medigraphic.com
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2008, Number 3

<< Back Next >>

Rev Esp Med Quir 2008; 13 (3)

Effect of an educational program on podal mycosis remission in a group of diabetic patients

Rosas BJV, Calva MJJ, Rojas TBO, Bonifaz A, Araiza SJ

Language: Spanish
References: 36
Page: 104-115
PDF size: 230.29 Kb.


ABSTRACT

Objective. To demonstrate that one educational practice course-program increased the healing rate for the onychomycosis of the diabetic’s foot, compared with control group. Both groups received specific therapy for the onychomycosis for three months. Material and methods: It was a comparative, blinded randomized clinical trial study. It was performed at HR 1° de Octubre and the Clínica Gustavo A. Madero from the ISSSTE. Onycomicosis diagnosis was made by direct saw with KOH 10% and culture. Patients were divided in two groups of 22 each one, both of them received itraconazole 200 mg daily for three months. The experimental group received a practice-course-program about foot’s care. They were followed-up for six months. Results: There were included 44 patients. At the end of educational program, four patients of 21 (19%) of the experimental group obtained clinical cure, versus 0/21 in the control group (p = 0.053). Six months after clinical remission there were in 6/21 (29%) vs 9/21 (43%) respectively (p = 0.328). Four patients had “yellowish palms” due to itraconazole ingest. Conclusions: There were no significant difference for both groups with tendency to experimental group.


REFERENCES

  1. Norma Oficial Mexicana. NOM-015-SSA2-1994 para la prevención, tratamiento y control de la diabetes mellitus en la atención primaria.

  2. Carter JS, Pugh JA, Monterrosa A. Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern Med 1996;125(3):221-32.

  3. Frati AC, Ariza CR. Diabetes mellitus y trastornos afines. En: Halabe J, Lifshitz A, López B, Ramiro M, editores. 1a ed. El Internista. Medicina Interna para Internistas. AMIM, México: Mc-Graw Hill Interamericana, 1997;pp:23-26.

  4. Ríos JM, Rull JA. Diagnóstico de la diabetes mellitus, lineamientos. En: Lerman I. Atención integral del paciente diabético. 1a ed. Interamericana-McGraw-Hill, 1994;pp:7-20.

  5. American Diabetes Association. Patogenia. En: Manejo médico de la diabetes no insulino dependiente (tipo II), 3a ed. 1994:15-9.

  6. Lifshitz A. El estado prediabético. Rev Med IMSS 1995;33(2):197-205.

  7. Zimmet PZ. The pathogenesis and prevention of diabetes in adults. Genes, autoimmunity, and demography. Diabetes Care 1995;18(7):1050-64.

  8. Youngren JF, Goldfine ID. The molecular basis of insulin resistance. Science & Medicine 1997;4(3):18-27.

  9. Franz MJ, Horton ES, Bantle JP, Beebe CA, et al. Nutrition principles for the management of diabetes and related complications. Diabetes Care 1994;17(5): 490-518.

  10. Solano A. Manual de dietas para el paciente diabético. Sociedad Mexicana de Nutrición y Endocrinología.

  11. Summary of the second report of the National Cholesterol Education Program (NCEP) expert panel of detection, evaluation, and treatment of high blood cholesterol in adults (Adults Treatment Panel II). JAMA 1993;269(23):3015-23.

  12. American Diabetes Association. Translation of the diabetes nutrition recommendations for health care institutions. Diabetes Care 1997;20(suppl 1):106-8.

  13. American Diabetes Association. Intervención Farmacológica. En: Manejo médico de la diabetes no insulino dependiente (tipo II). 3a ed. 1994:40-9.

  14. Yamanouchi K, Shinozaki T, Chikada K, Nishikawa T, et al. Daily walking combined with diet therapy is a useful means for obese NIDDM patients not only to reduce body weight but also to improve insulin sensitivity. Diabetes Care 1995; 18(6):775-8.

  15. Asociación Americana de Diabetes. Recomendaciones para la práctica clínica. 1996. Tratamiento farmacológico de la hiperglucemia en la DMNID. Diabetes Care 1996;19(supl 1):S54-S61.

  16. Gerhart JG, Forbes RC. Initial management of the patient with newly diagnosed diabetes. Am Fam Physician 1995;51(8):1953-62, 1966-8.

  17. Tan GH, Nelson RL. Pharmacologic treatment options for non-insulin-dependent diabetes mellitus. Mayo Clin Proc 1996;71(8):763-8.

  18. Moss SE, Klein R, Klein BE. The prevalence and incidence of lower extremity amputation in a diabetic population. Arch Intern Med 1992;152(3):610-6.

  19. Frykberg RG. Epidemiology of the diabetic foot: Ulcerations and amputations. En: Memorias del curso Diabetic Foot Management, noviembre 7-8 de 1996, auspiciado por Harvard Medical School, Deacones Hospital y Joslin Diabetes Center.

  20. García GE. El pie diabético. En: Lerman I. Atención integral del paciente diabético. Interamericana Mc-Graw Hill, 1994; cap. 26.

  21. Harrelson JM. Management of the diabetic foot. Orthop Clin North Am 1989;20(4):605-19.

  22. Gibbons GW. Overview of management of infection. En memorias del curso Diabetic Foot Management, noviembre 7-8 de 1996, auspiciado por Harvard Medical School, Deacones Hospital y Joslin Diabetes Center.

  23. Gibbons GW, Marcaccio EJ, Burgess AM, Pomposelli FB. Improved quality of diabetic foot care, 1984 vs 1990. Reduced length of stay and costs, insufficient reimbursement. Arch Surg 1993;128(5):576-81.

  24. Bild DE, Selby JV, Sinnock P, Browner WS, et al. Lower-extremity amputation in people with diabetes. Epidemiology and prevention. Diabetes Care 1989;12(1):24-31.

  25. Organización Panamericana de la Salud. Manual de normas técnicas y administrativas del programa de diabetes mellitus. Serie Paltex para ejecutores de programas de salud, núm. 2, 1988.

  26. Barth R, Campbell L, Allen S, Jupp JJ, et al. Intensive education improves knowledge, compliance, and foot problems in type 2 diabetes. Diabet Med 1991;8(2):111-7.

  27. Malone JM, Snyder M, Anderson G, Bernhard VM, et al. Prevention of amputation by diabetic education. Am J Surg 1989;158(6):520-3.

  28. Zaias N, Drachman D. A method for the determination of drug effectiveness in onychomycosis. Trials whit ketoconazole and griseofulvin ultramicrosize. J Am Acad Dermatol 1983;9(6):912-9.

  29. Drake L, Babel D, Stewart DM, Rich P. Once-weekly fluconazole (150, 300, and 450 mg) in the treatment of distal subungual onychomycosis of the fingernail. J Am Acad Dermatol 1998;38(6, part 2):S103-9.

  30. Reiber GE, Pecoraro RE, Koepsell ThD. Risk factors for amputation in patients with diabetes mellitus. A case-control study. Ann Intern Med 1992;117(2):97-105.

  31. Litzelman DK, Marriott DJ, Vinicor F. Independent physiological predictors of foot lesions in patients with NIDDM. Diabetes Care 1997;20(8):1273-8.

  32. Wanzke del Angel V, Arce M, Arenas R, Trejo-Izquierdo E y col. Detección de micosis podales y portadores en pacientes diabéticos ambulatorios. Estudio clínico micológico en 106 pacientes. Dermatol Rev Mex 1997;41(6):216-22.

  33. Arenas R. Las onicomicosis. Aspectos clínico-epidemiológicos, micológicos y terapéuticos. Gac Med Mex 1990;126(2):84-91.

  34. Fitzpatrick TB, Allen JR, Polano MK, Suurmond D, et al. Color atlas and synopsis of clinical dermatology: Common and serious diseases. 2nd ed. Estados Unidos: McGraw-Hill, 1992;pp:100-1.

  35. Arenas R, Ocejo D. Onicomicosis: frecuencia actual en un departamento de dermatología de la Ciudad de México. Dermatol Rev Mex 1997;41(5):171-5.

  36. Haneke E, Roseeuw D. The scope of onychomycosis: Epidemiology and clinical features. Int J Dermatol 1999; 38(suppl 2):7-12.




2020     |     www.medigraphic.com