Avatar Augmented Annotation Interface for e-Learning
Won-Sung Sohn, Jae‐Kyung Kim · E-learning · 2010
Introduction"Early intervention in order to prevent potential disaster in the management of Diabetic foot is not only a great responsibility, but also a great opportunity" Despite advances in our understanding and treatment of diabetes mellitus, diabetic foot disease still remains a terrifying problem.Diabetes is recognized as the most common cause of non-traumatic lower limb amputation in the western world, with individuals over 20 times more likely to undergo an amputation compared to the rest of the population.There is growing evidence that the vascular contribution to diabetic foot disease is greater than was previously realised.This is important because, unlike peripheral neuropathy, Peripheral Arterial Occlusive Disease (PAOD) due to atherosclerosis, is generally far more amenable to therapeutic intervention.PAOD, has been demonstrated to be a greater risk factor than neuropathy in both foot ulceration and lower limb amputation in patients with diabetes.Diabetes is associated with macrovascular and microvascular disease.The term peripheral vascular disease may be more appropriate when referring to lower limb tissue perfusion in diabetes, as this encompasses the influence of both microvascular dysfunction and PAOD.Richards-George P. in his paper about vasculopathy on Jamaican diabetic clinic attendees showed that Doppler measurements of ankle/brachial pressure index (A/BI) revealed that 23% of the diabetics had peripheral occlusive arterial disease (POAD) which was mostly asymptomatic.This underscores the need for regular Doppler A/BI testing in order to improve the recognition, and treatment of POAD.Ageing is associated with both neuropathic ulcers and peripheral vascular diseases among individual with diabetes. Diabetic footThe foot of a diabetic patient has the potential risk of pathologic consequences, including ulceration, infection and/or destruction of deep tissues associated with neurologic abnormalities, varying degrees of peripheral vascular disease and/or metabolic complications of diabetes in the lower limb. Epidemiology and problem statement of diabetic footThe foot ulcer incidence rates range between 2% and 10% among patients with diabetes mellitus.The age adjusted annual incidence for non traumatic lower limb amputations in diabetic persons ranges form 2.1 to 13.7 per 1000 persons. 1 www.intechopen.com Gangrene -Current Concepts and Management Options 122It is estimated that 15% of diabetic patients will experience a foot ulcer at some time over the course of their disease.People with foot problems and diabetes mellitus have 15 times the increased risk of undergoing a lower extremity amputation compared to those without diabetes 2 .Amputation is the end result of a cascade of diabetic foot leg lesions.Twenty percent of all diabetic persons enter the hospital because of foot problems.One study in UK showed that 50% of the hospital bed occupancy of diabetic patients is caused by foot problems.Apart from the morbidity and mortality associated with diabetic foot ulcers and amputations, the economic and emotional consequences for the patient and the family can be enormous 3 . Classification of the diabetic foot 4 How to referenceIn order to correctly reference this scholarly work, feel free to copy and paste the following: