scholarly journals NITRIC OXIDE ROLE IN DEVELOPMENT OF THE ENDOTHELIAL DYSFUNCTION IN DIABETIC FOOT SYNDROME

2019 ◽  
Vol 43 (4) ◽  
pp. 26-30
Author(s):  
O.O. Bilyayeva ◽  
H. P. Kozynets ◽  
O. I. Osadcha ◽  
Ye. Ye. Kryzhevskyy ◽  
M. A. Knivets
Keyword(s):  
Nitric Oxide ◽  
Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Diabetic Foot ◽  
Nitrogen Monoxide ◽  
Clinical Results ◽  
Diabetic Foot Syndrome ◽  
Capillary Zone ◽  
Endothelial Dysfunctions

Abstract Introduction. Diabetes mellitus causes many acute and chronic complications, including diabetic foot syndrome (DFS) – a serious complication that can be a test for patients and directly affect their quality of life.One of the most effective treatments for DFS is the use of nitric oxide (NO). The main advantage of using NO-therapy is the effect of polyfunctional nitrogen monoxide on all phases of purulent-inflammatory process. Purpose of the study. The nitric oxide effect features on the development of endothelial dysfunctions in patients with diabetic foot syndrome are explored. Materials and methods. In the department of purulent surgery at Kyiv City Clinical Hospital No. 6 in 2019 from January to June, 76 patients with DFS in stages II–V were treated by F. Wagner. In 47 (61.8%) patients the neuropathic form of DFS was observed, and 29 (38,2%) were neuroichemic form. According to the DFS rates of F. Wagner patients were distributed: II – 24 (31,7%) patient, III – 29 (38,1%) patient, IV – 15 (19,7%) and V stages – 8 (10,5%).All patients were studied in the capillary zone of necrotic lesions of the content of NO, the activity of superoxide dismutase (SOD). Results and discussion. The signaling role of NO in cells is highly dependent on the level of superoxide. The balance between systems that synthesize NO and superoxide determines the regulatory orientation of the signals, and its disruption contributes significantly to inflammation in diabetes. Conclusions. The use of NO-therapy helps to optimize the processes of regulation of the induction of nitric oxide and to improve the clinical results in the treatment of diabetic foot syndrome. Keywords: diabetes mellitus, diabetic foot syndrome, nitric oxide, NO-therapy, endothelial dysfunction.

scholarly journals The Role of Endothelial Microparticle in Coronary Heart Disease as The Complications of Diabetes Mellitus

2019 ◽  
Vol 4 (1) ◽  
pp. 31-39
Author(s):  
Eka Fithra Elfi ◽  
Yose Ramda Ilhami ◽  
Eryati Darwin
Keyword(s):  
Nitric Oxide ◽  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Endothelial Dysfunction ◽  
Cell Activation ◽  
Inflammatory Factors ◽  
Endothelial Cell Activation ◽  
Complications Of Diabetes

  Coronary heart disease (CHD) is caused by obstruction of coronary blood flow due to endothelial dysfunction triggered by various genetic and non-genetic risk factors such as hyperlipidemia, hypertension, hyperglycemia and obesity. Endothelial cell activation due to hyperglycaemia in diabetes mellitus induces production of pro-inflammatory factors that damage the cell membrane triggering the formation of membrane particles called microparticles. Endothe-lial microparticles contain proteins including endothelial nitric oxide synthase (eNOS) which plays a role in the production of nitric oxide (NO). To determine the role of microparticles in the occurrence of coro-nary heart disease in diabetes mellitus due to endothelial dysfunction, a study was conducted by comparing the levels of eNOS and NO in DM patients who had CHD with DM patients who had no CHD. Blood samples from 20 DM patients who had CHD and 20 DM patients who had no CHD of the outpatients in Cardiology Department and Inter-nal Medicine department of regional public hospital were included in this study. All patients were fulfilled inclusion and exclusion criteria and diagnosed by the appropriate specialist. The eNOS and NO lev-els were measured using the ELISA method. The results of this study show that eNOS levels in the group of DM patients who had CHD (21,292±12,415 ng/ml) were significantly lower (p <0.05) than those in the group of DM patients who had no CHD (29,721±11,952 ng/ml). Nitric oxide levels in DM patients who had CHD (0,053±0,021 nmol/ μl) were not statistically different to the levels in DM patients who had no CHD (0,047±0,032 nmol/μl). From the results of this study we concluded that endothelial microparticle protein eNOS plays a role in the occurrence of CHD due to the complications of diabetes mellitus 

scholarly journals Orthoses in diabetic foot treatment and prevention

2013 ◽  
Vol 94 (4) ◽  
pp. 536-541
Author(s):  
I V Klyushkin ◽  
K A Koreyba
Keyword(s):  
Diabetes Mellitus ◽  
Elastic Material ◽  
Diabetic Foot ◽  
Silver Ions ◽  
Cost Effective ◽  
Diabetic Foot Syndrome ◽  
Treatment And Prevention ◽  
Positive Treatment ◽  
Orthopedic Shoes

Aim. To define the role of orthoses in the treatment and rehabilitation of patients with diabetic foot syndrome. Methods. The review of the literature addressing the use of special orthopedic shoes in the treatment and rehabilitation of patients with complicated diabetes mellitus was performed. Results. The common requirements for orthopedic shoes for patients with complicated diabetes mellitus are the following: (1) rigid sole with an artificial curvature; (2) boot-tree elevated by 8 mm due to arch supporter, adequate volume, wide sole, removable insole; (3) insole without functional memory; (4) thermally variable elastic material, advisably with silver ions, for the lining; (5) minimal number of sutures at the lining; (6) no elastic material at the front of the shoe and at the lining at the toes; (7) increased volume and enough space for the toes; (8) front slant of 15°; (9) potential ability to adjust the inner volume of the shoe; (10) hard counter - stabilizing hard back with additional softening at the lining side; (11) heel with a front slant or a solid sole without a heel; (12) smooth non-traumatic surface suitable for scrubbing including cleansing with antiseptics. The indications for orthopedic relief in patients with diabetic foot syndrome are explained. Economic superiority of organ-preserving approaches in such patients is shown. There is an opposition for conservative methods of treatment of patients with diabetic foot syndrome, nevertheless, an amputation can not be estimated as a positive treatment outcome in such patients. Almost 70-90% of ulcers in this group of patients are healed without amputation. Limb-saving treatment and the use of specially selected shoes are cheaper and more cost-effective compared to the limb loss. Conclusion. The use of orthopedic shoes in patients with diabetic foot syndrome is used both for treatment and rehabilitation. This technique can reduce the risk of ulceration and prevent organ-sparing surgeries.

COMPARATIVE ANALYSIS CLINICAL CASES WITH DIABETIC FOOT SYNDROME

2021 ◽  
pp. 11-14
Author(s):  
Б.С. ДУЙСЕМБАЕВА ◽  
А.Б. БАЙЖУМА ◽  
Н.Е. АСКАРОВА ◽  
Б. АЛИБЕКОВ ◽  
Ш.Н. КЕРЕЙ ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Comparative Analysis ◽  
Conservative Treatment ◽  
Diabetic Foot ◽  
Diabetic Foot Syndrome ◽  
Foot Deformities ◽  
Complications Of Diabetes ◽  
Major Factors ◽  
Clinical Cases

В обзоре рассмотрены вопросы осложнения Сахарного диабета (СД) , как синдром диабетической стопы (СДС). Охарактеризована роль деформаций стоп и инфицирования поврежденных тканей как основных факторов развития СДС. Особое внимание уделено консервативному лечению и исходам хирургического вмешательства, такие как, ампутация и прочие операции. This review deals with complications of diabetes mellitus (DM) as diabetic foot syndrome (DFS). The role of foot deformities and infection of damaged tissues as major factors in the development of DFS is characterized. Particular attention is paid to conservative treatment and surgical maneuver such as amputation and other surgeries.

Role of Vitamin C in Endothelial Dysfunction in Patients with Type 2 Diabetes Mellitus Introduction

2020 ◽  
Vol 11 (2) ◽  
pp. 1701
Author(s):  
Nermien Abd El Rahman Ibraheim ◽  
Fatema El Zahraa Sayed Bukhary ◽  
Yehia Zakareia Mahmoud ◽  
Mahmoud Ragab Mohamed ◽  
Salama Rabei Abdel-Rahim
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Vitamin C

scholarly journals Study of the influence of vacuum therapy on the wound process in patients with diabetic foot syndrome

2019 ◽  
Vol 74 (4) ◽  
pp. 283-288
Author(s):  
Petr A. Gerasimchuk ◽  
Alexander V. Shidlovskyi ◽  
Dmitriy B. Fira ◽  
Andrey V. Pavlyshyn
Keyword(s):  
Diabetes Mellitus ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Chronic Wound ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Vacuum Therapy ◽  
Social Significance ◽  
Number Of Patients ◽  
Bed Days

Background: According to the International Diabetes Federation (IDF), the number of patients on diabetes mellitus is now more than 415 million people on Earth, until 2030 it will increase to 439 million, and by 2035 ― will reach 592 million. Throughout life, 4.625% of patients with diabetes mellitus develops a diabetic foot syndrome with the formation of wounds, whose treatment, can not yet be considered satisfactory, since in 1525% of patients are the direct cause of high amputations of the lower limbs. This requires finding new effective methods for treating wound defects in patients with diabetic foot syndrome, one of which can be vacuum wound therapy. Aims: To study the effectiveness of vacuum therapy in the treatment of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenetic form of the lesion. Materials and methods: The effect of vacuum therapy on the course of acute and chronic wound process in 231 patients with neuropathic and ischemic form of diabetic foot syndrome was studied during 20142017. Evaluation of the dynamics of the wound process was carried out on the basis of clinical, planimetric, microbiological, morphological methods, as well as microcirculation indices in the area round the wound. Results: Vacuum therapy of acute and chronic wounds in patients with different pathogenetic forms of diabetic foot syndrome, allows to stabilize the course of wound process, stimulate regenerative processes in the wound, improve local microcirculation (p0.05). This, in turn, allows a shorter time to prepare a wound for closure by one of the methods of plastic surgery or create favorable conditions for its independent epithelization. In patients with ischemic lesions (chronic arterial insufficiency of the third degree), the carrying out of vacuum therapy by standard method leads to an intensification of the pain syndrome. This causes the need to apply an initial negative pressure in the system in the range of 7080 mm Hg, which makes it possible to stop pain during the day. At 23 days of the postoperative period, negative pressure is established at standard values. Conclusions: Vacuum therapy of wounds in patients with diabetic foot syndrome is an effective method of treatment that allows the doctor to reduces the duration of treatment of patients in hospital with a neuropathic form of diabetic foot syndrome on average (4.31.7) bed-days, and patients with ischemic form ― on average (4.11.9) bed-days, which has both medical and social significance.

Lack of central nitric oxide triggers erectile dysfunction in diabetes

2007 ◽  
Vol 292 (3) ◽  
pp. R1158-R1164 ◽  
Author(s):  
Hong Zheng ◽  
Keshore R. Bidasee ◽  
William G. Mayhan ◽  
Kaushik P. Patel
Keyword(s):  
Nitric Oxide ◽  
Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Diabetic Rats ◽  
System Component ◽  
The Central Nervous System ◽  
Freely Moving ◽  
Prior Administration ◽  
Smooth Muscle Dysfunction

Erectile dysfunction is a serious and common complication of diabetes mellitus. The proposed mechanisms for erectile dysfunction in diabetes include central and autonomic neuropathy, endothelial dysfunction, and smooth muscle dysfunction. The paraventricular nucleus (PVN) of the hypothalamus is known to be involved in centrally mediated penile erection. This study was designed to examine the role of nitric oxide (NO) within the central nervous system component of the behavioral responses including erection in diabetic rats. N-methyl-d-aspartic acid (NMDA)-induced erection, yawning, and stretch through the PVN can be blocked by prior administration of NO synthase (NOS) blocker, l-NMMA, in freely moving, conscious male normal rats. Four weeks after streptozotocin (STZ) and vehicle injections, NMDA-induced erection, yawning, and stretch responses through the PVN are significantly blunted in diabetic rats compared with control rats. Examination of neuronal NOS (nNOS) protein by Western blot analysis indicated a reduced amount of nNOS protein in the PVN of rats with diabetes compared with control rats. Furthermore, restoring nNOS within the PVN by gene transfer using adenoviral transfection significantly restored the erectile and yawning responses to NMDA in diabetic rats. These data demonstrate that a blunted NO mechanism within the PVN may contribute to NMDA-induced erectile dysfunction observed in diabetes mellitus.

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