BACKGROUND: Postoperative nausea and vomiting (PONV) in pediatric patients is a common and clinically significant postoperative complication. The incidence of PONV has not been extensively studied in large pediatric cohorts. Furthermore, in 2020, the Fourth Consensus Guidelines for the management of PONV were published. However, the association between perioperative factors and adherence to these guidelines remains unclear. This study aims to assess both the incidence of PONV and guideline adherence within a large and diverse pediatric population. METHODS: We conducted a retrospective observational study at a large tertiary medical center, including pediatric patients (≤18 years) who underwent surgery between September 2020 and March 2023. We conducted a retrospective analysis of data from our electronic health records, focusing on patient demographics, surgical details, anesthesia details, and prophylaxis for PONV. We calculated the incidence of PONV and used multivariable logistic regression to identify the predictors of guideline adherence. RESULTS: The cohort included 3772 patients with a median (interquartile range [IQR]) age of 9.21 (3.55-14.68) years. The incidence (95% confidence intervals) of early PONV was 1.0% (0.7-1.4) and 3.8% (3.2-4.5) for delayed PONV. Adherence to the fourth consensus guidelines for PONV management was observed in 32.5% (31.0-34.0) of cases. A high risk of PONV was identified in 55.9% (54.3-57.5) of the patients. The most common number of PONV risk factors was 3, observed in 1151 patients (30.5% [29.1-32.0]). Significant predictors of guideline adherence included the intraoperative use of long-acting opioids (odds ratio [OR], 2.711, P < .001) and age ≥3 years (OR, 2.074, P < .001). Nonadherence was associated with a higher incidence of PONV at 24 hours postsurgery (4.4% (3.6-5.2) vs 2.7% (1.9-3.8), P = .012). Factors such as specific high PONV risk surgeries ( P = .001), maintenance with inhalational agents solely ( P = .017), and neostigmine use ( P < .001) were also all statistically significant. CONCLUSIONS: Our study revealed a lower-than-expected incidence of PONV in pediatric patients, highlighting the need for standardized definitions and improved reporting. Adherence to PONV guidelines was suboptimal, emphasizing the need for better implementation strategies.

• MeSH
• Antiemetics therapeutic use   MeSH
• Child MeSH
• Guideline Adherence * standards   MeSH
• Incidence MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Postoperative Nausea and Vomiting * epidemiology   diagnosis   prevention & control   MeSH
• Child, Preschool MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Practice Guidelines as Topic standards   MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH

PURPOSE: Auditory complications are potential side effects from childhood cancer treatment. Yet, limited evidence exists about the impact of auditory complications-particularly tinnitus-on health-related quality of life (HRQoL) among childhood cancer survivors (CCS). We determined the prevalence of hearing loss and tinnitus in the European PanCareLIFE cohort of CCS and examined its effect on HRQoL. METHODS: We included CCS from four European countries who were diagnosed at age ≤ 18 years; survived ≥ 5 years; and aged 25-44 years at study. We assessed HRQoL (Short Form 36), hearing loss, and tinnitus using questionnaires. We used multivariable linear regression to examine associations between these two auditory complications and HRQoL adjusting for socio-demographic and clinical factors. RESULTS: Our study population consisted of 6,318 CCS (53% female; median age at cancer diagnosis 9 years interquartile range [IQR] 5-13 years) with median age at survey of 31 years (IQR 28-35 years). Prevalence was 7.5% (476/6,318; confidence interval [CI]: 6.9-8.2) for hearing loss and 7.6% (127/1,668; CI: 6.4-9.0) for tinnitus. CCS with hearing loss had impaired physical (coefficient [coef.] -4.3, CI: -7.0 to -1.6) and mental (coef. -3.2, CI: -5.5 to -0.8) HRQoL when compared with CCS with normal hearing. Tinnitus was associated with impaired physical (coef. -8.2, CI: -11.8 to -4.7) and mental (coef. -5.9, CI: -8.8 to -3.1) HRQoL. CONCLUSION: We observed reduced HRQoL among CCS with hearing loss and tinnitus. Our findings indicate timely treatment of hearing loss and tinnitus may contribute to quality of life of survivors. IMPLICATIONS FOR CANCER SURVIVORS: CCS who experience auditory complications should be counseled about possible therapeutic and supportive measures during follow-up care.

• MeSH
• Child MeSH
• Adult MeSH
• Cohort Studies MeSH
• Quality of Life * MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Neoplasms * complications   psychology   MeSH
• Hearing Loss * epidemiology   etiology   MeSH
• Child, Preschool MeSH
• Prevalence MeSH
• Cancer Survivors * psychology   MeSH
• Surveys and Questionnaires MeSH
• Tinnitus * etiology   epidemiology   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH

OBJECTIVES: To report the clinical outcomes of the VictoTM (Promedon, Cordoba, Argentina) adjustable artificial urinary sphincter (AUS) implantation in a cohort of patients with severe urinary incontinence (UI) after prostate surgery. PATIENTS AND METHODS: This study enrolled patients with UI following prostate surgery who underwent a Victo implantation between May 2018 and December 2023. Patients were prospectively evaluated at baseline, and at 3 and 12 months after device activation, and thereafter annually. The 24-h pad-weight test (24hPWT) was used to assess severity of UI, while the Patient Global Impression of Improvement (PGI-I) and patient satisfaction according to a Likert scale were used to measure patient-reported outcomes. RESULTS: A total of 96 patients with a median (interquartile range [IQR]) age of 68 (65-72) years were included in the final analysis. The median (IQR) follow-up was 3 (1-4) years. In all, 10 patients completed the 5-year follow-up. After the treatment, we observed a significant reduction in 24hPWT by the median of 83% (P < 0.001) at 3 months and by a median of 79% (P < 0.001) at 3 years. According to the PGI-I, a total of 87%, 92%, 87%, 81%, 83%, and 50% (five of 10) of patients rated their condition/incontinence as 'very much improved', 'much improved' or 'little improved' at 3 months, 1-, 2-, 3-, 4-, and 5-year follow-up visits, respectively. The proportion of patients, who were 'very satisfied' or 'satisfied' with the treatment outcome was 79%, 80%, 75%, 69%, 80%, and 60% (six of 10) at 3 months, 1-, 2-, 3-, 4-, and 5-years, respectively. There were a total of 13 (14%) device failures during the follow-up period. CONCLUSION: In conclusion, our data suggest that Victo AUS significantly reduces the severity of UI after prostate surgery and provides a reasonably high patient-reported satisfaction with treatment outcomes at mid-term follow-up.

• MeSH
• Urinary Incontinence * surgery   therapy   MeSH
• Middle Aged MeSH
• Humans MeSH
• Postoperative Complications MeSH
• Prospective Studies MeSH
• Prostatectomy * adverse effects   MeSH
• Aged MeSH
• Patient Satisfaction MeSH
• Urinary Sphincter, Artificial * MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH

Cíl: Cílem naší práce bylo popsat epidemiologickou situaci výskytu rotavirových gastroenteritid (RG) a vliv očkování na hospitalizaci pro RG v České republice (ČR) v letech 2018–2023. Metody: Byla provedena deskriptivní analýza anonymizovaných případů RG hlášených pod kódem A08.0 v systému pro hlášení infekčních onemocnění (ISIN) v České republice v letech 2018–2023. K analýze binárních proměnných byl použit chí-kvadrát test. Vliv očkování na hospitalizaci byl hodnocen pomocí logistické regrese s odds ratio (OR) a 95 % intervalu spolehlivosti. Použity byly programy Excel, STATA a Datawrapper GmbH. Incidence onemocnění byla přepočítána na 100 000 obyvatel. Výsledky: Ve sledovaném období bylo v ČR hlášeno celkem 26 303 případů RG (v rozmezí 1 811–7 483 ročně), což odpovídá průměrné roční incidenci 41,0 (rozmezí 16,9–69,6) na 100 000 obyvatel. Padesát jedna procent případů se vyskytlo u žen. Průměrná roční specifická incidence podle pohlaví byla srovnatelná. Případy se vyskytly u osob 0–101letých (medián 3 roky, mezikvartilové rozpětí [IQR] 1–8 let). Maximální počty případů byly zaznamenány v měsících březen až červen, přičemž v pandemických letech 2020 a 2021 byly celkové počty případů nižší, a tedy i sezonnost byla vyjádřena méně. Průměrná roční specifická incidence byla nejvyšší v krajích Vysočina, Jihočeském a Olomouckém. Hospitalizováno bylo 18 693 (71,1 %) případů RG, nejvíce případů ve věkové skupině 1–4 roky (34,7 %) a 5–9 let (11,9 %). Údaje o očkování byly dostupné pro 21 142 osob s RG, z nich 304 (1,4 %) osob bylo vykázáno jako očkováno. Riziko hospitalizace pro RG bylo u očkovaných osob statisticky významně nižší (p < 0,001) než u neočkovaných. Nahlášeno bylo celkem 27 epidemií RG, v největší bylo zaznamenáno 152 případů. Jako import bylo hlášeno 226 případů onemocnění. Závěr: Po zahájení očkování proti RG v ČR bylo očekáváno snížení počtu onemocnění, hospitalizací a úmrtí pro tato onemocnění. Nicméně významný dopad očkování na zátěž RG dosud v ČR pozorován není a domníváme se, že hlavním důvodem je nadále nízká proočkovanost proti RG v ČR. Doporučujeme proto zařadit toto dobrovolné očkování mezi očkování hrazená zdravotními pojišťovnami a zároveň apelujeme na časnou komunikaci vhodnosti očkování mezi praktickým lékařem pro děti a dorost a rodiči dětí.

Aim: To describe the epidemiological situation of rotavirus gastroenteritis (RVGE) and the impact of vaccination on hospitalization for RVGE in the Czech Republic in 2018–2023. Methods: A descriptive analysis was performed of anonymized RVGE cases reported under code A08.0 to the Infectious Diseases Reporting System (ISIN) in the Czech Republic in 2018–2023. The Chi-square test was used to analyse binary variables. The effect of vaccination on hospitalization was assessed using logistic regression with odds ratio (OR) and 95% confidence interval. Excel, STATA, and Datawrapper GmbH programs were used. The incidence of the disease was calculated per 100,000 population. Results: In the monitored period, a total of 26,303 RVGE cases were reported in the Czech Republic (range 1,811–7,483 per year), which corresponds to an average annual incidence of 41.0 (range 16.9–69.6) per 100,000 population. Fifty-one percent of cases occurred in women. The average annual sex-specific incidence rates were comparable. Patients were aged 0–101 years (median 3 years, interquartile range [IQR] 1–8 years). The maximum numbers of cases were recorded in the months of March to June. In the pandemic years 2020 and 2021, the overall numbers of cases were lower, and therefore the seasonality was less expressed. The average annual specific incidence was highest in the Vysočina, South Bohemian and Olomouc Regions. A total of 18,693 (71.1%) cases of RVGE were hospitalized, most of them in the age groups 1–4 years (34.7%) and 5–9 years (11.9%). Vaccination data were available for 21,142 individuals with RVGE, of whom 304 (1.4%) were reported as vaccinated. The risk of hospitalization for RVGE was statistically significantly lower (p < 0.001) in vaccinated than in unvaccinated individuals. A total of 27 RVGE outbreaks were reported, with the largest one involving 152 cases. Two hundred and twenty-six cases were classified as imported. Conclusions: After the introduction of RVGE vaccination in the Czech Republic, a reduction in RVGE cases, hospitalizations, and deaths was expected. However, a significant impact of vaccination on the RVGE burden has not yet been observed in the country. The main reason continues to be low RVGE vaccine coverage. We therefore recommend including this voluntary vaccination in the schedule covered by health insurance and also call for early communication of the appropriateness of such vaccination between the paediatric/adolescent medicine practitioners and children’s parents.

Background: Burns in children represent a significant public health issue due to their high frequency and potential for severe physical and psychological consequences. This study aims to describe the clinical characteristics of burns in hospitalized children and adolescents in the Republic of Srpska between 2018 and 2020. Methods: A multicenter retrospective study was conducted, collecting data from the national e-base of the Agency for Certification, Accreditation and Quality Improvement of Health Care of the Republic of Srpska for patients aged ≤19 years hospitalized for burns. ICD-10 codes were used to identify burns, from which demographic and clinical characteristics were extracted. Results: A total of 70 patients were identified, with a median age of 1 year [interquartile range (IQR3): 1-4 years]. The majority were children aged 0 to 9 years (84.3%), and 67.1% were boys. Most burns occurred during winter (34.3%), and the median hospital LOS was 6.5 days (IQR: 5-9 days). Scalds from hot liquids were the most common type (84.3%), primarily affecting the lower extremities (31.4%) and head and neck (25.7%). Statistically significant differences were observed in the causes of burns, affected anatomical regions, and age groups (p < 0.05). The burned body surface area ranged from less than 10% to 29% TBSA, with 61.4% having less than 10%, and no significant differences based on age, gender, or cause of hospitalization (p > 0.05). Conclusion: Burns from hot liquids and contact burns are the main causes of injuries in hospitalized children aged 1 to 4 years in the Republic of Srpska, highlighting the need for targeted prevention strategies.

• MeSH
• Child, Hospitalized * statistics & numerical data   MeSH
• Child MeSH
• Epidemiologic Studies MeSH
• Inpatients statistics & numerical data   MeSH
• Humans MeSH
• Adolescent MeSH
• Burns * epidemiology   etiology   pathology   MeSH
• Routinely Collected Health Data MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Multicenter Study MeSH
• Geographicals
• Serbia MeSH

We analyzed mucormycosis data from the Zygomyco.net registry (2009-2022), encompassing cases from 16 countries. India, Russia and the Czech Republic provided the largest contributions. India reported the highest case number, consistent with its substantially higher incidence compared to that of high-income countries. Among the 382 patients with mucormycosis, 236 (61.8%) were male (male-to-female ratio 1.6). The median age was 48 years [interquartile range (IQR) 32-60]. There were 59 pediatric patients (median age ranging from < 1 month to 19 years). Diabetes mellitus type 2 was the most common underlying condition (39%), with significant geographic variation (> 70% of cases in India and Iran but only 6.9% in Europe). Hematologic malignancies (HM, 31.4%), the second most common underlying condition, were absent in India and Iran. The primary clinical presentations were rhino-orbito-cerebral mucormycosis (ROCM, 36.6%), pulmonary (33.2%) and cutaneous mucormycosis (17.5%). Patients with diabetes mellitus typically developed ROCM (55.9%), while pulmonary infections were more common in those with HM or hematopoietic cell transplantation (HCT) (47.5%, p < 0.001). Rhizopus was the leading fungal genus (58%), followed by Lichtheimia (13.7%) and Mucor (7%), with regional variations. Pulmonary infections in HM patients were linked to L. corymbifera and R. microsporus, while Apophysomyces spp. and Saksenaea spp. were more frequent in Indian healthcare-associated cutaneous cases. Concomitant infections were observed in 8.7% of patients with HM, complicating diagnosis and treatment. In most of them (57.1%), Aspergillus spp. was involved. Improved diagnostic practices, including direct microscopy and cultures, showed higher positivity rates, although PCR remained underutilized. Antifungal therapy, primarily with an amphotericin B formulation, combined with surgery, was the most common therapeutic approach. Overall mortality was high (47.8%), particularly in disseminated or advanced ROCM cases. Multivariable analysis identified older age, advanced ROCM, and HM/HCT as independent mortality risk factors (p < 0.05); whereas localized sinusitis and combined medical and surgical therapy were independently associated with improved outcomes (p < 0.006). This study underscores regional disparities in the mucormycosis epidemiology and species distribution. Improved early detection is needed, particularly in immunocompromised populations with HM. Enhanced surveillance and tailored public health strategies are crucial to address this ongoing global health threat.

• MeSH
• Global Health MeSH
• Child MeSH
• Adult MeSH
• Incidence MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Mucormycosis * epidemiology   microbiology   drug therapy   MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Registries * MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH

OBJECTIVES: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short-,intermediate-, and long-term post-discharge complications among these patients. METHODS: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged. The primary outcome was the 3-month post-discharge IBD-related complication rates defined as steroid dependency, re-admissions (emergency department or hospitalization), IBD-related surgery, or mortality. We assessed post-discharge IBD-related complications within 6 month and mortality at 12 month among secondary outcomes. Risk factors for complication were assessed by multivariable logistic regression. RESULTS: In a cohort of 654 patients hospitalized for IBD {age 68.9 (interquartile range [IQR]): 63.9-75.2 years, 60.9% ulcerative colitis (UC)}, 23.4% were CDI-positive. Post-discharge complication rates at 3 and 6 months, and 12 months mortality, did not differ significantly between CDI-positive and CDI-negative patients (32% vs 33.1%, p = 0.8; 40.5% vs 42.5%, p = 0.66; and 4.6% vs 8%, p = 0.153, respectively). The Charlson comorbidity index was the only significant risk factor for complications within 3 months (aOR 1.1), whereas mesalamine (5-aminosalicylic acid [5-ASA]) use was protective (aOR 0.6). An UC diagnosis was the sole risk factor for complication at 6 months (aOR 1.5). Clostridioides difficile infection did not significantly impact outcomes or interact with IBD type. CONCLUSIONS: In elderly IBD patients hospitalized for IBD flare and subsequently discharged, a concurrent CDI infection was not associated with post-discharge IBD-related complications or mortality up to 1 year.

• MeSH
• Clostridioides difficile MeSH
• Hospitalization statistics & numerical data   MeSH
• Inflammatory Bowel Diseases * complications   MeSH
• Clostridium Infections * complications   epidemiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Patient Discharge MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Aged MeSH
• Symptom Flare Up MeSH
• Patient Readmission statistics & numerical data   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

OBJECTIVES: This case series evaluated the clinical efficacy of the novel "lateral approach" combined with an enamel matrix derivative (EMD) and bone grafting in the regenerative surgical treatment of intrabony defects associated with an edentulous ridge. MATERIAL AND METHODS: The innovative flap, called the "lateral approach," is explicitly designed for regeneration of unchallenged isolated intrabony defects associated with edentulous alveolar ridges. The flap is defined by a curved vertical incision on the buccal side opposite the treated defect and a sulcular incision on the buccal and defect-associated sides, promoting uneventful healing and regeneration while minimizing complications. Seven intrabony defects (one per patient) distal to the lower second molar were treated using the "lateral approach" combined with EMD and grafting with deproteinized bovine bone mineral. The primary outcome was clinical attachment level (CAL) change. As additional parameters, pocket probing depth (PPD) reduction and complication rate were analyzed. All the outcomes were assessed 6 months post-surgery and compared with the baseline values. RESULTS: Primary wound healing occurred in 100% of cases, and no complications were reported. At the 6-month re-evaluation, the initial median CAL of 6 mm (interquartile range 5-8 mm) was reduced to 3 mm (3-5 mm). The corresponding median PPD was reduced from 6 mm (IQR 6-8 mm) to 4 mm (IQR 3-5 mm). These differences were statistically significant (p < 0.05). CONCLUSIONS: The "lateral approach" is a technique for the surgical treatment of intrabony defects associated with the edentulous ridge. Within the limitations of the study, this method seems to be suitable for distal intrabony defects in the lower second molars, which frequently develop after third molar extraction.

• MeSH
• Alveolar Ridge Augmentation * methods   MeSH
• Jaw, Edentulous surgery   MeSH
• Surgical Flaps transplantation   MeSH
• Adult MeSH
• Wound Healing MeSH
• Bone Substitutes therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Prospective Studies MeSH
• Dental Enamel Proteins therapeutic use   MeSH
• Bone Regeneration MeSH
• Alveolar Bone Loss * surgery   MeSH
• Guided Tissue Regeneration, Periodontal methods   MeSH
• Aged MeSH
• Bone Transplantation methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: In relapsing-remitting multiple sclerosis (RRMS), extended exposure to high-efficacy disease modifying therapy may increase the risk of side effects, compromise treatment adherence, and inflate medical costs. Treatment de-escalation, here defined as a switch to a lower efficacy therapy, is often considered by patients and physicians, but evidence to guide such decisions is scarce. In this study, we aimed to compare clinical outcomes between patients who de-escalated therapy versus those who continued their therapy. METHODS: In this retrospective analysis of data from an observational, longitudinal cohort of 87,239 patients with multiple sclerosis (MS) from 186 centers across 43 countries, we matched treatment episodes of adult patients with RRMS who underwent treatment de-escalation from either high- to medium-, high- to low-, or medium- to low-efficacy therapy with counterparts that continued their treatment, using propensity score matching and incorporating 11 variables. Relapses and 6-month confirmed disability worsening were assessed using proportional and cumulative hazard models. RESULTS: Matching resulted in 876 pairs (de-escalators: 73% females, median [interquartile range], age 40.2 years [33.6, 48.8], Expanded Disability Status Scale [EDSS] 2.5 [1.5, 4.0]; non-de-escalators: 73% females, age 40.8 years [35.5, 47.9], and EDSS 2.5 [1.5, 4.0]), with a median follow-up of 4.8 years (IQR 3.0, 6.8). Patients who underwent de-escalation faced an increased hazard of future relapses (hazard ratio 2.36 and 95% confidence intervals [CI] [1.79-3.11], p < 0.001), which was confirmed when considering recurrent relapses (2.43 [1.97-3.00], p < 0.001). It was also consistent across subgroups stratified by age, sex, disability, disease duration, and time since last relapse. CONCLUSIONS: On the basis of this observational analysis, de-escalation may not be recommended as a universal treatment strategy in RRMS. The decision to de-escalate should be considered on an individual basis, as its safety is not clearly guided by specific patient or disease characteristics evaluated in this study.

• MeSH
• Adult MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Recurrence MeSH
• Multiple Sclerosis, Relapsing-Remitting * drug therapy   MeSH
• Retrospective Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH

Aim: To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM). Materials and Methods: Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records. Analyses were performed using parametric or nonparametric statistical tests for variables with normally or nonnormally distributed values, respectively. Comparisons of the qualitative data were performed using the chi-square test. Results: Seven hundred seventy-four patients with DM and CNO were included. The mean age at diagnosis of CNO was 54.5 ± 11.7 years, and the median (interquartile range (IQR)) diabetes duration at diagnosis of CNO was 15 (10-22) years. Among participants, 71.8% (n = 546) were male and 83.2% (n = 634) had T2DM. Neuropathy was present in 91.7% (n = 688), retinopathy in 60.2% (n = 452), and nephropathy in 45.2% (n = 337). Subjects with T1DM, compared to T2DM, were diagnosed with CNO at a younger age (46.9 ± 11.0 vs. 57.9 ± 10.2 years, p < 0.001), had longer diabetes duration (median value (IQR): 29.0 (21.0-38.0) vs. 14.0 (8.0-20.0) years, p < 0.001), and had more often microvascular complications (neuropathy, 95.2% in T1DM vs. 87.4% in T2DM, p = 0.006; retinopathy, 83.3% vs. 55.4%, p < 0.001; and nephropathy 67.5% vs. 40.5%, p < 0.001). Conclusions: CNO is predominant in males, occurs in long-standing DM, and is often accompanied by microvascular complications. People with T1DM, compared to those with T2DM, are affected at a younger age, have longer diabetes duration, and have more often microvascular complications.

• MeSH
• Diabetes Mellitus, Type 1 * epidemiology   complications   MeSH
• Diabetes Mellitus, Type 2 * epidemiology   complications   MeSH
• Diabetic Foot epidemiology   diagnosis   MeSH
• Diabetic Retinopathy epidemiology   MeSH
• Diabetic Neuropathies epidemiology   diagnosis   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Arthropathy, Neurogenic * epidemiology   MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH