{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T21:58:34Z","timestamp":1765231114024,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T00:00:00Z","timestamp":1546905600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2019,1,8]]},"abstract":"<jats:p><jats:italic>Aims<\/jats:italic>. To evaluate the factors that predict reulceration beneath the hallux in people with a history of diabetic foot ulceration. <jats:italic>Methods<\/jats:italic>. A prospective study conducted between January 2012 and December 2014 was performed in a diabetic foot unit to assess the risk factors associated with hallux reulceration. Sixty patients with diabetic neuropathy and a history of previous ulcer were consecutively included. Sociodemographic factors and comorbidities plus the biomechanical and radiographic factors were obtained. Follow-up on participants was conducted every month, and they wore offloading therapeutic footwear and custom-made insoles. Hallux reulceration during the follow-up period was assessed as the main outcome measure in the study. <jats:italic>Results<\/jats:italic>. Patients were followed up during 29 (14.2-64.4) months. Twenty-nine patients (52%) developed a new ulceration: 9 patients (31%) in the hallux and 20 (69%) in other locations. Functional hallux limitus (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.005<\/mml:mn><\/mml:math>, 95% CI (2.097\u201373.128), HR 12.384) and increased body mass index (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.044<\/mml:mn><\/mml:math>, 95% CI (1.003-1.272), HR 1.129) were associated with the hallux ulceration-free survival time in the multivariate Cox model. <jats:italic>Conclusions<\/jats:italic>. Obesity and the presence of functional hallux limitus increase the probability of developing hallux reulceration in patients with diabetic neuropathy and a history of ulcers.<\/jats:p>","DOI":"10.1155\/2019\/9038171","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T19:14:15Z","timestamp":1546974855000},"page":"1-7","source":"Crossref","is-referenced-by-count":7,"title":["Predictors of Diabetic Foot Reulceration beneath the Hallux"],"prefix":"10.1155","volume":"2019","author":[{"given":"R. J.","family":"Molines-Barroso","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-0265","authenticated-orcid":true,"given":"J. L.","family":"L\u00e1zaro-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. V.","family":"Beneit-Montesinos","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. J.","family":"\u00c1lvaro-Afonso","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Garc\u00eda-Morales","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Garc\u00eda-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2002.00698.x"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2470"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.5.855"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12639"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2012.12.003"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(02)80081-3"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2004.11.0144"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(01)00187-8"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1177\/107110070402500605"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2014.08.006"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.7547\/0960189"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2008.07.025"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2009.07.005"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2255"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-9021"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2005.08.002"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.7547\/1010208"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-86-11-538"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199903000-00009"},{"year":"2015","key":"23"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2253"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12202"},{"key":"26","doi-asserted-by":"publisher","DOI":"10.7547\/0980236"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.7.1036"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2018.02.012"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1330"}],"container-title":["Journal of Diabetes Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/jdr\/2019\/9038171.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jdr\/2019\/9038171.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jdr\/2019\/9038171.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,3,7]],"date-time":"2019-03-07T18:34:01Z","timestamp":1551983641000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/jdr\/2019\/9038171\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,8]]},"references-count":29,"alternative-id":["9038171","9038171"],"URL":"https:\/\/doi.org\/10.1155\/2019\/9038171","relation":{},"ISSN":["2314-6745","2314-6753"],"issn-type":[{"type":"print","value":"2314-6745"},{"type":"electronic","value":"2314-6753"}],"subject":[],"published":{"date-parts":[[2019,1,8]]}}}