Search

Direct and indirect costs of diabetes and its complications figure prominently in health care expenditure globally. The diabetic foot is one of the most common complications of diabetes and is usually associated with neurological and peripheral vascular problems, yielding foot ulcers and infection. The aim of this study was to analyze hospitalized diabetic foot patient costs and amputation rate changes over time. Hospitalized patients with infected diabetic foot ulcerations within a 4-year span, starting in January 2012, were retrospectively evaluated to analyze cost and amputation rate changes over time. One hundred thirty-eight diabetic patients were hospitalized and treated. Major amputation rates tended to increase; however, minor amputation rates tended to decrease over time. Mean cost per patient was $2880. The distribution of the costs according to the years was not significant. Treatment of infected diabetic foot ulceration is challenging and incurs high healthcare costs. Through intensive foot care and multidisciplinary team approaches, major amputation rates have gradually increased in recent years.

Adult onset Still's disease is a rare systemic inflammatory disease of unknown origin. It is common to involve liver and spleen, and less often lungs. A 24-year-old man presenting with spiking fever, pulmonary infiltrations, and pleural effusion on the right side mimicking pneumonia. All serologic tests of infectious causes, antinuclear antibody, and rheumatoid factor were negative. He was diagnosed as Adult onset Still's disease according to the criteria of Yamaguchi. Adult onset Still's disease is considering in the differential diagnosis pneumonia that is unresponsive to antimicrobial treatment, negative cultures and serologically diagnostic laboratory tests, and high-level serum ferritin.