Podiatry Today

Case Studies In Palliative Wound Care

By Martin E. Wendelken, DPM, RN, Lee Markowitz, DPM, and Oscar M. Alvarez, PhD

There may be instances when advanced therapies are contraindicated in elderly patients. In other instances, elderly patients with multiple comorbidities may be wary of the risks of surgical intervention for lower extremity wounds. Accordingly, these authors offer a variety of case studies that illustrate fundamental principles of palliative wound care.

The demographics of the American population are shifting dramatically toward a majority of people being over the age of 65. There are currently more than 35 million Americans age 65 and over, which is almost 15 percent of the United States population. This number is expected to increase to 70 million (20 percent of all Americans) by the year 2030 and to almost 80 million by 2050. In contrast, the population under age 65 will increase only 7 percent by 2050.

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Study Cites Link Between Higher Triglycerides And Diabetic Neuropathy

By Brian McCurdy, Senior Editor

A recently published study in Diabetes suggests a correlation between elevated triglyceride levels and diabetic neuropathy, lending credence to the idea that hyperlipidemia is a factor in the progression of diabetic neuropathy.

The study involved 427 patients with diabetic neuropathy. Researchers analyzed patients’ sural nerve myelinated fiber density (MFD), nerve conduction velocities, vibration perception thresholds, clinical symptom scores and visual analogue scale for pain.

The study defined a loss of greater than or equal to 500 fibers/mm2 in sural nerve MFD over 52 weeks as progressing diabetic neuropathy. A MFD loss of less than or equal to 100 fibers/mm2 during the same time interval signified non-progressing neuropathy, according to the study.

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