On diabetic foot, wound healing, amputation prevention, and the merger of consumer tech with medical devices
At today's Malvern Diabetic Foot Conference, Georgetown psychiatrist Dan Powell, MD made the case for embedding behavioral health into wound healing and limb preservation programs — with Hopkins data showing a 3-day median reduction in length of stay when psychiatric consultation is proactive rather than reactive.
Field notes from Malvern, year 40. With thanks to @FranGame for the slide that should hang in every multidisciplinary clinic in the world. I came in this morning expecting another graceful walk through the National Diabetes Foot Care Audit dashboard. What I got instead was the most useful reframe I have heard in a long... Continue Reading →
A new Frontiers in Science Lead Article from Granados, Khanna, Fischer, and colleagues at King's College London — with Prokar Dasgupta as senior author — takes a swing at one of the harder questions in modern surgery. When the operating room becomes a sensorized, situationally aware ecosystem with embodied AI agents, robotic scrub assistants, and... Continue Reading →
Johann Georg Mönckeberg was a Hamburg patrician, born in 1877. His father — same name — was a senator of the free city, with the Mönckebergstrasse running from the Rathaus to the Hauptbahnhof named after him. The son grew up in a household where the name was already on the streets. He studied medicine at... Continue Reading →
A long-time friend's offhand observation in Bremen — that small artery disease is easy to see on an angiogram because it doesn't look like nature — leads to Mandelbrot, Murray's law, and a quantifiable complexity index for the diabetic foot.
Over dinner at EWMA-DEWU in Bremen with longtime collaborator and renowned biomechanist Prof. Sicco Bus, talk drifted from classification to language — and to why English insists on two words for the same hole in the body. A slow look at what wound vs. ulcer is silently encoding every time we write it down.
Gavish et al. flip photobiomodulation into a diagnostic stress test. With dynamic thermal imaging, DFUs warm by ~2.1 °C after PBM while venous ulcers barely budge — and colder DFUs respond most. A clean proof-of-concept for precision triage of chronic leg ulcers.
Google Scholar ticked over to 95,006 citations overnight. The number is real — the story behind it isn't mine. An h-index of 134 and an i10-index of 568 reflect 568 conversations between collaborators, residents, fellows, patients, and friends. A note on what citations actually are, why limb preservation is and always will be a team sport, and gratitude to everyone whose hand has been on the work.
An email from Ben Lipsky brings new biomarker data — IL-17, IL-12p70, HMGB1, IL-8, CRP — that may be the strongest case yet for splitting "moderate" and "severe" diabetic foot infections in the IDSA and WIfI classification.
A Pasadena startup lets you check your diabetes risk with a single smartphone eye photo and a few questions — no needles, no lab. The direction is right: move screening upstream, make it free, make it fast.
