蒋桂勇

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03 9月 2019

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Author : 伤口世界

熟练掌握骨科常见病、多发病的诊治。在急诊手外科、创面早期处理及运动损伤方面有一定的经验。曾赴比利时鲁汶大学进修学习复杂骨折、肩肘外科，发表论文3篇，参编著作2部。博士，主治医师，讲师，毕业于北京协和医学院八年制临床医学专业，自2008年毕业至南方医院创伤骨科工作后，经过骨科系统培训和专科学习。

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Current strategies and priorities for diabetic footwear design and production: a cross-European exploratory survey of clinicians and shoemakers 2026-04-11 00:00

Hadi Sarlak1,2 · Kamran Shakir1,2 · Giulia Rogati2 · Alberto Leardini2 · Lisa Berti1,3 · Paolo Caravaggi2

Received: 11 December 2025 / Accepted: 5 February 2026 © The Author(s) 2026

Abstract

Background Therapeutic footwear plays an important role in preventing ulceration in people with diabetes. Despite guide-lines recommending offloading footwear for individuals at risk of ulceration, limited data are available on the alignment between current industrial practices, clinical expectations, and evidence. This study explored current practices, priorities and challenges associated with diabetic footwear from manufacturers’ and clinicians’ perspectives across Europe.

Methods An exploratory cross-sectional survey was conducted between May and October 2025 to gather insights from diabetic footwear manufacturers and clinicians involved in diabetic foot care across Europe. A 26-item questionnaire was developed to explore product design, materials, innovation, and adherence to guidelines among manufacturers. Additionally, a separate 14-item questionnaire for clinicians examined footwear prescription, patient barriers, and industry communica-tion. Quantitative data were analysed descriptively, and open-text responses underwent thematic analysis.

Results Nine manufacturers and twelve clinicians participated in the survey. While only half of the Manufacturers that completed the survey reported having a research and development department, most reported adopting data-driven design approaches (n=8) and scientific literature (n=7). Offloading, internal volume, and toe protection were the highest-ranking priorities for manufacturers, whereas aesthetics ranked lowest. Clinicians, conversely, prioritised accommodation of defor-mities, offloading, and comfort, and highlighted poor aesthetics and shoe weight as major limitations to adherence.

Conclusions This exploratory study suggests partial alignment between diabetic footwear manufacturers and clinicians on functional and offloading features but highlights gaps in aesthetics, materials, and sustainability. Better collaboration, data-driven innovation, and clearer product specifications could improve user adherence, prescription efficacy, and the preventive role of therapeutic footwear in diabetes care.

Keywords Diabetic foot ulcers · Therapeutic footwear · Offloading · Survey · Footwear design

Communicated by Massimo Federici.

Kamran Shakir

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Hadi Sarlak

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Giulia Rogati

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Alberto Leardini

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Lisa Berti

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Paolo Caravaggi

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1 Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Via Zamboni,33, Bologna 40126, Italy

2 Movement Analysis Laboratory and Functional Evaluation of Prostheses, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, Bologna 40136, Italy

3 Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna 40136, Italy
The erythropoietin gene polymorphism (rs1617640) is associated with retinopathy in type 2 diabetes patients 2026-04-10 00:00

Jolanta Szeliga-Krol1 · Agata Betlejewska1 · Monika Buraczynska1 · Wojciech Zaluska1

Received: 29 September 2025 / Accepted: 25 January 2026 © The Author(s) 2026

Abstract

Aims Our study aimed to evaluate the association between the erythropoietin gene rs1617640 polymorphism and diabetic retinopathy (DR) in diabetes patients.

Methods In this preliminary retrospective study the genotyping was performed on 860 DNA samples from Caucasian patients with type 2 diabetes mellitus (T2DM). For analyzing the effect of the polymorphism, patients were assigned into three phenotypic subgroups: non-DR (without retinopathy), NPDR (with non-proliferative diabetic retinopathy) and PDR (with proliferative diabetic retinopathy). The rs1617640 polymorphism was analyzed using polymerase chain reaction (PCR)–restriction fragment length polymorphism (RFLP) and direct DNA sequencing procedures.

Results A statistically significant difference in the polymorphism distribution was observed between T2DM patients with DR (both NPDR and PDR) and those without DR. The minor G allele was associated with the increased risk of DR. In the NPDR subgroup subjects carrying the G allele had 1.53-fold higher risk of developing retinopathy. Similarly, in the PDR subgroup patients carrying the G allele showed almost twofold increased risk of PDR in a dominant model of inheritance.

Conclusion Our results demonstrate that in T2DM patients the EPO rs1617460 polymorphism is associated with signifi-cantly increased risk of developing DR. This finding can provide a new insight into the role of EPO gene in the pathophysi-ology of microvascular complications of diabetes.

Keywords EPO gene · Type 2 diabetes mellitus · Diabetic retinopathy · Single nucleotide polymorphism · Risk allele

Communicated by Marta Letizia Hribal.

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1 Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950 Lublin, Poland
Type 2 diabetes mellitus is associated with asymptomatic acute abdomen among elderly patients admitted to acute tertiary care hospital wards 2026-04-09 00:00

Andrea Tumminia1 · Raffaella Romano2 · Francesco Frasca1,3 · Francesco Galeano3 · Roberto Baratta1 · Vittorio Oteri3 · Alessia Longo3 · Lucia Frittitta3,4 · Rosario Le Moli5 · Tommaso Piticchio6 · Antonino Di Pino7 · Maurizio Di Marco7 · Luigi Piazza8 · Maria Carolina Picardo9 · Paola Magnano San Lio10 · Filippo Luca Fimognari11 · Marcello Romano2

Received: 13 November 2025 / Accepted: 5 February 2026 © The Author(s) 2026

Abstract

Background Pain may be absent in a substantial proportion of elderly patients with acute abdominal conditions. This study explored the association between type 2 diabetes mellitus (T2DM) and asymptomatic presentation.

Methods We conducted a cross-sectional analysis of 215 patients aged≥65 years admitted with acute abdominal conditions. Demographic, clinical, and laboratory data were extracted from medical records. Descriptive statistics and multivariable logistic regression were used to identify associative predictors of asymptomatic acute abdomen (AAA).

Results The median age was 82 years [77–86]; 54.4% (n=117) were female; 31.2% (n=67) had T2DM. Overall, 33.5% (n=72) presented without abdominal pain. T2DM prevalence was higher in AAA than symptomatic patients (44.4% vs. 24.5%, p<0.01). In multivariable analysis, T2DM (OR 1.95, 95% CI 1.10–3.45, p=0.02), lower heart rate (OR 0.83, 95% CI 0.71–0.96, p=0.01), and absence of fever (OR 0.50, 95% CI 0.26–0.95, p=0.03) were associated with AAA. Among patients with T2DM, longer diabetes duration (12.5 years [10.5–14.5] vs. 8.8 years [5.0–11.0]; p<0.01) and higher HbA1c (8.2% [7.2–8.7] vs. 7.5% [6.8–7.6]; p=0.02) were associated with asymptomatic presentation.

Conclusions Asymptomatic acute abdomen is common among elderly patients. Long-standing and poorly controlled T2DM is associated with absent pain. Prospective studies are needed to clarify causal mechanisms, and early glyco-metabolic assessment may aid recognition of at-risk patients.

Keywords Type 2 diabetes · Acute abdomen · Elderly · Pain perception · Emergency medicine · Predictors

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

蒋桂勇

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

蒋桂勇

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