The effect of rheopheresis treatment on the cytokine profile in diabetic foot syndrome with hyperviscosity in the aspect of clinical changes: A preliminary study

2021 ◽  
pp. 1-9
Author(s):  
Kristof Gal ◽  
Katalin Veres ◽  
Sándor Halmi ◽  
Krisztina Bozoki-Beke ◽  
Klara Fekete ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Whole Blood ◽  
Life Quality ◽  
Foot Ulcer ◽  
Serum Levels ◽  
Plasma Viscosity ◽  
Cytokine Profile ◽  
Diabetic Foot Syndrome ◽  
Tnf Alpha ◽  
Preliminary Study

BACKGROUND: Rheopheresis is a selective extracorporal double cascade filtration treatment, which can extract high molecular weight proteins being responsible for hyperviscosity. As the whole blood and plasma viscosity decrease microcirculation improves. OBJECTIVE: In this preliminary study we aimed to analyze additional beneficial effects of rheopheresis treatment with changes of pro-inflammantory cytokine levels in diabetic foot syndrome patients. METHODS: Two rheopheresis treatments were performed for 6 patients with diabetic foot ulcer and/or neuropathy on consecutive days. Before and after the treatments whole blood and plasma viscosity, as well as IL-6, IL-8, and TNF-alpha serum levels were determined, and complex angiological and ENG examinations were performed. RESULTS: Rheopheresis decreased the whole blood and plasma viscosity, and the serum levels of IL-6, IL-8, and TNF-alpha were markedly reduced. The life quality of the patients improved, the ulcers healed, the pain decreased. Daily dose of analgesics decreased in the follow-up period (6 months). The ENG showed improving amplitude and/or normalizing conduction speed. CONCLUSION: Application of rheopheresis in patients with diabetic foot syndrome has a beneficial effect, providing favorable rheological condition, normalizing cytokine profile and reducing the sensorineural symptoms.

scholarly journals Preulcerous Risk Situation in Diabetic Foot Syndrome: Proposal for a Simple Ulcer Prevention Score

2020 ◽  
pp. 193229682092259
Author(s):  
Stephan Kress ◽  
Helmut Anderten ◽  
Anja Borck ◽  
Guido Freckmann ◽  
Lutz Heinemann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Screening Tools ◽  
Diabetic Foot Syndrome ◽  
Foot Ulcers ◽  
Individual Risk ◽  
Diabetic Foot Ulcers ◽  
Prevention Measures

Background: Preulcerous risk situations in patients with diabetes are often undiagnosed and care administered too late. Even with regular medical check-ups and status documentation, foot examinations have not been given enough attention. Diagnosing an individual patients’ risk of developing diabetic foot ulcers may increase vigilance for diabetic foot syndrome (DFS), and the appropriate prevention measures matching the risk involved may prevent the emergence of diabetic ulcers. The classical DFS risk factors are well established and have been extensively covered in the literature; however, there is a lack of efficient screening tools that could be used for a rapid assessment of diabetic foot ulcer risk. Methods: A methodical literature search was conducted to assess relevant publications for the preparation of a simple risk score for amputation related to diabetic foot ulcer. We then analyzed the risk factors for predictive value as odds ratios in foot ulcers and/or amputation. We used the available data to deduce a mean value to reflect the authors’ consensus. Results: In view of the current literature on the matter, we have developed a semi-quantitative scoring system using just a few items to allow rapid and visual risk assessment for diabetic foot ulcers alongside recommendations for prevention and a sensible follow-up strategy to match the risk. Conclusion: This relatively simple score enables rapid risk classification for patients that can ease the way for both physicians and patients in gaining an insight into individual risk situations. The score provides more effective preventative measures for high-risk patients against future complications.

Evaluation of the life quality in patients with diabetic foot syndrome before treatment and in the late period

2019 ◽  
Vol 0 (2) ◽  
pp. 56-60
Author(s):  
O. V. Marchenko ◽  
M. B. Gorobeiko ◽  
T. Yu. Yuzvenko ◽  
Z. G. Krushinska
Keyword(s):  
Diabetic Foot ◽  
Life Quality ◽  
Diabetic Foot Syndrome ◽  
Late Period

scholarly journals High Incidence of Adverse Outcomes in Haemodialysis Patients with Diabetes with or without Diabetic Foot Syndrome: A 5-Year Observational Study in Lleida, Spain

2021 ◽  
Vol 10 (7) ◽  
pp. 1368
Author(s):  
Montserrat Dòria ◽  
Àngels Betriu ◽  
Montserrat Belart ◽  
Verónica Rosado ◽  
Marta Hernández ◽  
...  
Keyword(s):  
Observational Study ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Adverse Outcomes ◽  
Diabetic Foot Syndrome ◽  
High Incidence ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
Baseline Characteristics ◽  
The Impact

Background: We evaluated whether, in subjects receiving haemodialysis (HD), the presence of diabetic foot syndrome (DFS) was associated with increased mortality compared with subjects with diabetes mellitus (DM) without DFS and with non-diabetic subjects. Methods: Retrospective, observational study in 220 subjects followed for six years. We calculated and compared the frequency and 5-year cumulative incidence of all-cause mortality, cardiovascular (CV) mortality, CV events, major adverse CV events (MACE), and new foot ulcer (FU) or amputation. We also examined prognostic factors of all-cause and CV mortality based on baseline characteristics. Results: DM patients had a 1.98 times higher probability of all-cause mortality than those without DM (p = 0.001) and 2.42 times higher likelihood of CV mortality and new FU or amputation (p = 0.002 and p = 0.008, respectively). In the DM cohort, only the risk of a new FU or amputation was 2.69 times higher among those with previous DFS (p = 0.021). In patients with DM, older age was the only predictor of all-cause and CV mortality (p = 0.001 and p = 0.014, respectively). Conclusions: Although all-cause and CV mortality were increased on HD subjects with DM, the presence of DFS did not modify the excess risk. Additional studies are warranted to further explore the impact of DFS in subjects with DM undergoing HD.

scholarly journals Distribution of Apolipoprotein A1 Polymorphism (G-75A and C+83T) in Patients with Diabetic Foot Ulcers-A Parallel Group Hospital Based Observational Study

2021 ◽  
Author(s):  
Rachita Nanda ◽  
Suprava Patel ◽  
Preetam Wasnik ◽  
Radhakrishna Ramchandani ◽  
Debajyoti Mohanty ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Observational Study ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Serum Levels ◽  
Apolipoprotein A1 ◽  
Low Grade ◽  
Parallel Group

Introduction: Diabetic Foot Ulcer (DFU), a serious complications of diabetes mellitus is a result of persistent low grade infection. The Apolipoprotein A1 (ApoA1) has an anti-inflammatory role and therefore can influence the chronic inflammation associated with the DFU. Polymorphisms of ApoA1gene have been implicated as determinants of plasma HDL-C and Apo A1 levels. However, the influence of ApoA1 polymorphism on susceptibility to DFU has not been studied. Aim: To study the distribution of ApoA1 polymorphism (G-75A and C+83T) and association between the polymorphism and the risk of DFU in patients with Type 2 Diabetes Mellitus (T2DM) so that timely detection and prevention of DFU can be done. Materials and Methods: This was a hospital based observational study on patients of DFU (n=80), diabetes mellitus without ulcers (n=80) and normal controls (n=75). ApoA1 polymorphism (G-75A and C+83T) was detected by Real Time Polymerase Chain Reaction (RTPCR) technique and plasma ApoA1 by immunoturbidimetric assay using blood collected in EDTA. Data was analysed using IBM® Statistical Package for Social Sciences (SPSS) 21.0 software. A p<0.05 was considered as statistically significant. Results: The GA and CC were the most predominant genotype in all the groups. HDL and ApoA1 were significantly lower in GG (p=0.009, p=0.03) and CT (p=0.03, p=0.002) compared to GA and CC. The APOA1-75A allele and +83C allele were associated with raised levels of HDL and ApoA1 in T2DM and DFU (p<0.05). Conclusion: The two polymorphism G-75A and C+83T were found to be equally distributed across the study populations. These polymorphisms were associated with serum levels of ApoA1 and HDL in the DFU patients.

scholarly journals Endothelial Function, Adipokine Serum Levels, and White Matter Hyperintesities in Subjects With Diabetic Foot Syndrome

2019 ◽  
Vol 104 (9) ◽  
pp. 3920-3930 ◽  
Author(s):  
Antonino Tuttolomondo ◽  
Domenico Di Raimondo ◽  
Alessandra Casuccio ◽  
Giovanni Guercio ◽  
Alessandro Del Cuore ◽  
...  
Keyword(s):  
White Matter ◽  
Endothelial Function ◽  
Diabetic Foot ◽  
Augmentation Index ◽  
Reactive Hyperemia ◽  
Serum Levels ◽  
Significant Negative Correlation ◽  
Diabetic Foot Syndrome ◽  
Significant Finding ◽  
Foot Complications

Abstract Context No study has analyzed the prevalence of white matter hyperintensities (WMHs) in subjects with diabetic foot syndrome (DFS) and their relationship to adipokine serum levels and indexes of endothelial and cognitive performance. Objective To evaluate omentin and vaspin serum levels and the prevalence of WMHs in subjects with DFS and to analyze their relationship with other endothelial, arterial stiffness, and cognitive functions. Design Case-control study enrolling 40 subjects with DFS, 40 diabetic subjects without foot complications, 40 controls with foot lesions without diabetes, and 40 patients without diabetes mellitus. Main Outcome Measures Pulse wave velocity (PWV), augmentation index, reactive hyperemia index (RHI), serum vaspin and omentin levels, Fazekas score, and Mini-Mental State Examination (MMSE). Results Subjects with DFS showed higher mean PWV values when compared with diabetic controls and lower RHI values when compared with controls. They also showed a lower mean MMSE score, significantly lower omentin serum levels, and a higher prevalence of grade 2 severity of periventricular hyperintensities (PVHs). We observed a significant positive correlation between PWV and PVH and between Fazekas score and PWV among diabetic subjects, whereas among subjects with diabetic foot we observed a significant negative correlation between PVH and RHI. Conclusions Diabetes seems to be more associated with endothelial function disturbance in comparison with patients with diabetic foot that exhibit a more strict association with microvascular brain damage as indicated by our significant finding of an association with PVHs.

Predictive Effect of Inflammatory Response and Foot Ulcer Localization on Outcome in Younger and Older Individuals with Infected Diabetic Foot Syndrome

2020 ◽  
Author(s):  
Stefan Dörr ◽  
Michael Schlecht ◽  
Apostolos Chatzitomaris ◽  
Gregor Weisser ◽  
Lara Lucke-Paulig ◽  
...  
Keyword(s):  
Renal Function ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Scoring Systems ◽  
Major Amputation ◽  
Interphalangeal Joint ◽  
Diabetic Foot Syndrome ◽  
Foot Ulcers ◽  
Older Individuals ◽  
Age Dependent

AbstractThe diabetic foot syndrome (DFS) is the most important cause for non-traumatic major amputation in adult individuals and actually one of the most frightening events in diabetics’ life. Despite the often protracted treatment of infected DFS at the end patients are often confronted with amputation. We investigated 352 individuals with infected DFS in two age separated-groups. Older individuals presented with significant worse renal function and lower HbA1c on day of admittance. Most detected ulcers involved the plantar sides of the metatarsal heads (MTH) and the toes. We saw an age-dependent translocation of foot ulcers from plantar and hindfoot to the forefoot and toes. In average every third wound provoked amputation, in the majority (94%) minor amputations, only 1.9% major amputations occurred. Lesions of the 5th toe or its MTH and interdigital or interphalangeal joint ulcers led to amputation in more than 60%. Worse renal function and WBC above 11 tsd/µl were linked with higher amputation risk. But in particular current scoring systems like SINBAD or Wagner-Armstrong scale and thus finally clinician’s assessment of the wound situation gave a substantial hint for subsequent amputation – regardless of age.

Sign in / Sign up

Export Citation Format

Share Document