who had undergone a toe-ray amputation for proven or documented osteomyelitis. RESULTS: The mean ankle/brachial index of all patients was 0.81 (range, 0.68 to 1.14); the mean functional days lost on antibiotic therapy was 39 (range, 7 to 84 days). The cost of 6 to 8 weeks of preoperative antibiotic therapy was $900 to $2240 (mean, $1440). CONCLUSIONS: Diabetic patients with good circulation and osteomyelitis of the toe may benefit from prompt toe amputation.
Asunto(s)
Amputación Quirúrgica , Complicaciones de la Diabetes , Osteomielitis/etiología , Osteomielitis/cirugía , Dedos del Pie/cirugía , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Humanos , Osteomielitis/tratamiento farmacológico , Cuidados Preoperatorios , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Canales de Calcio/efectos de los fármacos , Calcio/metabolismo , Halotano/farmacología , Proteínas Musculares/efectos de los fármacos , Proteínas de Neoplasias , Proteínas del Tejido Nervioso , Ácidos Oléicos/farmacología , Animales , Proteínas Portadoras/metabolismo , Sinergismo Farmacológico , Proteína de Unión a los Ácidos Grasos 7 , Proteínas de Unión a Ácidos Grasos , Masculino , Miocardio/metabolismo , Ácido Oléico , Ácidos Oléicos/metabolismo , Ratas , Canal Liberador de Calcio Receptor de Rianodina , Retículo Sarcoplasmático/metabolismo , Albúmina Sérica Bovina/metabolismoRESUMEN
Absent or erratic fetal electrocardiographic signal can result in artifactual electronic fetal heart rate recording. We report a case where detection of maternal heart rate through internal fetal scalp monitor may have masked intrauterine fetal demise secondary to acute uterine rupture during a VBAC trial.