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Diabetes AND Ulcers

Halimeh Hassanzadeh, Maryam M Matin, Hojjat Naderi-Meshkin, Hamid Reza Bidkhori, Mahdi Mirahmadi, Mahmood Raeesolmohaddeseen, Nasser Sanjar-Moussavi, Ahmad Reza Bahrami
Recent advances in wound healing have made cell therapy a potential approach for the treatment of various types of skin defects such as trauma, burns, scars and diabetic leg ulcers. Cultured keratinocytes have been applied to burn patients since 1981. Patients with acute and chronic wounds can be treated with autologous/allograft cultured keratinocytes. There are various methods for cultivation of epidermal keratinocytes used in cell therapy. One of the important properties of an efficient cell therapy is the preservation of epidermal stem cells...
August 13, 2018: Cell and Tissue Banking
Hsien-Yen Chang, Sonal Singh, Omar Mansour, Sheriza Baksh, G Caleb Alexander
Importance: Results of clinical trials suggest that canagliflozin, a sodium-glucose cotransporter 2 (SGLT-2) inhibitor for treating type 2 diabetes, may be associated with lower extremity amputation. Objective: To quantify the association between the use of oral medication for type 2 diabetes and 5 outcomes (lower extremity amputation, peripheral arterial disease, critical limb ischemia, osteomyelitis, and ulcer). Design, Setting, and Participants: A retrospective cohort study was conducted using Truven Health MarketScan Commercial Claims and Encounters data on new users between September 1, 2012, and September 30, 2015...
August 13, 2018: JAMA Internal Medicine
Minfeng Wu, Yan Li, Dongjie Guo, Gang Kui, Bin Li, Yu Deng, Fulun Li
Chronic ulcer, including diabetic ulcer, varicose ulcer, and pressure ulcer, negatively affects patients' quality of life. As microbiology plays an important role in the mechanism of pathology for chronic wound healing, this study concentrates on microecology environment of the wound and how Traditional Chinese Medicine (TCM) regulates wound bacteria. Method . The study took wound samples from 35 patients and analyzed bacteria variation before and after TCM treatment by 16s rRNA sequencing. All samples were evaluated from aspects of α -diversity, β -diversity, and Simpson's Diversity index...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
C V Loupa, E Meimeti, E Voyatzoglou, A Donou, E Koutsantoniou, S Lafoyanni
BACKGROUND: Diabetic foot ulcer (DFU) is a common complication in patients with diabetes mellitus (DM) and can consequently lead to soft tissue infection and osteomyelitis. CASE PRESENTATION: We present a case of a 68-year-old man with a history of Type 2 DM and symptomatic peripheral artery disease, referred to our hospital due to an infected lower extremity DFU. Cultures revealed methicillin-resistant Staphylococcus aureus and Stenotrophomonas maltophilia. There was a significant increase of inflammatory marker levels and plain X-rays revealed osteomyelitis...
August 13, 2018: BMC Research Notes
F Crawford, G Cezard, M Chappell
AIMS: Diabetes guidelines recommend screening for the risk of foot ulceration but vary substantially in the underlying evidence base. Our purpose was to derive and validate a prognostic model of independent risk factors for foot ulceration in diabetes using all available individual patient data from cohort studies conducted worldwide. METHODS: We conducted a systematic review and meta-analysis of individual patient data from 10 cohort studies of risk factors in the prediction of foot ulceration in diabetes...
August 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Shih-Chi Wu, William Tzu-Liang Chen, Chih-Hsin Muo, Chung Y Hsu
OBJECTIVES: Hepatic parasympathetic nerves branch off the vagus nerve. The vagal and hepatic nervous systems are important in liver physiological processes and some diseases such as diabetes, obesity and liver cirrhosis. We were interested in vagal nerve integrity and subsequent diseases in peptic ulcer patients. Herein, we used National Health Insurance database in Taiwan and retrospectively assessed the risk of developing liver cirrhosis in peptic ulcer patients with and without complications by surgical treatments...
August 12, 2018: Journal of Gastroenterology and Hepatology
Huidi Tchero, Pauline Kangambega, Lazarre Noubou, Beatrice Becsangele, Fluieraru Sergiu, Luc Teot
Diabetic foot infection is a common diabetic complication that may end in lower limb amputation if not treated properly. We performed this systematic review to assess the clinical efficacy of different antibiotic regimens, whether systemic or topical, in the treatment of moderate to severe diabetic foot infections. We searched Medline, Web of Science, SCOPUS, Cochrane CENTRAL and ScienceDirect for randomized controlled trials that evaluated the efficacy of antibiotic regimens in moderate to severe diabetic foot infections...
August 12, 2018: Wound Repair and Regeneration
Jocelyn Lu, Michael V DeFazio, Chrisovalantis Lakhiani, Michel Abboud, Morgan Penzler, Tammer Elmarsafi, Paul J Kim, Christopher E Attinger, Karen K Evans
BACKGROUND:  Recent evidence documenting high success rates following microvascular diabetic foot reconstruction has led to a paradigm shift in favor of more aggressive limb preservation. The primary aim of this study was to examine reconstructive and functional outcomes in patients who underwent free tissue transfer (FTT) for recalcitrant diabetic foot ulcers (DFUs) at our tertiary referral center for advanced limb salvage. METHODS:  Between June 2013 and June 2016, 29 patients underwent lower extremity FTT for diabetic foot reconstruction by the senior author (K...
August 12, 2018: Journal of Reconstructive Microsurgery
S Borys, J Hohendorff, T Koblik, P Witek, A H Ludwig-Slomczynska, C Frankfurter, B Kiec-Wilk, M T Malecki
PURPOSE: Negative pressure wound therapy (NPWT) is an adjunct method used in the treatment of diabetic foot ulceration (DFU). Real world data on its effectiveness and safety is scarce. In this prospective observational study, we assessed the short-term efficacy, safety, and long-term outcomes of NPWT in patients with type 2 diabetes (T2DM) and neuropathic, noninfected DFUs. METHODS: Based on wound characteristics, mainly area (>1 vs. ≤1 cm2 ), 75 patients with DFUs treated in an outpatient clinic were assigned to NPWT (n = 53) or standard therapy (n = 22)...
August 11, 2018: Endocrine
Biplab Giri, Sananda Dey, Tanaya Das, Mrinmoy Sarkar, Jhimli Banerjee, Sandeep Kumar Dash
Chronic exposure of glucose rich environment creates several physiological and pathophysiological changes. There are several pathways by which hyperglycemia exacerbate its toxic effect on cells, tissues and organ systems. Hyperglycemia can induce oxidative stress, upsurge polyol pathway, activate protein kinase C (PKC), enhance hexosamine biosynthetic pathway (HBP), promote the formation of advanced glycation end-products (AGEs) and finally alters gene expressions. Prolonged hyperglycemic condition leads to severe diabetic condition by damaging the pancreatic β-cell and inducing insulin resistance...
August 8, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Charles E Ananian, Yadwinder S Dhillon, Carl C Van Gils, D Craig Lindsey, Raymond J Otto, Cyaandi R Dove, Jessica T Pierce, Molly C Saunders
Randomized controlled clinical trials (RCTs), the gold standard to determine treatment efficacy against control, have demonstrated advantages of skin substitutes for the treatment of chronic diabetic foot ulcers (DFUs) in comparison to standard of care (SOC). However, RCTs comparing efficacy between 2 or more skin substitutes are very limited. With growing numbers of new skin substitutes, such studies are essential for treatment and policy-making decisions by wound care providers and payers. In this study, we analyzed clinical outcomes and product cost between a viable cryopreserved placental membrane (vCPM) and a human fibroblast-derived dermal substitute (hFDS) for the treatment of chronic DFUs in a prospective, multicenter, single-blind study...
August 11, 2018: Wound Repair and Regeneration
B Saka, A E Abilogoun-Chokki, S Akakpo, J Teclessou, G W Soga, G Mahamadou, W Gnassingbe, A Mouhari-Toure, K Kombate, E D Dosseh, V P Pitche
The aim of this study was to document the profile and causes of chronic leg ulcers (CLU) in patients hospitalized in Lomé, Togo. This retrospective study reviewed records from the dermatology departments (CHU Sylvanus Olympio and Campus, and the dermatology center of Gbossimé) from 2000 to 2017 and from the general surgery department of CHU Sylvanus Olympio from 2013 to 2017 to identify cases. In all, 125 cases of CLU were identified during the study period. The patients' mean age was 56.6 years and the sex ratio (M/F) was 0...
August 8, 2018: Médecine et Santé Tropicales
R Herring, D Russell-Jones
Despite advances in insulin analogues and monitoring, and changes in insulin delivery, Type 1 diabetes is still difficult to control. It can result in significant short- and long-term adverse health effects including renal failure, blindness, early cardiovascular disease and foot ulceration. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have potential benefit as an adjunct treatment in people not achieving adequate glycaemic control with insulin alone. This article is protected by copyright. All rights reserved...
August 8, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Rania Indu, Anjan Adhikari, Indira Maisnam, Piyali Basak, Tapas Kumar Sur, Anup Kumar Das
Purpose/Aim: Diabetes mellitus is associated with several comorbid conditions. Thus, often, diabetic patients are prescribed multiple drugs. Although multiple drugs help to combat various diseases, they also increase the propensity of drug interactions and adverse drug reactions. The present study thus tried to evaluate the comorbid conditions and concurrent medications associated with type 2 diabetic patients. It also aimed to address patient compliance for the medications provided to them...
July 2018: Perspectives in Clinical Research
Olga Kashpur, Avi Smith, Behzad Gerami-Naini, Anna G Maione, Rossella Calabrese, Ana Tellechea, Georgios Theocharidis, Liang Liang, Irena Pastar, Marjana Tomic-Canic, David Mooney, Aristidis Veves, Jonathan A Garlick
Diabetic foot ulcers (DFUs) are a major complication of diabetes, and there is a critical need to develop novel cell- and tissue-based therapies to treat these chronic wounds. Induced pluripotent stem cells (iPSCs) offer a replenishing source of allogeneic and autologous cell types that may be beneficial to improve DFU wound-healing outcomes. However, the biologic potential of iPSC-derived cells to treat DFUs has not, to our knowledge, been investigated. Toward that goal, we have performed detailed characterization of iPSC-derived fibroblasts from both diabetic and nondiabetic patients...
August 8, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Birendra Kumar Paikra, Hemant Kumar J Dhongade, Bina Gidwani
Moringa oleifera Lam . or munga is one of the most important plant widely cultivated in India. It belongs to family Moringaceae. This plant is widely used as nutritional herb and contains valuable pharmacological action like anti-asthmatic, anti-diabetic, hepatoprotective, anti-inflammatory, anti- fertility, anti-cancer, anti-microbial, anti-oxidant, cardiovascular, anti-ulcer, CNS activity, anti-allergic, wound healing, analgesic, and antipyretic activity, Moringa oleifera Lam . The plant is also known as Horse - radish tree, Drumstick tree...
September 2017: Journal of Pharmacopuncture
Roberto Ferraresi, Andrea Casini, Maurizio Caminiti, Fabrizio Losurdo, Giacomo Clerici
The diabetic foot represents one of the most dangerous complications of diabetic disease, and it is characterized by the presence of infection, ulceration, or necrosis of the foot tissues associated with various degrees of neuropathy or ischemia. If not correctly and promptly treated, it leads to high rates of major amputations. Although in Italy diabetics are about 5% of the population, more than 50% of major amputations are performed in diabetic patients. Compared to non-diabetic patients, diabetic peripheral artery disease localizes more distally, mostly in the below-the-knee vessels, is typically bilateral with multi-level involvement, and presents earlier onset and more aggressive course...
September 2018: Giornale Italiano di Cardiologia
Guifang Shi, Wenting Chen, Yu Zhang, Xiaomei Dai, Xinge Zhang, Zhongming Wu
The patients with diabetic wounds have deficient local and systemic cellular immunity. Herein, a new silver nanoparticles-contained hydrogel with antifouling property was developed for enhancing immune response in diabetic wound healing. The antifouling property was obtained by adjusting the composition of cationic chitosan and anionic dextran to approach to zero charge. Furthermore, this hybrid hydrogel showed long-lasting and broad-spectrum antibacterial activity. The rapid wound contraction was observed after the treatment of hydrogel, which suggested its superior healing activity to promote fibroblast migration, granulation tissue formation and angiogenesis...
August 7, 2018: Langmuir: the ACS Journal of Surfaces and Colloids
Sivakamasundari Pichu, Selvaraj Vimalraj, Jayalalitha Sathiyamoorthy, Vijay Viswanathan
Hypoxia inducible factor 1 alpha (HIF-1α) is a key regulator of the genes involved in the cellular response to hypoxia. This study aims to determine the HIF-1α gene polymorphism and its association with protein expression in diabetic subjects with and without diabetic foot ulcers (DFU). A total of 529 patients with T2DM (N = 185), DFU (N = 199) and Control (N = 145) were accounted for the study. PCR-RFLP experiment was carried out in order to find the allelic and genotypic comparison of HIF-1α gene in various groups of patients...
August 4, 2018: International Journal of Biological Macromolecules
Alessandro Mantovani, Ilaria Teobaldi, Vincenzo Stoico, Fabrizia Perrone, Marina Zannoni, Luca Cima, Massimiliano Bruti, Lucia Mingolla, Maddalena Trombetta, Enzo Bonora
After basal cell carcinoma, the cutaneous squamous cell carcinoma (cSCC) is the second most frequent non-melanoma skin cancer worldwide, and, classically, arises from the upper coats of the epidermis of sun-exposed areas or from skin areas constantly exposed to a chronic inflammatory stimulus. The occurrence of cSCC seems to be linked to several factors, including exposure to sunlight (or other ultraviolet radiations), immunosuppression, chronic scarring conditions and some familial cancer syndromes. Although the majority of cSCCs are adequately eradicated by surgical excision, a subgroup of cSCC may be linked with an increased risk of recurrence, metastasis and death...
2018: Endocrinology, Diabetes & Metabolism Case Reports
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