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The objective of medical research is the quest for scientific truth, as well as the communication of new knowledge to the medical society through publication of novel results. Journals publishing these results rely on the trust that all persons involved (authors, peer reviewers, editors, and publishers) remain honest, following the rules and ethics of scientific integrity. Unfortunately, this is not always the case and a wide spectrum of pitfalls and misconducts may occur, ranging from less serious violations of ethical rules to most serious ones. In ascending order of severity, these include borderline questionable practices (HARKing [Hypothesizing After the Results are Known] and hyping), redundant publications, authorship misconducts, plagiarism, and all types of fraud (data falsification or fabrication). Awareness of all these fraudulent practices is essential to mitigate misconduct in academic writing.

Posters are an established mode of disseminating scientific research. They require careful preparation and presentation. During the former, the authors need to pay attention to the following features: choice of text, fonts and colors, illustrations and graphics, adequate presentation of methods and results, as well as to-the-point discussion of key messages. The latter is regrettably slightly neglected but very important. Indeed, poster presenters need to give a brief talk highlighting the research question and communicating the findings of the study, their novelty, and the anticipated clinical implications. In conclusion, practice is needed to create successful posters, but the result may be useful and pleasing.

This study aimed to examine the rates and risk factors for ipsilateral re-amputation in 121 patients with diabetic foot and prior amputation. Twenty-six (21.5%) patients required re-amputation during a mean follow-up of 18 months. Most re-amputations were performed within the first 6 months of the initial amputation. Re-amputation was more common among patients in whom the initial amputation had only affected one or two toes. Age (hazard ratio: 1.06) and heel lesions (hazard ratio: 2.69) were significantly associated with re-amputation. There is a high risk of re-amputation in the diabetic foot, especially within the first 6 months of the initial amputation, mainly due to poor selection of the original amputation level in an effort to save a greater part of the lower extremity. Patients 70 years and those with heel lesions are at greatest risk of re-amputation.

There is a need for quantitative investigations in the vascular laboratory to manage lower extremity ulcers. The majority of leg ulcers are of venous (45%-60%) or arterial origin (10%-20%). Despite the increasing complexity of new devices used in vascular surgical practice, the anklebrachial pressure index (ABPI) remains the cornerstone for the differential diagnosis of ischemic ulcers. The toe-brachial pressure index and the pole test represent attractive alternative tests especially in patients with diabetes. Color flow Doppler imaging (CFDI) is advantageous over ABPI in cases in which wounds and ulcers prevent the use of a cuff by virtue of their size or location; additionally CFDI technology can detect nonflow limiting lesions, lesions to nonaxial arteries such as the deep femoral artery, or lesions limited to a single tibial artery. Continued improvements in the accuracy of CFDI have prompted some vascular surgeons to replace contrast arteriography in distal bypass procedures. Transcutaneous partial oxygen tension measurement (TcPO2) is another noninvasive method that is reliable to select the level of amputation and recommended to determine tissue viability in critically ischemic limbs and in the management of the diabetic foot. CFDI has revolutionized the diagnostic approach to venous disorders and it is considered the gold standard for the assessment of the venous system of the lower limb, causes minimal inconvenience to patients, and is easily repeatable, but it is considered highly operator dependent. Various plethysmography techniques are of limited application in ulcer investigations, because of their difficulty to calibrate signal, unless time measurements such as the postexercise refilling time are used.

The diabetic foot represents one of the major complications of diabetes, posing a tremendous impact on morbidity and mortality. Overall, 1 out of 4 patients with diabetes runs the risk of developing a foot lesion throughout his or her life. Worldwide, the prevalence of the diabetic foot in population-based studies ranges between 1.4% and 5.9%. In Greece, this prevalence has been reported at 4.75%. Diabetic foot ulcers represent the main cause of amputations. Hence, both established and emerging treatment modalities should be diligently applied in an attempt to reduce ulcers and amputations. In Greece, Doupis et al reported that the majority of diabetic foot patients had neuropathic (64.9%) rather than neuroischemic ulcers (35.1%). By contrast, Skoutas et al reported 52.1% frequency of neuroischemic, 17.9% frequency of ischemic, and 30% frequency of neuropathic ulceration. The latter authors have suggested that the frequency of the neuroischemic foot is rising in Greece. Of note, there is some evidence of significantly greater age and longer diabetes duration, male preponderance, as well as increased morbidity among neuroischemic in comparison with neuropathic foot patients and significantly higher frequency of smoking, hypertension, dyslipidemia, retinopathy, nephropathy, and coronary artery disease. Very little is known on the frequency of amputations in Greece. Karagianni reported a prevalence of 12.5/1000 patients in 1999, equivalent to 2.48/10 000 general population, mean 10-year incidence of amputations (1990-1999) was 3.7/1000 patients per year, equivalent to 0.59/10 000 general population per year. It was also reported that amputees suffered a mortality of 56%, which represented a 3-fold increase compared with the general population. Above knee amputations were 18%, below knee 18%, foot 29%, and toe 35%; importantly, 15% of amputations were bilateral. Furthermore, revascularization was only attempted in a minority of those patients, whereas the majority was treated by general surgeons of district hospitals. Repeat amputations are also reported to be more frequent. Papazafiropoulou et al observed that patients with diabetes required a second amputation and a contralateral amputation significantly more frequently than their nondiabetic peers. Skoutas et al found that ipsilateral re-amputation was required in 21.5% of patients during a mean follow-up of 18 months, whereas most re-amputations were performed within the first 6 months of the initial operation, age (hazard ratio 1.06 by increase of 1 year) and heel lesions (hazard ratio 2.69) were significantly associated with ipsilateral re-amputations based on multiple regression analysis of the data. Paradoxically, an initial choice of distal amputation in an attempt to minimize tissue loss increased the risk of ipsilateral re-amputation, especially in older subjects (≥70 years). Revascularization procedures, which may be either bypass surgery or percutaneous transluminal angioplasty, appear not to be used enough, although data are sparse. In 1999, underuse of femorodistal bypass surgery and similar revascularization procedures in Greece was reported. Since then, considerable progress seems to have been made. There are now 14 vascular departments accredited for training and about 200 vascular surgeons in the country. Substantial progress has also been accomplished in interventional radiology facilities, resulting in increased number of angioplasties. However, actual data of this progress are not yet available. Of further significance, revascularization is possible in large cities, but remains little available in small hospitals, leading to substantial geographical variation. Infection of chronic foot ulcers represents a major problem, especially in the presence of ischemia. Methicillin-resistant Stapylococcus aureus (MRSA) is a notorious microorganism, whose prevalence is very high in patients with infected foot ulcers. It is also alarming that MRSA infection or colonization was not associated with known risk factors, reflecting its increased prevalence in the community. When conservative medical measures fail to heal, surgery offering either wound incision and drainage, or amputation should follow. However, there is a lack of unanimity concerning the optimal timing and aggressiveness for such intervention. Against this background, the improvement in the study of the diabetic foot in Greece that has taken place since 2005 is of some reassurance. It was in this, the year of the diabetic foot, that specialists established the Greek Association for the Study of the Diabetic Foot and the Study Group of Neuropathy–Diabetic Foot of the Greek Diabetes Association. Thanks to these societies, more than 10 scientific meetings on the diabetic foot, targeting both local and nationwide