The Catalan diabetic foot health program was established in 2009 in order to prevent complications caused by type 2 diabetes. This study aims to describe its application from 2009 to 2018. The objective was to describe diabetic foot care provision in the National Health System of Catalonia between 2009 and 2018, including the number of patients and professionals involved, the causes behind patients’ visits, and the most demanded codes for diagnosis and treatment filled by the podiatrist in each consultation during 2018–2020. This description was addressed through an analysis of the database provided by the Association of Podiatrists to evaluate the implementation of the program. The results for the diabetic foot health program in Catalonia showed a growth in demand from 2009 (1,726) to 2018 (213,095) in terms of visits and from 2009 (1,541) to 2018 (104,629) in terms of patients. The number of registered podiatrists from 2009 to 2018 increased from 165 to 470. The most commonly used diagnosis codes were (a) without sensory alterations in control and treatment of grade 1 lesions; (b) grade 0 without neuropathic, vascular, structural, or biomechanical alteration; (c) no sensory structural alterations in the foot; (d) keratopathies. The treatments most commonly used were (a) conservative (chiropody), (b) without ortho-podiatric treatment, and (c) plantar supports. The conclusions show that the health program is in great demand amongst the population. Similarly, the coding system has made it possible to identify the diagnosis and treatment of such demand.
Objetivo: El propósito fue evaluar la relación entre onicodistrofia y la alteración venosa crónica.Material y métodos: Se realizó un estudio observacional y transversal con 83 pacientes entre 40 y 84 años afectados de alteración venosa crónica, en un grado clínico de C0 a C6 en la escala CEAP. La valoración ungueal se llevó a cabo mediante iconografía y onicoscopia.Resultados: Las mujeres padecen más onicodistrofia que los hombres. Ambas extremidades inferiores presentan igual afectación onicodistrófica. El primer dedo tiene mayor afectación onicodistrófica que el tercero, cuarto y quinto. En la extremidad inferior izquierda, el quinto dedo tiene mayor afectación que el segundo y cuarto. Para la extremidad inferior derecha, el primer dedo tiene mayor afectación queel tercero, cuarto y quinto. Existe una asociación positiva entre la onicodistrofia en los pies y la enfermedad venosa crónica.Conclusiones: La onicodistrofia se observa mayoritariamente entre las mujeres, afecta a ambas extremidades por igual, el primer y el quinto dedo suelen ser los más afectados, su prevalencia aumenta cuanto mayor es el grado de patología venosa crónica
Background: A new water-soluble formulation with ciclopirox has shown a higher penetration than other ciclopirox nail lacquers currently marketed, thus providing a higher concentration of ciclopirox into the nail.Objective: To evaluate the efficacy and safety of a new ciclopirox nail hydrolacquer compared with its vehicle and an active comparator (hydroxypropyl chitosan-based 80 mg/g ciclopirox nail lacquer) for the treatment of toenail fungal infection.Methods: Phase III, multicenter, randomised, double-blind, clinical trial in patients with distal mild to moderate toenail onychomycosis due to dermatophyte fungi.Patients were randomised to apply topically a ciclopirox nail hydrolacquer, its vehicle or a reference product once daily for 48 weeks with a follow-up period of 4 weeks up to week 52.Results: A total of 381 patients were included. No statistically significant differences were observed between patient groups in the proportion of subjects achieving a complete cure. At week 52, a higher percentage of patients in the ciclopirox nail hydrolacquer group achieved a mycological cure (negative for culture and DTS/KOH test, with results: 32.0% ciclopirox nail hydrolacquer , 23.2% vehicle and 27% reference product, respectively), and similar results were found for improvement (mycological cure and reduction of diseased nail ≥20%, with results: 27.2% ciclopirox nail hydrolacquer, 21.6% vehicle and 20.6% reference product, respectively). Regarding mycological results, only ciclopirox nail hydrolacquer demonstrated significant statistical superiority versus vehicle negativizing dermatophyte culture (p = .039) with no recurrences, relapses or re-infections in a four-week follow-up patients with complete cure. The safety profile was comparable to the vehicle and reference product and consistent with the previously reported.
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