Maintenance treatment of diabetic patients, associating arterial obstructive tibio-peroneal disease

When a melito-diabetic patient presents trophic infected injury on the limb, it is essential an evaluation of the circulatory conditions for therapeutic procedures orientation. In some circumstances, although arterial pulsation is absent, there is no ischemia of tissues. In these cases, the maintenance treatment, with eventual resection of the necrosed and infected tissues may be adopted. Evolution of 70 diabetic patients with trophic injuries on extremities were submitted to a maintenance treatment. Age of patients varied from 28 to 88 years, with an average of 56.8. The most occurrence was verified in women, with 42 cases. Diabetes non-dependant on insuline (type II) was observed in 64 patients (91.5%), being the remaining 6 patients of type I. Diabetic retinopathy was observed in 14 (20%) of the patients, neuropathy in 22 (31%) and nephropathy in 8 patients (11.4%). All the patients presented arterial pulsation until the popliteal region. They were divided in 2 groups, considering trunk arteries of legs: Group I, pervial legs arteries, composed by 48 patients; Group II, occluded legs arteries, with 22 patients. In what refers to the anatomic local of the injuries, patients were classified in three groups: Group A, formed by 32 patients (45.7%), presenting injuries in one or two toes only, without affecting the metatarsic region; Group B, formed by 16 patients (22.9%), trophic injuries affecting the metatarsic region and Group C, formed by 22 patients (31.4%), injuries affecting the calcaneous region. Injuries in both of the groups were caused by mechanical traumatism. Duration of the injury in the inferior member varied from 7 to 48 days, resulting in a 12 days average. Analyzing pervicacity in trunk arterias and evolution of patients, it may be observed that there has been a significantly better result in those with all the pulses present (81.3% x 45.5%)(p<0,01). Studying the injury locals associated to the evaluation of the cases, we may observe that for injuries in the extreme digital, result is significantly better than in locals more nearly. When distal pulses are absent, there is no significant difference in the result of the treatment, being performed in distal injuries or in the more near ones (p>0,05)(Table IV).

Download Full-text

HAEMOSTATIC PARAMETERS, ENDONEURIAL OXYGEN TENSION AND SURAL NERVE HISTOLOGY IN DIABETES MELLITUS

10.1055/s-0038-1643107 ◽

1987 ◽

Author(s):

I Ford ◽

P G Newrick ◽

R Malik ◽

F E Preston ◽

J D Ward ◽

...

Keyword(s):

Endothelial Cell ◽

Oxygen Tension ◽

Sural Nerve ◽

Clot Lysis ◽

Diabetic Patients ◽

Membrane Thickness ◽

Basement Membrane Thickness ◽

Significant Difference ◽

Group A ◽

Group B

We have examined coagulation parameters in 15 neuropathic (Group A) and 10 complication-free diabetic patients (Group B). Venesection and sample testing were performed under standard conditions. Group A underwent sural nerve biopsy and 14 also had measurements of endoneurial oxygen tension. Factor VIII related antigen was higher in Group A (l-617u/ml ± 0.67) compared to Group B (0.944u/ml ± 0.26); (mean ± SD; p<.0.05) perhaps suggesting endothelial cell damage, although this did not correlate with capillary basement membrane thickness or endothelial cell number nor with endoneurial oxygen levels. Platelets from Group A were more sensitive to arachidonate than those of Group B, showing aggregation thresholds in platelet rich plasma of 0.36 ± 0.17mM and 0.57 ± 0.9mM respectively compared with 0.65 ± 0.37mM in non-diabetic controls.Platelets from Group A subjects also produced more thromboxane B2 in response to arachidonate than Group B or normal controls (37.95 ± 27.5; 25.5 ± 13.0; 16.55 ± 15-5pmol/107 platelets). Blood fibrinolytic capacity measured by euglobulin clot lysis time, was diminished in NIDDs (post-occlusion ECLT 165.7 mins ± 116.0), compared to IDDs (55.5 ± 34.5) (p<0.05) due at least in part to excess of tissue plasminogen-activator inhibitor, although we found no significant difference in ECLT between Group A and Group B. Interaction between haemostatic and microvascular abnormalities in diabetes may contribute to the pathogenesis of diabetic neuropathy.

Download Full-text

The value of continuous nursing in patients after cardiac mechanical valve replacement

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01326-5 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Sai-lan Li ◽

Sheng-huo Zhou ◽

Yan-juan Lin

Keyword(s):

Valve Replacement ◽

Mechanical Valve ◽

Anxiety And Depression ◽

Patient Anxiety ◽

Significant Difference ◽

Group A ◽

Cardiac Valve Replacement ◽

Group B ◽

Better Than ◽

Group 1

Abstract Objective The purpose of this study was to explore the value of continuous nursing in patients after cardiac valve replacement. Methods The clinical data of 116 patients after cardiac mechanical valve replacement from January 2017 to January 2018 were analysed retrospectively. According to the nursing mode, the patients were divided into two groups: the continuous nursing group (group A, n = 56) and the conventional nursing group (group B, n = 60). Results The continuous nursing group exhibited significantly decreased SAS and SDS scores 1 year after surgery compared to the preoperative SAS and SDS scores(P < 0.05). The SAS and SDS scores of the continuous nursing group were significantly better than those of the traditional nursing group 1 year after surgery(P < 0.05). There were 4 patients with anticoagulant complications after discharge in the continuous nursing group, and 13 cases of anticoagulant complications in the conventional nursing group. There was a significant difference between the two groups. Conclusion Continuous nursing improves patient compliance with treatment and reduces the occurrence of postoperative anticoagulation complications. The patient also receives proper psychological evaluations, which relieve patient anxiety and depression.

Download Full-text

Effects of exogenous growth hormone pretreatment on the pituitary growth hormone response to growth hormone-releasing hormone alone or in combination with pyridostigmine in Type I diabetic patients

Acta Endocrinologica ◽

10.1530/acta.0.1250510 ◽

1991 ◽

Vol 125 (5) ◽

pp. 510-517 ◽

Cited By ~ 12

Author(s):

Andrea Giustina ◽

Simonetta Bossoni ◽

Corrado Bodini ◽

Antonino Cimino ◽

Giuseppe Pizzocolo ◽

...

Keyword(s):

Growth Hormone ◽

Blood Glucose ◽

Normal Subjects ◽

Diabetic Patients ◽

Type I ◽

Gh Secretion ◽

Glucose Levels ◽

Group A ◽

Group B ◽

And Control

Abstract. We evaluated the effects of iv pretreatment with exogenous GH on the GH response to GHRH either alone or in combination with pyridostigmine in 14 Type I diabetic patients and 6 normal subjects. All the subjects received an iv bolus injection of biosynthetic human GH, 2 IU; 2 h later they received either a. pyridostigmine, 120 mg orally, or b. placebo, 2 tablets orally, followed 1 h later by iv injection of GHRH(1-29) NH2, 100 μg. In normal subjects the median GH peak after GH+GHRH was 1.8, range 1.2-6.9 μg/l. Pyridostigmine enhanced the GH response to GHRH in all subjects. The median GH peak after pyridostigmine+ GH+GHRH was 32.7, range 19.8-42.1 μg/l (p<0.001 vs GHRH alone). Seven diabetic subjects had median GH peaks after GH+GHRH >6.9 μg/l (the maximum GH peak after GH+GHRH in normal subjects) (group A: median GH peak 35.7, range 21.7-55 μg/l). The other diabetic subjects had GH peak lower than 6.9 μg/l (group B: median GH peak 4.4, range 2.1-6.5 μg/l). Pyridostigmine significantly increased the GH response to GHRH in group B patients (median GH peak 29.3, range 15.7-93.4 μg/l, p<0.001 vs GH+GHRH alone), but not in group A patients (median GH peak 39.9, range 21.9-64.9 μg/l). Group A diabetic patients were younger and had higher HbA1c and blood glucose levels than group B patients. In those diabetic patients with an exaggerated GH response to GH+GHRH, pyridostigmine failed to cause the increase in GH secretion observed in diabetic and control subjects with no responses to GH+GHRH. It can be suggested that elevated 24-h GH levels in some Type I diabetic patients may be due to decreased somatostatinergic tone which in turn causes altered autoregulation of GH secretion. We hypothesize that this finding is a consequence of a reset of the hypothalamic control of GH secretion caused by a chronically elevated blood glucose level in this subpopulation.

Download Full-text

Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study

International Surgery Journal ◽

10.18203/2349-2902.isj20205019 ◽

2020 ◽

Vol 7 (12) ◽

pp. 3986

Author(s):

Arijit Roy ◽

Pramatha Nath Datta ◽

Kushankur Guha

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Recovery ◽

Controlled Study ◽

Post Operative Pain ◽

Quality Life ◽

Significant Difference ◽

Group A ◽

Group B ◽

To Receive ◽

Better Than

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.

Download Full-text

Conventional approach to glucose management for diabetic patients undergoing coronary artery bypass surgery

Perfusion ◽

10.1191/0267659102pf539oa ◽

2002 ◽

Vol 17 (2) ◽

pp. 141-144 ◽

Cited By ~ 5

Author(s):

Patricia A Gustafson ◽

Debra L Zarro ◽

David A Palanzo ◽

Norman J Manley ◽

Ralph M Montesano ◽

...

Keyword(s):

Blood Glucose ◽

Insulin Infusion ◽

Diabetic Patients ◽

Type I ◽

Cardioplegic Solution ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Group I ◽

Significant Difference ◽

Group Ii

Continuous insulin infusion was not an effective mode of treatment in maintaining safe blood glucose levels (<200 mg/dl) during the intraoperative period of diabetic patients requiring open-heart surgery. The two modifications investigated to gain better control of the blood glucose were a change in the base solution of the cardioplegia and the use of a sliding insulin scale. Fifty patients including Type I and Type II diabetics were selected for the purpose of this study. The patients were then randomly divided into two groups categorized by the type of cardioplegic solution administered and the mode of insulin treatment. Group I patients received a dextrose 5%-based cardioplegic solution and blood glucose was treated via continuous intravenous insulin infusion. Group II patients received normal saline 0.9%-based cardioplegic solution and blood glucose was treated via sliding scale. Blood glucose levels were monitored pre- and postcardio- pulmonary bypass (CPB) and every 30 min while on CPB. Glucose values were analyzed by group t test. A p value of < 0.05 was considered statistically significant. When comparing Group I (mean=258 mg/dl) with Group II (mean= 158 mg/dl), there was a statistically significant difference between the glucose values at each of the time intervals when the glucose values were recorded. In conclusion, Group II maintained an acceptable blood glucose level (<200 mg/dl) throughout the entire intra- operative period, which suggests that the combination of the sliding insulin scale and modification of the base cardioplegic solution was an effective mode of treatment.

Download Full-text

Comparison of clinical outcomes of sitagliptin+metformin combination and glimepiride in the management of uncomplicated type 2 diabetics

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20185156 ◽

2018 ◽

Vol 8 (1) ◽

pp. 16

Author(s):

Jarinabanu Tahashildar ◽

Ravi Shekhar Singh ◽

Jameela Tahashildar

Keyword(s):

Adverse Events ◽

Clinical Outcomes ◽

Diabetic Patients ◽

Open Label ◽

Type 2 Diabetics ◽

Significant Difference ◽

Group A ◽

Group B

Background: To evaluate the comparison of clinical outcomes of sitagliptin +metformin and glimepride in uncomplicated Type-2 diabetics.Methods: This one year (July 2016 to August 2017) prospective, open label, observational clinical cohort study was carried out on type-2 diabetics. In this study 299 Type-2 diabetics patients were enrolled and were randomly allocated to two groups viz Group A and Group B. Group A received sitaglitin+metformin (50+500) mg/day and Group B received glimepride 1mg/day respectively. The follow up started after 10 days of stabilization of the patient and data recorded on 10th day was considered Zero month data and follow up continued up to Six month in each group. Comparison of FPG, PPG and HbA1c was evaluated between zero and six months within group and at six month between groups. Adverse events were recorded and summarized by treatment group.Results: At the end of six months follow up the patients of Group A who received sitaglitin+metformin (50+500) mg/day had greater reduction in FPG, PPG and HbA1c (all P<0.001) was recorded when compared between zero and six month within group. A significant reduction in FPG, PPG and HbA1c (all P<0.01) also recorded in Group B who received glimepride 1mg/day when compared between zero and six months within group. A statically significant difference (all P<0.05) was recorded at six months between group. The adverse events like hypoglycemic episodes, gastrointestinal adverse events etc were greater in Group B than Group A. Changes in weight also noted in both Groups. Weight loss in Group A and weight gain in Group B was recorded.Conclusions: The present study suggests that a significant difference may be existing in the clinical outcome interm of glycemia control and adverse events between sitagliptin+metformin combination and glimepride in type-2 diabetic patients.

Download Full-text

Fecal Calprotectin as early predictor for screening and relapse in pediatric chronic diarrhea in India

IP International Journal of Medical Paediatrics and Oncology ◽

10.18231/j.ijmpo.2021.036 ◽

2021 ◽

Vol 7 (4) ◽

pp. 178-184

Author(s):

Gujjarlapudi Deepika ◽

Namburu Veeraiah ◽

Syed Hassan Naveed ◽

D. Nageshwar Reddy

Keyword(s):

Fecal Calprotectin ◽

Inflammatory Disorder ◽

Group I ◽

Subgroup Ii ◽

Significant Difference ◽

Group A ◽

Group Ii ◽

Hs Crp ◽

Group B ◽

Early Predictor

: IBS and IBD are two abdomen ailments commonly seen in children. IBD is a life-long disorder that includes two major forms of chronic illness UC and CD, IBS may occur when the bowel is sensitive to specific foods or other triggers like stress. The aims of the study is to investigate clinical usefulness of FC as early predictor for screening and differentiating IBD and IBS and to monitor the treatment for relapse and remission in pediatric Indian population. This was hospital based observational cohort study, conducted over a period of twelve months from January 2019 to December 2019 Total 325 patients attending OPD were included in the study, in children between 1-18years in which FC was measured using commercially available CLIA kit. HB, ESR, Hscrp were also assessed, these patients were followed up. Patients were grouped asGroup I: IBS: 115(50:65M/F), Group II: 185 IBD, had Subgroup I:116 CD(48:68M/F);Group A: 62.7% presented with relapse Group B: 37.3% had disease in remission Subgroup II: 69 patients had UC(31:38 M/F); Group A: 60.9% had relapse and Group B: 39.1% in remission after follow up. Subgroup III: Others were 25(7.7%). In Study I: Levels of FC were significantly lower in patients with group I when compared to group II. In Subgroup I & Subgroup II Group A had higher FC levels when compared to group B. In Study II: A significant difference (P<0.001) and lower values of the FC, ESR, Hs-crp, frequency of stools in IBS than in CD and UC patients were observed. In Study III: FC in IBD has positive correlation (p<0.01), with the activity of the inflammatory disorder, HB, ESR, Hs-CRP and with increased frequency of diarrhea. In Study IV Fecal calprotectin value of ≥100 ug/g was diagnostic of IBD with sensitivity of 94.1%, specificity of 82.2%, PPV of 86.32%, NPV of 80.39%. The present study showed that the determination of FC assists to differentiate between IBD and IBS also useful in monitoring of remission and in early prediction of relapse in pediatric IBD.

Download Full-text

Comparison of Repeated Chemical and Microwave Disinfection on Dimensional Accuracy of Gypsum Casts

Journal of The Pakistan Dental Association ◽

10.25301/jpda.304.235 ◽

2021 ◽

Vol 30 (04) ◽

pp. 235-242

Author(s):

Mariya Khalid ◽

◽

Mohammad Ali Chughtai ◽

Sohrab Shaheed ◽

Syed Nasir Shah

Keyword(s):

Sample Size ◽

Sodium Hypochlorite ◽

Dimensional Accuracy ◽

Dimensional Change ◽

Control Group ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Group A ◽

Group B

OBJECTIVE: The aim of this experimental study is to compare the dimensional accuracy of gypsum casts after repeated disinfection in microwave at 900 Watts, 2450 MHz (5 minutes) and immersion in 0.5% Sodium hypochlorite (10 minutes). Disinfecting casts is recommended to prevent cross infection but may cause dimensional changes. During fabrication of prosthesis, a cast may get contaminated several times so there is a need of repeated disinfection. METHODOLOGY: Sample size was 33 (11 in each group), calculated through WHO software for sample size determination by using standard deviation of 0.16 at 95% confidence interval and 80% power of study. Impressions in irreversible hydrocolloid were recorded of an acrylic cast fabricated for this study. The impressions were poured with die stone and were randomly divided into 3 groups; Group I: Microwave disinfection, Group II: Immersion disinfection in 0.5% Sodium hypochlorite, Group III: Control group. For Groups I and II, each cast was disinfected 7 times with 5 minutes interval between two disinfection cycles, after every cycle anteroposterior and mediolateral measurements were recorded using digital Vernier caliper (accuracy upto 0.01 mm). For group III, casts were rinsed with distilled water, dried in open air within temperature range of 28+/-2OC for 10 mins followed by anteroposterior and mediolateral measurements. This procedure was repeated seven times for each cast. RESULTS: Anteroposterior and Mediolateral differences of dimensional change between and within the Group A, B and C was calculated by One Way ANOVA. Inter/intra examiner reliability was taken into consideration at the time of study. Mean dimensional change in the casts were insignificant through six disinfecting cycles. However, in the seventh cycle, a significant difference (p=0.003) was observed in the anteroposterior dimension (0.03% dimensional change for Group A and 1.26 % for Group B whereas, in mediolateral dimension, dimensional change was 0.35% for Group A and 0.59% for Group B (p=0.004). Dimensional change of >0.5% was considered as the cutoff value for casts to be considered as dimensionally accurate. Casts disinfected through immersion disinfection did not produce dimensionally inaccurate casts in anteroposterior dimension after third cycle and in seventh cycle in mediolateral dimension. However, result is significant only in seventh cycle. Microwave disinfection produced dimensionally accurate casts throughout all cycles. CONCLUSION: Microwave disinfected casts remained dimensionally stable compared to immersion disinfection. KEYWORDS: Disinfection, microwave, immersion, dimensional stability, gypsum casts

Download Full-text

Abstract 12171: Biomarkers and Echocardiographic Predictors of Myocardial Dysfunction in Patients With Hypertension

Circulation ◽

10.1161/circ.130.suppl_2.12171 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Agata Bielecka-Dabrowa ◽

Marta Michalska-Kasiczak ◽

Anna Gluba ◽

Jacek Rysz ◽

Maciej Banach

Keyword(s):

Left Ventricular ◽

Doppler Imaging ◽

Exercise Intolerance ◽

Type I ◽

Tgf Beta ◽

Exertional Dyspnea ◽

Collagen Iii ◽

Significant Difference ◽

Group A ◽

Group B

Introduction: The aim of the study was to clarify the basis of exertional dyspnea in patients with hypertension with well-controlled blood pressure and normal ejection fraction (EF). Methods: 99 patients with hypertension of mean age 63±11 years: group A - 22 patients without symptoms; group B - 27 patients with exertional dyspnea; group C - 50 patients with overt heart failure (HF). Patients in groups A and B had normal resting echocardiography.Patients underwent echocardiography at rest and during submaximal exercise on a bicycle ergometer; cardiotrophin-1, cystatin C (CysC), syndecan-4, collagen III N-terminal propeptide (PIIINP), transforming growth factor beta (TGF-beta), tumor necrosis factor alpha (TNF-alpha), interleukin 1 receptor, type I (IL1R1), galectin-3 and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured. Results: In test group B the level of PIIINP was higher than in group A (2.9±0.94 vs 1.27±1.03 ng/ml; p=0.0001). Patients in groups A and B were characterized by lower levels of cardiotrophin-1, syndecan-4, NT-proBNP, and CysC than in group C. The concentration of TGF-beta was lower in group C than in A and B (p=0.000). Groups A and B had comparable echocardiographic findings at rest except isovolumic relaxation time, which was higher in group B (104.87±19 vs 89.4±26 ms; p=0.03). In exertional echocardiography the patients from group B compared with group A had lower E’ and S’ according to tissue Doppler imaging(12.83±1 vs 14.94±3, p=0.02; 9.35±2 vs 10.98±2; p=0.01) and E/E’ ratio was increased in the symptomatic group as compared to controls (6.99±1 vs 5.91±1; p=0.03). A late diastolic mitral annular velocity (A') increase was observed in group A and a reduction in group B with a significant difference in [[Unable to Display Character: ∆]]A’ between these two groups (-0.62±2.46 vs 1.22±3.41; p=0.04). Conclusions: PIIINP might be the first early biomarker for the development of HF in patients with hypertension. Patients with normal resting echocardiography can present exercise intolerance and breathlessness associated with reduced left atrial function, worse left ventricular relaxation and impaired function of the longitudinal fibers of myocardium on exercise. Exertional echocardiography may indicate patients with incipient HF with preserved EF.

Download Full-text

Endothelial Progenitor Cells(EPC) in Peripheral blood in Diabetic Foot with and without PAD.

Blood ◽

10.1182/blood.v114.22.5130.5130 ◽

2009 ◽

Vol 114 (22) ◽

pp. 5130-5130

Author(s):

Alexander Krutikov ◽

Sergey Anisimov ◽

Malika Gabaidulina ◽

Irina Meln ◽

Elena Grineva ◽

...

Keyword(s):

Diabetic Foot ◽

Peripheral Blood ◽

Conflicts Of Interest ◽

Diabetic Patients ◽

Type I ◽

Colony Assay ◽

Colony Forming Unit ◽

Age Related ◽

Group A ◽

Group B

Abstract Abstract 5130 EPC is not very well defined population. These cells have either angiopoietic or angiostimulating function, the latter seems to be more relevant. It is well known that Mobilization of EPC to peripheral blood is decreased in diabetic rats. From the opposite, ischemia proved to stimulate mobilization. That is why, we decided to study EPC in diabetic patients with and without PAD Patients and methods 40 pts with diabetes(type I- 4, type II-36) were studied. Duration of diabetes -1-46 years. The duration of more than 10 years was in 57% patients. Age- 49-73 years(mean age- 62 years). The patients were divided into two groups- diabetic foot without PAD(25 pts) – Group A, and diabetic foot with PAD- group B. PAD was diagnosed with sonography, duplex sonography and Rx arteriography. Normal volunteers were use as controls(mean age 51.6+2.0) CD34+ and CD133+ cells were numerated with CytoFlow(BD). 5 Day CFU-Hill Colony Assay- non-adherent mononuclear cells (MNCs) was used to study EPC In this method, peripheral blood MNCs are plated on fibronectin-coated dishes (6-well). After a 48 h pre-plating step to deplete the sample of adherent macrophages and mature endothelial cells, the non-adherent cells are removed and re-plated on fibronectin-coated dishes (24-well). Unique colonies that are formed in the 5 Day CFU-Hill Colony Assay are referred to as colony-forming unit-Hill colonies (CFU-Hill colonies) or colony-forming unit-ECs (CFU-ECs). Count the number of colonies per well for each sample. CFU-Hill colonies are defined as a central core of round cells with radiating elongated spindle-like cells at the periphery. Colonies without the CFU-Hill morphology may also be present but are not scored as CFU-Hill colonies. CFU-Hill Colonies are fixed with methanol and stained with a Giemsa solution. Plasma concentration of VEGF was studied by ELISA Results EPC colony forming ability in group A was 4.0+ 0.7, in group B-27.4+3.9. The differences between these two groups is highly significant(p 0.001). Low EPC level in diabetic neuropathy is probably related to decreased mobilization(G.Fadini e.a.2006). Rather unusual was higher EPC level in group B. It was shown that age-related decrease in EPC is due to decline in HIF-1 signaling(M. Hoenig e.a 2008). Probably, diabetic defect of mobilization is partly overcome with ischemia induced up-regulation of HIF-1 and VEGF. EPC in group B patients does not differ from controls(26.1+6.5). There were now correlations between EPC number and the number of either CD34+, CD133+, or KDR+ cells. We also failed to find any correlations between VEGF and EPC Conlusion EPC number in peripheral blood in diabetic patients without PAD is severely decreased. Diabetic patients with PAD have near normal EPC number. Thus, ischemia in diabetic patients is unable adequately mobilize EPC Disclosures No relevant conflicts of interest to declare.

Download Full-text