Chronic leg ulcer is a strong predictor to determine the major cardiovascular events in diabetic patients with peripheral arterial disease in Thailand

2017 ◽  
Vol 38 (4) ◽  
pp. 461-470
Author(s):  
Rungrujee Kaweewan ◽  
Saritphat Orrapin ◽  
Natapong Kosachunhanun ◽  
Kiran Sony ◽  
Nimit Inpankaew ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Cardiovascular Events ◽  
Strong Predictor ◽  
Arterial Disease ◽  
Leg Ulcer ◽  
Diabetic Patients ◽  
Major Cardiovascular Events ◽  
Peripheral Arterial

Peripheral Arterial Disease in Non-Diabetic Patients is Associated with Worse Outcomes after LVAD Implantation

2021 ◽  
Vol 40 (4) ◽  
pp. S171-S172
Author(s):  
V.T. Truong ◽  
S. Shreenivas ◽  
I. Rajapreyar ◽  
M. Shah ◽  
R.J. Alvarez ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Peripheral Arterial

scholarly journals Perbandingan efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Angelica M. J. Wagiu ◽  
Richard M. Sumangkut ◽  
Heber B. Sapan ◽  
Louise A. J. Waworuntu
Keyword(s):  
Peripheral Arterial Disease ◽  
Proteus Mirabilis ◽  
Peracetic Acid ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Citrobacter Diversus ◽  
Peripheral Arterial ◽  
Topical Antimicrobial

Abstract: Diabetic ulcer is a condition of infection, ulceration, and or destruction of inner skin tissue related to neurological disorders and degrees of peripheral arterial disease (PAD) in diabetic patients. Diabetic ulcer is prone to infection due to decreased immune response, therefore, opportunistic microbes can become pathogens. Infection is sttill a serious problem in diabetic ulcer since the high cost and long duration of treatment lead to complicated neclected ulcer. This study aimed to obtain the present profile of microbes in diabetic ulcers and the effectivitveness of peracetic acid dan feracrylum in the treatment of diabetic ulcers. This was a descriptive analytical study. The ulcer degree was determined by using PEDIS criteria. Pus specimen was taken with a sterile technique using a transport media, cultured in the Baxtec machine, and the microbes were identified and further tested for sensitivity to peracetic acid dan feracrylum 1%. The results showed that of the 57 patients there were 36 females with a mean age of 58.77+ 9.077 years. Most of the patients (30 patients) had diabetic ulcers of 4th degree. The result of pus culture showed Gram negative Proteus mirabilis as the most frequent microbe (17.5%). The sensitivity test showed that 100% of 12 types of microbes, 83.3% of Citrobacter diversus, and 60% of Proteus mirabilis samples were sensitive to peracetic acid, meanwhile, all microbes were resistant to feracrylum 1% dan NaCl as controls,. Conclusion: Peracetic acid was more effective than feracrylum 1% as topical antimicrobial for diabetic ulcer.Keywords: diabetic ulcer, microbe, topical antimicrobial agentAbstrak: Ulkus diabetik adalah suatu kondisi adanya infeksi, ulserasi dan atau kerusakan jaringan kulit yang lebih dalam yang berhubungan dengan kelainan neurologik serta berbagai tingkatan peripheral arterial disease (PAD) pada penderita diabetes melitus (DM). Ulkus diabetik lebih mudah terinfeksi karena respons kekebalan tubuh penderita DM biasanya menurun, bahkan kuman oportunistik juga dapat menjadi patogen. Infeksi masih menjadi masalah yang paling serius dialami penderita ulkus diabetik oleh karena biaya pengobatan yang besar dan waktu perawatan yang lama sehingga ulkus sering dibiarkan terinfeksi dengan komplikasi tanpa perawatan adekuat. Penelitian ini bertujuan untuk memperoleh data terkini pola kuman penderita ulkus diabetik dan untuk mengetahui efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik. Jenis penelitian ini ialah deskriptif analitik. Derajat ulkus dinilai dengan kriteria PEDIS. Spesimen pus diambil secara steril dengan media transpor, ditanam dalam mesin Baxtec, kemudian dilakukan identifikasi kuman dan uji sensitivitas terhadap asam perasetik dan feracrylum 1%. Hasil penelitian memperlihatkan dari 57 penderita ulkus diabetik terbanyak ialah perempuan (36 penderita) dengan rerata usia 58,77+9,077 tahun. Sebagian besar ulkus diabetik (30 penderita) termasuk derajat 4. Hasil kultur memperlihatkan Proteus mirabilis (Gram negatif) yang tersering (17,5%). Hasil uji sensitivitas pola kuman memperlihatkan 100% sampel dari 12 jenis kuman, 83,3% dari Citrobacter diversus, dan 60% dari Proteus mirabilis sensitif terhadap asam perasetik, sedangkan terhadap feracrylum 1% dan NaCl sebagai kontrol, seluruh kuman telah resisten. Simpulan: Asam perasetik lebih efektif dibandingkan feracrylum 1% sebagai antimikroba topikal pada ulkus diabetik.Kata kunci: ulkus diabetik, mikroba, antimikroba topikal

Prevalence, incidence and progression of peripheral arterial disease in Asian Indian type 2 diabetic patients

2014 ◽  
Vol 28 (5) ◽  
pp. 627-631 ◽  
Author(s):  
Jayasheel Eshcol ◽  
Saravanan Jebarani ◽  
Ranjit Mohan Anjana ◽  
Viswanathan Mohan ◽  
Rajendra Pradeepa
Keyword(s):  
Peripheral Arterial Disease ◽  
Asian Indian ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Peripheral Arterial ◽  
Type 2 Diabetic

Abstract 20579: Chronic Kidney Disease is Associated With Increased Mortality and Major Adverse Cardiovascular Events in Patients With Peripheral Arterial Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Gregory G Westin ◽  
Ehrin J Armstrong ◽  
Debbie C Chen ◽  
John R Laird
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Peripheral Arterial Disease ◽  
Cardiovascular Events ◽  
Cox Model ◽  
Univariate Analysis ◽  
Arterial Disease ◽  
Major Adverse Cardiovascular Events ◽  
Ckd Stage ◽  
Peripheral Arterial

Introduction: Chronic kidney disease (CKD) is common in patients with peripheral arterial disease (PAD), but patients with severe CKD have been excluded from many trials and no objective performance goals exist for patients with PAD and CKD. We sought to analyze the association between severity of CKD and cardiovascular and limb-related outcomes among patients with PAD. Methods: We reviewed records of all patients at our institution who underwent lower extremity angiography between 2006 and 2013. We analyzed outcomes including mortality, major adverse cardiovascular event (MACE) rate, and major adverse limb event (MALE) rate according to clinical stage of CKD, determined by calculating each patient’s glomerular filtration rate using the Cockcroft-Gault equation. We used Cox proportional hazard modeling to account for covariates, along with Bonferroni correction for multiple comparisons. Results: Of 773 patients, 45% had CKD stage 3-5. The patients had a median age of 67, were 58% male, 51% diabetic, and 57% presented with critical limb ischemia (CLI). During a median follow-up time of 3.2 years, patients with higher stages of CKD had an increased rate of death (Figure 1, p<0.001). CKD stages 4 and 5 were significant predictors of mortality in a multivariate model (HR 3.2 and 2.4 vs. CKD 1, P<0.001 and P<0.01, respectively). An analysis of MACE by CKD stage demonstrated similar results (CKD 4 HR 2.2, p<0.01; CKD 5 HR 2.0, p<0.01). CKD stage also predicted MALE in a univariate analysis (p<0.01), driven by increased limb events among patients with CKD stage 5 (p<0.01). However, CKD stage did not demonstrate a significantly increased hazard of MALE in a multivariate Cox model. Conclusions: Patients with PAD who also have CKD have increased rates of adverse outcomes. This relationship seems to be more robust for major cardiovascular events and overall mortality than for major limb events. Future studies should investigate how management of PAD should differ for patients with CKD.

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