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By Michel H.E. Hermans, MD

The 2014 SAWC Fall conference took place in October in Las Vegas. As always, it was good to see colleagues, share thoughts and stories, stroll through the exhibition areas and attend the lectures. As usual, the meeting was well organized although given the size of the Vegas hotels, reaching it—even from your room within the conference hotel itself—provided enough walking exercise for a week.

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By Michel H.E. Hermans, MD

We, the wound care community, are doing it wrong! We are using FDA approved, expensive diagnostics and treatments while the solution for your diabetic foot ulcers, pressure ulcers, full-thickness burns and keloid scars are on the web and cost peanuts in comparison to a visit to your doctor.

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By Michel H.E. Hermans, MD

The CDC recently published encouraging data in the New England Journal of Medicine about a decline in the rate of five major complications related to diabetes mellitus: hyperglycemia, heart attack, stroke, kidney failure and amputations1. The report did not include eye-related problems (i.e. retinopathy, glaucoma, cataract). The rate of amputations went down from approx. +/- 55/10.000 adults (1990) to +/-26/10.000 adults (2010). The 2010 numbers on amputations are roughly in line with a more recent publication by the Agency for Healthcare Research and Quality (AHRQ) which reported an expected (2014) amputation rate of 3.75/person-year for type II and 3.8 for type I (figure I).

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By Michel H.E. Hermans, MD

With a recent acute and serious vision problem, I have had to visit three ophthalmologists (all with different specialties) and a neurologist. I have undergone a series of tests, on the eyes as well as an MRI of the skull, brain and orbita, tests for the coagulatory system, atrial fibrillation and an ultrasound of the carotids.

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By Michel H.E. Hermans, MD

Merriam Webster defines bias as "selecting or encouraging one outcome or answer over others." The Cochrane handbook states: "The reliability of the results of a randomized trial depends on the extent to which potential sources of bias have been avoided."

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By Michel H.E. Hermans, MD

In the first part of this series on the challenges of conducting clinical trials in wound care, I discussed factors that include patient populations and lesion prevalence. Additional criteria and conditions of the clinical trial will be further examined in this blog.

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By Michel H.E. Hermans, MD

To do a Randomized Controlled Trial within a reasonable time frame, the disease to be studied should be common and the patient population large and accessible. In addition, preferably the effect of the treatment should be fast and specific.

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By Michel H.E. Hermans, MD

A recent article in Mayo Clinic's Proceedings studies contamination of stethoscopes. After a standardized physical examination, several parts of the physicians' hand were cultured and the results were compared to cultures of the stethoscope diaphragm and tube. As it turned out, fingertip contamination was highest but the diaphragm of the stethoscope showed a higher level than the thenar eminence of the physician's hand. The conclusion of the article stated that the stethoscope may play a serious role in cross contaminating patients.

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