scholarly journals Morphometric Analysis of Connective Tissue Sheaths of Sural Nerve in Diabetic and Nondiabetic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Braca Kundalić ◽  
Slađana Ugrenović ◽  
Ivan Jovanović ◽  
Natalija Stefanović ◽  
Vladimir Petrović ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Sural Nerve ◽  
Nerve Fibers ◽  
Diabetic Group ◽  
Control Group ◽  
Peripheral Vascular ◽  
Disease Group ◽  
Imagej Software

One of the most common complications of diabetes mellitus is diabetic neuropathy. It may be provoked by metabolic and/or vascular factors, and depending on duration of disease, various layers of nerve may be affected. Our aim was to investigate influence of diabetes on the epineurial, perineurial, and endoneurial connective tissue sheaths. The study included 15 samples of sural nerve divided into three groups: diabetic group, peripheral vascular disease group, and control group. After morphological analysis, morphometric parameters were determined for each case using ImageJ software. Compared to the control group, the diabetic cases had significantly higher perineurial index (P<0.05) and endoneurial connective tissue percentage (P<0.01). The diabetic group showed significantly higher epineurial area (P<0.01), as well as percentage of endoneurial connective tissue (P<0.01), in relation to the peripheral vascular disease group. It is obvious that hyperglycemia and ischemia present in diabetes lead to substantial changes in connective tissue sheaths of nerve, particularly in peri- and endoneurium. Perineurial thickening and significant endoneurial fibrosis may impair the balance of endoneurial homeostasis and regenerative ability of the nerve fibers. Future investigations should focus on studying the components of extracellular matrix of connective tissue sheaths in diabetic nerves.

Cerebrovascular CO2Reactivity during Anesthesia in Patients with Diabetes Mellitus and Peripheral Vascular Disease 

1998 ◽  
Vol 89 (4) ◽  
pp. 887-893 ◽  
Author(s):  
Ryuichi Kawata ◽  
Kazuhiko Nakakimura ◽  
Mishiya Matsumoto ◽  
Kouji Kawai ◽  
Mitsuru Kunihiro ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Carbon Dioxide ◽  
Blood Flow ◽  
Vascular Disease ◽  
Flow Velocity ◽  
Peripheral Vascular Disease ◽  
Blood Flow Velocity ◽  
Control Group ◽  
Peripheral Vascular ◽  
Carbon Dioxide Reactivity

Background Diabetes mellitus (DM) and systemic atherosclerosis are risk factors for stroke. Although the origins of increased risk are complex, one possibility is that cerebrovascular reactivity is impaired and does not allow the brain to compensate for aberrations in physiology. The current study tested this issue by evaluating mean blood flow velocity of the middle cerebral artery (Vmca) and carbon dioxide reactivity during anesthesia in patients with DM and peripheral vascular disease (PVD). Methods Fifty-two patients were observed: 20 patients with DM (the DM group), 12 patients with PVD (the PVD group), and 20 patients classified as American Society of Anesthesiologists physical status 1 or 2 (the control group). The Vmca was measured using transcranial Doppler ultrasonography during isoflurane-nitrous oxide anesthesia. After measuring baseline Vmca at a partial pressure of carbon dioxide in arterial blood (PaCO2) of 37.7 +/- 4.5 mmHg (mean +/- SD), measurements were repeated at a PaCO of 44.2 +/- 3.8 mmHg, and the carbon dioxide reactivity (absolute value: cm x s(-1) x mmHg(-1); relative value: percentage of baseline Vmca/mmHg) was calculated. Results The baseline Vmca of the DM group (51 +/- 12 cm/s) was significantly greater than those of the control group (42 +/- 6 cm/s) and the PVD group (42 +/- 13 cm/s). The absolute and relative values of carbon dioxide reactivity in the DM group (3.1 +/- 1.3 cm x s(-1) x mmHg(-1); 6.3 +/- 2.4%/mmHg) were significantly greater than or equivalent to those of the control group (2.3 +/- 0.8 cm x s(-1) x mmHg(-1); 5.3 +/- 1.7%/mmHg), respectively. In the PVD group, the baseline Vmca was equivalent to the control group, but the carbon dioxide reactivity (1.1 +/- 0.5 cm x s(-1) x mmHg(-1) 2.8 +/- 1.2%/mmHg) was significantly less. Conclusions The patients with DM have increased baseline cerebral blood flow velocity and normal carbon dioxide reactivity during anesthesia. The patients with PVD have decreased carbon dioxide reactivity, but baseline flow velocity is maintained.

scholarly journals Olive oil- and fish oil-enriched diets modify plasma lipids and susceptibility of LDL to oxidative modification in free-living male patients with peripheral vascular disease: the Spanish Nutrition Study

1999 ◽  
Vol 82 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Carmen Ramírez-Tortosa ◽  
Jose M. López-Pedrosa ◽  
Antonio Suarez ◽  
Eduardo Ros ◽  
José Mataix ◽  
...  
Keyword(s):  
Fish Oil ◽  
Olive Oil ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Dietary Intervention ◽  
Plasma Lipids ◽  
Reference Group ◽  
Oxidative Modification ◽  
Control Group ◽  
Peripheral Vascular

The present study describes a clinical trial in which Spanish patients suffering from peripheral vascular disease (Fontaine stage II) were given specific lipid supplements. Designed as a longitudinal intervention study, patients were provided with olive oil for 3 months, followed by a 3 month wash-out period, then supplemented with a combination of fish oil and olive oil for the final 3 months. Changes in plasma and lipoprotein fatty acid composition and susceptibility of LDL toin vitrooxidation were examined. Furthermore, lipid-supplement-induced changes in LDL properties were measured as relative electrophoretic mobility and macrophage uptake. In addition, thirteen patients not provided with olive oil and fish oil were included as a control group and twenty healthy age-matched individuals were used as a reference group. A complete clinical study and a nutritional survey concerning food habits and lifestyle were performed every 3 months. Yao indices and claudicometry did not change significantly with dietary intervention although changes in plasma lipid composition suggested an improvement in the condition of the patients. The intake of the fish-oil supplement resulted in significantly increased plasma levels of eicosapentaenoic acid (20:5n−3) and docosahexaenoic acid (22:6n−3) in comparison with baseline concentrations, olive-oil and control groups. Fish-oil consumption significantly decreased plasma triacylglycerol levels compared with the olive-oil period, control and reference groups. The susceptibility of LDL to Cu-mediated oxidation was lower in the patients consuming olive oil and the fish-oil supplement than in the control group, and the uptake of LDL by macrophages was significantly lower in the group supplemented with fish oil. In conclusion, consumption of olive oil together with a dietary supplement of fish oil may be useful in the nutritional management of patients suffering from peripheral vascular disease in terms of increasing plasman−3 long-chain polyunsaturated fatty acids and decreasing susceptibility of LDL to oxidation.

HYPOCHLOROUS ION BASED DRESSING: THROWBACK TO THE SURGEONS’ CHOICE

2021 ◽  
pp. 273-276
Author(s):  
Manikantha G ◽  
Hemant Muktaram Jawale ◽  
Akshat Awdhesh Kumar Mishra ◽  
Amarjeet E Tandur ◽  
Pratik J Agrawal
Keyword(s):  
Vascular Disease ◽  
Surface Area ◽  
Peripheral Vascular Disease ◽  
Pressure Ulcer ◽  
Normal Saline ◽  
Tertiary Care ◽  
Care Facility ◽  
Control Group ◽  
Wound Surface ◽  
Peripheral Vascular

1.1 BACKGROUND : As per Robbin's pathology(Robbins & Cotran Pathologic Basis of Disease - 10th Edition, n.d.) "an ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing out of inamed necrotic tissue." In an era of modern-day fast track surgery and premier practices of medicine, management of wound remains an archaic, almost omnipresent challenge to a health care provider mediating the need for solutions. The hunt for an optimum dressing agent has been everlasting, one of which is our point of discussion in this study. The addition of Chlorine(Cl2) to Water(H2O) gives rise to Hypochlorous ion, a weak acid that has been used traditionally as disinfectant, sterilizer and beaches. These properties can be utilised for wound disinfection and swifter wound healing. 1.2 AIMS AND OBJECTIVES: Ÿ To study the efcacy of Hypochlorous ion-based dressing over traditional normal saline based dressing . Ÿ To study the effects factoring in various associated comorbidities in patients such as Diabetes Mellitus, Peripheral Vascular Disease, Trauma and Pressure Ulcer. 1.3 METHODOLOGY: A comparative study was conducted in a tertiary care facility in India that included 101 patients who were distributed randomly utilizing computerised algorithms into study and control group. The control group received daily normal saline dressing whereas the study group underwent daily hypochlorous ion-based dressing. The subjects were analysed after 4 weeks and evaluated for decrease in wound surface area and improvement of wound quality and tabulated for analysis. 1.4 CONCLUSION: Hypochlorous ion based daily dressing shows signicant reduction in wound surface area as well as signicantly better and faster improvement in the quality of wound in patients of Traumatic, Diabetic and Pressure Ulcer whereas the results in patients suffering from Peripheral Vascular Disease were equivocal.

scholarly journals Comparison of negative pressure wound therapy with moist wound therapy in the treatment of diabetic foot ulcers with non-revascularisable peripheral vascular disease

2017 ◽  
Vol 4 (7) ◽  
pp. 2173
Author(s):  
Someshwara Rao Narayana Pallela ◽  
Padmavathi Narahari
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Wound Therapy

Background: Diabetic foot problems are the commonest reason for hospitalization of diabetic patients (about 30% of admissions) and absorb some 20% of the total health-care costs of the disease more than all other diabetic complication. The numbers of patients with chronic wounds and wound complications continues to increase. Wound management is a challenge in diabetic wound. Chronic wounds require significant medical, nursing and financial input with poor long-term results. One-third of all diabetic patients have significant peripheral neuropathy and/or peripheral vascular disease (PVD). In India prevalence of foot ulcers in diabetic patients in clinic population is 3%. Over the past several years negative pressure wound therapy (NPWT) using vacuum- assisted closure has emerged as the treatment of complex wounds of the diabetic foot. Many reports on the use of Vacuum Assisted Closure (VAC) therapy after failed revascularization have found increased chances of success. Clinicians should consider negative pressure wound therapy as an adjunct to other modalities in an effort to avoid complications.Methods: Total of 51 patients were included in this prospective study. They were randomly divided into two groups, negative pressure wound therapy (NPWT) group (25 patients) and control group (26 patients) who were treated with regular dressings. All the patients included had peripheral vascular disease which was declared non-revascularisable after vascular workup. Initial mean surface area was measured in each patient. Transcutaneous oxygen pressure was recorded in all the patients and each patient followed up based on their granulation tissue development and need for amputation in each group.Results: After wound management, mean surface area of the diabetic wounds was 39.08cm2 in the NPWT group (P=0.019), and 38.63cm2 in the control group (P=0.327). The use of NPWT may be an effective initial wound therapy to achieve faster wound bed granulation showing signs of healing in 19 among 25 patients (76%) compared to control group 7 showed granulation among 26 patients (26%) (P=0.001). The incidence of secondary higher amputation in NPWT group is 6/25 (24%), the control group 17/26 (65%) (P=0.003), suggesting reduced incidence of secondary higher amputations in NPWT group. After treatment, the experimental group significantly improved in measures of foot ulcer surface area compared with the control group. Further studies are needed to clarify the effects and indications and to modify the technique of this alternative treatment for use on non healing wounds.Conclusions: NPWT-treated patients reached a successful wound treatment endpoint more rapidly, and the benefit was apparent in all wound sizes. NPWT appears to be a safer and efficacious method, than moist wound therapy for the treatment of diabetic foot ulcers. 

Tests for Platelet Changes, Acute Phase Reactants and Serum Lipids in Diabetes mellitus and Peripheral Vascular Disease

1982 ◽  
Vol 48 (03) ◽  
pp. 289-293 ◽  
Author(s):  
B A van Oost ◽  
B F E Veldhuyzen ◽  
H C van Houwelingen ◽  
A P M Timmermans ◽  
J J Sixma
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Acute Phase ◽  
Serum Lipids ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Acute Phase Reactants ◽  
Control Subjects ◽  
And Control

SummaryPlatelets tests, acute phase reactants and serum lipids were measured in patients with diabetes mellitus and patients with peripheral vascular disease. Patients frequently had abnormal platelet tests and significantly increased acute phase reactants and serum lipids, compared to young healthy control subjects. These differences were compared with multidiscriminant analysis. Patients could be separated in part from the control subjects with variables derived from the measurement of acute phase proteins and serum lipids. Platelet test results improved the separation between diabetics and control subjects, but not between patients with peripheral vascular disease and control subjects. Diabetic patients with severe retinopathy frequently had evidence of platelet activation. They also had increased acute phase reactants and serum lipids compared to diabetics with absent or nonproliferative retinopathy. In patients with peripheral vascular disease, only the fibrinogen concentration was related to the degree of vessel damage by arteriography.

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